This isn’t what you might think. This isn’t some clever pregnancy announcement. No tricks or surprises here. No cryptic Facebrag. This is, in fact, the opposite. This is an explanation and a crucial piece of my recovery jigsaw going forward.
Two and a half years after losing my mind and falling down a gigantic mental rabbit hole, I suddenly and urgently needed to know. My brain was still healing but my body ached and my subconscious mind was constantly throwing up this: baby, baby, baby. It invaded my dreams. It infiltrated my conversations. I’m ashamed to say it affected my ability to be happy for others.
My initial reaction to that point. Fuck, no! Why on earth would I knowingly put myself through that again? But once planted, the thought simply wouldn’t budge. I needed to know. Baby #2?
My husband seemingly wanted another baby and I didn’t feel right depriving him, depriving ourselves. Was it greedy to tempt fate? Were we fools to think it was even an option?
We were also getting a hefty amount of well-meaning, nosy questions from the usual suspects as well as randoms. New friends. Neighbours. My ‘only child’ dentist. “An only child is a lonely child,” she told me. The only people who never really asked were those who knew the true extent of what we’d already been through. The ones who no doubt thought we’d be bat shit crazy to “go again”. My father-in-law didn’t mince his words: “That would be my worst nightmare”.
But as an ever-curious person with less self-respect and esteem than she deserves, I decided to do what had seemed unthinkable since Liam’s birth.
Dr Jensen was very open to meeting with us. He’d taken up the reigns as the head of psychiatry at Perth’s major maternity following the tragic passing of Dr Jon Rampono. I don’t think it was until Baby #2 was on the cards that I really recalled discussing the prospect with Dr Rampono while still in the depths of postnatal oblivion. He’d been surprisingly open to the idea – encouraging, in fact. He’d said, very matter-of-factly, he’d had patients just like me, some much worse, who had gone on to have more children and survived. In fact, he said several patients with the right supports thrived second time around.
So, on a sunny Autumn morning in 2014, my husband and I trundled up to the hospital that had been both my failure and saviour back in 2012 for “pre-conception counselling”. In retrospect, the perfectionist in me wishes I’d taken notes. I don’t recall the meeting in detail but Dr Jensen also seemed remarkably positive about the prospect of Baby #2.
We spent a big chunk of the meeting discussing my postnatal history and time in the Mother Baby Unit (MBU). This is detailed in Dr Jensen’s follow-up letter. Clinical, precise and to the point. He didn’t miss a beat. Apparently, I was quite emotional:
“She was tearful at several points in the interview, particularly when describing events surrounding her previous admission to hospital and concerns about her own mental health should she and her partner decide to embark on another pregnancy. She presented with good levels of insight and intact judgement.”
I’ve always been told I had good insight, even when I was extremely unwell. That’s got to be a bonus for a future pregnancy, I thought.
The letter goes on to discuss how my illness could be “managed” should I have Baby #2. Several forks in the road were presented to us. A pregnancy with medication; a pregnancy without; a pregnancy without and with. We had options!
“The risks and benefits of these approaches were discussed.” Essentially, it all revolved around Lithium. To be on it or not to be. That was the question. As far as the postnatal period was concerned, this option wasn’t really negotiable. As soon as Baby #2 arrived, I would be “strongly advised” to resume taking medication.
“Relapse rates for Bipolar Affective Disorder in the immediate post-partum period for someone who has had a previous episode range between 50 and 90 percent. The decision on using medications post-partum has implications for the consideration of breastfeeding also, with Sodium Valproate being the safest agent”.
Not exactly music to my ears. But there were many positives. We were guaranteed close psychiatric monitoring throughout a second pregnancy. We were guaranteed a voluntary admission to the Mother Baby Unit in the immediate post-birth period. This would help me transition back onto medications, help manage any sleep-related issues and, above all, catch any psychotic symptoms asap and prevent my “high risk of relapse”. Throughout, I would also be closely monitored by my private psychiatrist with the option of psychological therapy as well. Not bad for someone who didn’t even cop a single Edinburgh Scale during the first pregnancy.
Up until this point, it was the fear that had kept me in check. Trauma has that impact. It’s like bravery in reverse: knowing what’s in store and actively avoiding putting yourself in harm’s way. But for some inexplicable reason the fear had shifted. Maybe it’s the whole time heals theory. Maybe it’s the cockiness that comes with getting well. Maybe it’s the desire to prove everyone, especially the doctors, wrong.
I’m not a stupid person. I’ve done my research and I’m acutely aware of the risks. Women who have suffered postnatal psychosis have a 60 to 90 per cent chance of developing the condition again. Add the Bipolar to the mix and BAM. I know full well I will most probably relapse – I simply want to believe I won’t. I simply want to risk it anyway. I don’t think I realised at the time of the preconception counselling but I desperately wanted to be that rogue statistic. The woman who defeated postnatal psychosis and triumphantly sailed through a second pregnancy untainted. I actually pictured myself a book about it whilst going through it.
I know this outcome is unlikely but I desperately need to believe in my recovery journey. I need to believe my mind can do this, regardless of the consequences. There are no guarantees so the one thing I hold onto is this: Nothing could be any worse than what I’ve already been through. I’ve been manic, psychotic, heard voices, wanted to die. I survived.
It took me nearly three years to get to a point where I’d even consider Baby #2. Three long, hard years of slogging it out with my own mind. Popping my pills day and night. Talking about myself endlessly with my psychs. Reading and studying my illness. Managing my stress.
Recovery takes time and that’s the one thing I was starting to run out of; the one thing no amount of therapy could change. Two years on and nearly five years of recovery has plonked me near middle age and left our bank account sad and desperate. Age, finances: All catching up and threatening to overwhelm us.
Suddenly, Baby#2 wasn’t a priority anymore. Suddenly, Baby #2 wasn’t really up for discussion anymore. Suddenly, I was being told we simply couldn’t afford Baby #2 because we couldn’t afford my next breakdown. Suddenly, Baby #2 came with conditions – money in the bank and a job with guaranteed maternity leave.
I woke up one day and realised despite every mental milestone climbed and conquered, I simply couldn’t change the facts presented to me by my other half’s economic brain. And without an unexpected change in fortune, there would be no changing it.
So, there it is: My fertility held hostage by circumstances solely created by my once broken mind. Recovery with a price tag.
To be continued.