Content note: this post contains descriptions of perinatal mental illness, suicidal ideation, and intrusive thoughts.
Hannah is a midwife, hypnobirthing teacher, and emotional health and wellbeing practitioner based in Hastings, East Sussex. She is the founder of Reframing Birth, offering trauma-informed birth preparation and perinatal emotional health support. Hannah writes from both clinical experience and personal lived experience of perinatal mental illness, autism, and PMDD. You can find her at reframingbirth.co.uk
‘I always suffer with severe mood changes on the lead up to my period’'
I told the midwife, at my booking appointment.
I had always thought it was just how people felt during this stage of their menstrual cycle and had never connected the dots. Unfortunately, neither did they – but the signs were there.
I had been so desperate to conceive and was so excited when I found out I was pregnant. Being a midwife myself, I thought I knew what to expect, but I was so wrong. Near the end of the first trimester, I had my first mental health crisis and this is when everything changed. My thoughts were racing…
‘Why do I not feel like everyone else?’
‘Why do I just want my baby, or myself, to die?’
‘Why am I in SO much physical pain already?’
After being on the labour ward for 3 days, I was finally seen by the mental health team who deemed me to be fit to go home. I didn’t feel fit. I now know how powerful masking can be and that my presentation does not always reflect the deep physical and emotional pain that I am experiencing.
I tried so hard to be excited. Family and friends thought I was and some still do to this very day. Multiple anti-depressants were trialled, but there was still no one to talk to. There was no one validating or recognising the signs.
‘Your baby has a heart defect and only one kidney. We need you to be seen for a second opinion’
I asked for this, I wanted my baby to die. I tempted fate. Perhaps the only moment in my whole pregnancy that I knew, deep down, that my thoughts were not mine, because I couldn’t think of anything worse than my baby dying. Thankfully, they were wrong. On re-scanning, he was fine, but I was not. How can one person say that my baby has anomalies and another completely contradict that? I knew I should feel reassured, but I just felt untrusting. All my thoughts were telling me that my baby was not going to survive and it was all my fault. The suicidality increased and I was unable to take care of myself, drugged up to my eyeballs and still trying to survive.
I was allocated a perinatal mental health nurse who gave me some light in the darkness. She unfortunately left and I did not feel safe to open up to the replacement. I plucked up courage to voice that I wanted to change, a very hard step for someone who experiences a fear of rejection and my fears came true – I was told there was no one else. I felt stuck, unprotected and vulnerable.
Over a period of months, I was diagnosed with an eating disorder and became physically disabled by the severe pelvic girdle pain. I was denied pain relief, couldn’t sleep and felt like I deserved this suffering. I was a shell of a person, desperate to have my baby removed from my body. I felt like he was a parasite. I was naïve – I thought when he was born, I would feel better.
The Crash
After a physically difficult birth (although not one I deemed as traumatic – thankfully, I required multiple blood transfusions BUT felt physically better than I had in many months. I knew my baby was not normal though. The noises he made, the unrelenting screams, it was nothing that I had ever experienced in my years as a midwife. Everyone said he was just being a newborn. I vividly remember our second night – I told the midwife to take him away and that I did not want him. She laughed and left the room.
He cried, I cried. He didn’t sleep, I didn’t sleep – even when I was offered a rest, I could not take it. My brain and body would not shut off. I was having what I now know were hallucinations. I just wanted everything to go away. The overstimulation from the screams, the constant being attached to my breast, the lack of personal space. When the ‘baby blues’ hit, they HIT. It was like a form of torture. I have never felt a hormonal crash like it. Now I know that there is nothing like it.
I wanted to shake him, throw him out the window, run away and never come back. He didn’t need me, I was doing him no good. And so it went on, I was repeatedly told I was experiencing low mood due to excessive blood loss and that my body would recuperate soon. The perinatal nurse even told me I was just ‘struggling to adjust’ – a phrase I will never forget. Many anti-depressants later, I felt like a walking pharmacy yet, still, nothing hit the spot. My best friend had a baby 2 weeks after me and she appeared to be thriving, what did I do to deserve this?
He started to projectile vomit, the smell was overwhelming. The washing, the fear of leaving the house incase he was unwell, is my breast milk poisoning him? Multiple trips to the doctors and hospital, he is just being a baby. You need to just get on with it. I could hear him snoring through the ceiling – he is not normal but no one was listening. I retreated. I stopped breastfeeding and guess what - another crash. I was offered to be admitted to a mother and baby unit, but the closest one was over 2 hours away, I could not be alone with my baby – who was the problem in my mind. I declined and in retrospect, I really should have gone.
My saviour, the specialist midwife for infant feeding, told me I was right. He wasn’t acting like a ‘normal’ baby, and ultimately led to a diagnosis of reflux, CMPA and laryngomalacia. I wasn’t overreacting. I just wasn’t heard. I felt relief, yet huge anger and continued distrust for healthcare professionals.
‘Hannah, have you ever thought you may be autistic?’
What? Is someone finally on my wavelength? The months of torment, it all made sense. I have always considered myself to have autistic traits and it was something my husband and I joked about often when I couldn’t be late for an event or go on holiday without severe panic. As a child I was told I was shy, struggled with change, different from others. My psychiatrist had been building up to this point. After 28 years, she was the first person to recognise it and little did I know, it would be the turning point. She did the full assessment herself, it took a few months but she diagnosed me with autism one year after my baby was born. I was in shock. One piece of the puzzle, complete. But in my own time, I had been researching myself.
Pre-Menstural Dysphoric Disorder (PMDD) came up. I had called it at the beginning of my pregnancy, without even knowing, but no one had connected the dots. As soon as I stopped breastfeeding, my periods returned and the crash came again. I began tracking. I recognised a pattern, that I would become increasingly irritable, low in mood, filled with rage, suicidal, unable to cope, 1-2 weeks prior to my period. I told my psychiatrist about this and she listened. I knew she was on my side. She said she couldn’t diagnose it but would seek an opinion and she did. It took a long time, many months of suffering, with no treatment plan, but I got my diagnosis.
PMDD is incredibly common in people who are neurodivergent and although for most, symptoms improve during pregnancy as there is an absence of a menstrual cycle, some people can suffer severely due to the extreme sensitivity we have to hormonal changes. After such a long time of wondering what was wrong with me, I was able to give it a name – PMDD and severe perinatal depression and anxiety, linked to hormonal changes.
I wasn’t going mad. I wasn’t struggling to adjust. It wasn’t the baby blues. It is in my biology.
Hannah is a midwife, hypnobirthing teacher, and emotional health and wellbeing practitioner based in Hastings, East Sussex, and the founder of Reframing Birth. She offers trauma-informed birth preparation and perinatal emotional health support to families across East Sussex and beyond.
You can follow her journey and work at reframingbirth.co.uk and on Instagram at @reframingbirth.