[Editor’s Note: How women are treated during labor and delivery can have a direct impact on whether they develop postpartum post-traumatic stress disorder (PTSD) and/or postpartum depression. It doesn’t matter if the doctors and nurses have seen it all before, and it’s just another day at the office for them.

If the mom feels her life or her baby’s life was threatened, or if she feels she was powerless and unheard, and if those experiences were traumatic to her, then she may develop postpartum PTSD. The actual experience, and how the mother feels about her experience, both matter.

Warrior Mom Lisa sent me her story, and I wanted to share it with you as an example of how physical trauma either during or after birth can lead to postpartum depression or postpartum PTSD. Please note this story includes a very scary and difficult delivery aftermath, so if you are sensitive right now it would be best to skip it. -Katherine]

Dear Dr. P.,

I labored for 28 hours on August 22, 2011, and did everything you and your colleagues asked of me in order to have the VBAC (vaginal birth after c-section) I so badly wanted. I had delivered my first baby only 19 months prior by emergency c-section, and I really wanted my second daughter to be born vaginally so that I would have an easier recovery and be able to care for my newborn and my toddler.

Who knew the hell that was to follow?

I started pushing at ten o’clock at night. You came in, after I’d been supervised by your senior resident all day and evening, as I pushed. You told me you had to perform some surgery later that night so you were hoping to get there soon.  

I got the message: Go fast. I was okay with that; I wanted to meet my new baby. I pushed for 40 minutes and you said the perineum was really holding, that next push, I’d need an episiotomy. I wanted no part of that so I really went for the next push and out my beautiful daughter came.

She was perfectly healthy and off you went, leaving me to deliver my placenta with the resident.  

You never checked on me. As soon as you left, the resident realized I was bleeding heavily. She massaged my uterus; I pushed out the placenta (most of it, anyway).  

She “cracked the bed” and blood poured all over the floor. Her face registered concern, and I knew something was wrong. I asked her if I was going to be okay. I was scared.

I looked at my husband, who was taking photos of our daughter as she was carefully checked over, and wondered if he could take care of our girls by himself.

The resident examined me up close and determined that I had sustained “catastrophic” (her word) vaginal tearing—up the front, not towards the back. She tried her best to sew me back together and told me that a part of my most sensitive parts had torn off and was missing.

She finished up and I was rushed into the shower to clean up. Blood mixed with the water and the bathroom looked like a slaughter house. I felt nauseated and weak. I wanted to snuggle with my daughter but I was being kicked out of my delivery suite and put onto the mother-baby floor.  

I didn’t get to ask any questions and I didn’t feel right. I was rushed to my regular room, where I vomited and vomited. I should have been cuddling with my baby.

The next morning, a nurse took out my catheter. I had the urge to go to the bathroom and by the time I got there, I had peed all over the floor. I was numb and completely incontinent.

I never got to see a doctor again, and never got to ask any questions. Off I was sent to my house with my gorgeous, healthy daughter and my toddler waiting for me at home.  What was to come was six weeks of total incontinence, a horrified look in the mirror at my mutilated body that had been poorly repaired, and daily bleeding until I was 13 weeks postpartum, at which point I passed a chunk of placental tissue the size of a chicken egg.

The pain from the tearing was terrible. It was excruciating to go to the bathroom. I went through five months of invasive, though successful, pelvic floor physiotherapy.

My daughter was colicky. I could barely walk from the damage to my body but had to carry my weeping child for hours upon hours a day. She never calmed down; I couldn’t help her. I couldn’t care for my toddler because I was so sore I couldn’t play with her.  

I struggled everyday.  

I felt that I was continually letting my children down. I hated myself as I wasn’t the mom I wanted to be. I was diagnosed with postpartum depression and still fight, six months postpartum, to heal from that. And today, six months later, after the specialist I was referred to turned out to be the very doctor who walked out on me after my delivery, I have to heal now from the repair surgery I finally had.

This is not your fault, but you could have helped me more than you did, and all you had to do was slow down. Please don’t rush mom’s deliveries. Please check on us after the baby is born. Please say sorry when I tell you what happened, even if it’s just that you’re sorry that I’ve been through hell when I should have been so happy.  

It would mean so much.
~ Lisa