The spare bedroom is filled with boxes of maternity outfits and tiny baby clothes, as well as a sparkling new single bed and mattress for my 18-month old to go into when his cot is needed for the new brother or sister we are currently trying to conceive. So, you may ask, what am I hoping for this time - a boy or a girl? Well, to tell the truth, I'm crossing my toes and fingers and praying for me this time. Oh yes, I will certainly be counting the fingers and toes of my new arrival, and holding my breath until he or she passes the routine health checks. But the real tester will be the weeks after the birth, and hoping that I don't again fall prey to the monster that is postpartum psychosis.
My last pregnancy was a breeze, and I literally glowed with good health throughout the 9 months. I beamed at people walking down the street, proudly showing off my bump in trendy maternity clothes. When our son was born 5.5 weeks early after two-days of stop-start labour, I seemed to take that in my stride too. But my world soon came crashing down, and in a very dangerous fashion. When my son was just four weeks old, I was diagnosed with postpartum psychosis, a postnatal illness that affects one in 1000 new mums in the first few weeks after birth. I was admitted to a psychiatric ward, and then spent a month in a specialist mother-baby unit. Medication, provided with supportive professional care while I recovered from the peak of the illness, and the love and assistance of my family, were the key to my immediate recovery.
At the time, I had no idea what caused this massive episode. I was perfectly healthy, and had everything organized a tee. But looking back with an impartial viewpoint, I can see where it started to unfold. For me, it was the combination of many factors that I may have handled independently, but not all at once. The shock of a premmie baby and his stay in a special care nursery, major sleep deprivation, the change from a busy career woman to an at-home mum caring for a newborn baby, very high expectations of myself as a mum, moving house, and news that my own mother had been given a preliminary diagnosis of cancer (she was later cleared), put everything into a spin.
The weeks that followed were very hard on not just me, but my husband and my family. I was frightened, confused, withdrawn, pestered by illogical thoughts that randomly popped into my head including self harm and harming my baby. Twice in the mother-baby unit I handed in my nail clippers and craft scissors to the staff because I was feeling low, and I had no idea what this damned illness was capable of, or whether I would actually harm myself. Understandably, my self-confidence was shot. What else would this illness do to me, and why were these completely illogical thoughts coming into my mind? Who was this new person, and when would the old me come back?
Amazingly, my baby coped beautifully, sleeping well, gaining weight and feeding happily from a bottle (as my medication was too potent to pass onto him through my breast milk). One of the best pieces of advice I was given was maintaining eye contact with bubs, and talking and singing to him. This was a great step to cementing our bond.
I had many things to address before the old me could make a resurgence, and it took time. As the much stressed-over house move had been taken care of while I was sick, I moved into my new home and made friends in the new town. I lowered my initial standards of being the perfect mum, maintaining an immaculate house and having freshly baked goods for guests. Instead, I settle on having a mostly happy baby, wearing clean clothes and dragging myself out of bed every morning! My baby and I relaxed into a routine, highlighted by regular visits from family, weekly in-home appointments from a psychiatric nurse, and regular trips to the maternal child health nurse.
Luckily for me, my husband was a pillar of strength. He propped me up when I was low, he did above and beyond what many other dads do, and most importantly he loved me and told me I'd be laughing about this whole ordeal in time. And laugh we did! But there were also tears as we adjusted to our new role of parenting and the associated strains an episode like mine adds to any relationship. At first I wanted to talk about it regularly with my husband, and cross-check my memories with his about what I said and did in those hazy weeks under the fog of the illness. At times I was upset to hear the words that had come out of my mouth, and remember my unusual behaviour, but I took solace in my husband's reassurances that he knew it wasn't the real me, and that like any 'injury' he understood it would take time to recover. As time went on, I lost the urge to analyze everything that happened, instead accepted it and moved on.
My friends, especially my mums group, were also a lifeline. I saw that other babies were being bottle-fed, that not everyone had opted for cloth nappies, and that they had bad days too. We shared tips on what worked well for our babies, cringed together over the outrageous parenting hints we had received from strangers in the street, and helped one another navigate this new territory of motherhood. Gradually I lost the lingering worry of 'oh my God, I had a mental illness, what will people think?' and came out of my shell. It took several months until I felt more like my old self again, albeit a slightly quieter, less confident and chubbier version of myself. Even though I'd lost all my pregnancy weight and then some when I got sick, my appetite resumed with a vengeance once I started medication, and the weight I'd piled on proved very hard to shift. I dragged myself to the gym, went walking in a convoy of prams with the other mums, and started reading and going to the movies again. My psych reviews were less frequent as I improved without any sign of relapse, and as the months went on, I didn't feel I needed those reviews as I had in the earlier stages of recovery.
I now feel like I'm back to full strength. I've started working again part-time, and I celebrated my first medication-free night by sharing a bottle of expensive French champagne with my husband. My son and I are also going great. Our relationship still shows no sign of impact from the ordeal, and it is wonderful to watch him learn new things and charm us with his toothy grin.
Although it's not something I usually bring up in conversation, I have shared my experience with others who mention that they have struggled with a post-natal illness, to reassure them that they are not alone. I still haven't told all of my new friends about my experience with postpartum psychosis, but those I have told said they were very surprised to think of me as anything but the happy, confident and capable mum I now am. I've also been surprised by friends and even relatives who have come out and told me about their own experiences with mental illnesses after hearing about my journey. And hopefully by sharing my story, I can help people to see that mental illness can affect anyone, and management and recovery is plausible.
So, with my ovulation calendar in hand, it is now time to embark on the exciting stage trying to conceive our second baby. Of course, we are now well aware of the potential risks, and my 25% chance of a reoccurrence, but like the Scouts, our new motto is 'be prepared'. We have a list of the 'early warning signs' that preceded my last, and hopefully only, episode and I will not hesitate to resume medication again if we see any signs of ante-natal or post-natal trouble. With a bit of luck, we'll end up with a healthy mum and bubs!