Day Nine

by Amanda Munday

  Copyright © Amanda Munday, 2019

  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise (except for brief passages for purpose of review) without the prior permission of Dundurn Press. Permission to photocopy should be requested from Access Copyright.

  Cover image: istock.com/amirage

  Printer: Webcom, a division of Marquis Printing Inc.

  Library and Archives Canada Cataloguing in Publication

  Title: Day nine : a postpartum depression memoir / Amanda Munday.

  Names: Munday, Amanda, author.

  Identifiers: Canadiana (print) 20189068663 | Canadiana (ebook) 20189068671 | ISBN 9781459744455 (softcover) | ISBN 9781459744462 (PDF) | ISBN 9781459744479 (EPUB)

  Subjects: LCSH: Munday, Amanda. | LCSH: Postpartum depression—Patients—Biography. | LCGFT: Autobiographies.

  Classification: LCC RG852 .M86 2019 | DDC 362.1987/60092—dc23

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  We acknowledge the support of the Canada Council for the Arts, which last year invested $153 million to bring the arts to Canadians throughout the country, and the Ontario Arts Council for our publishing program. We also acknowledge the financial support of the Government of Ontario, through the Ontario Book Publishing Tax Credit and Ontario Creates, and the Government of Canada.

  Nous remercions le Conseil des arts du Canada de son soutien. L’an dernier, le Conseil a investi 153 millions de dollars pour mettre de l’art dans la vie des Canadiennes et des Canadiens de tout le pays.

  Care has been taken to trace the ownership of copyright material used in this book. The author and the publisher welcome any information enabling them to rectify any references or credits in subsequent editions.

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  Printed and bound in Canada.

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  To Fiona: I am strong because of you.

  Table of Contents

  A Note to You, Reader

  Part I - Birth

  June 16, 2014

  June 17, 2014

  June 18, 2014

  June 19, 2014

  June 20, 2014

  June 21, 2014

  June 22, 2014

  June 23, 2014

  June 25, 2014

  June 26, 2014

  June 27, 2014

  Part II - Sleep, Please

  June 28, 2014

  June 29 – 30, 2014

  July 1, 2014

  July 3, 2014

  July 4, 2014

  July 5, 2014

  July 7 – 8, 2014

  July 10 – 11, 2014

  July 14, 2014

  Part III - Death and Life

  July 23, 2014

  July 20, 2015

  January 10, 2016

  March 27 – 28, 2016

  March 30, 2016

  April 2016

  July 2016

  August 23, 2016

  August 27, 2016

  August 31, 2016

  Epilogue

  June 28, 2018

  Acknowledgements

  A Note to You, Reader

  THIS BOOK IS TRIGGERING. I’m of two minds as I describe the book to you: one wants to push forward and the other wants to protect. On pushing forward, if we don’t start an open conversation about mental health, those who are sick will continue to ache in the dark, unable to communicate their symptoms for fear of judgment at best, and loss of personal freedom, or death, at worst. Studies have shown that talking about suicide does not cause those who are depressed to consider ending their own lives. Rather, it can help to normalize their feelings and save their lives. It’s only through an honest conversation about mental health that we can identify which thoughts are fleeting, and which ones could be a signal that illness is looming.

  For that reason, I also want to offer some advance protection. I hope that you will take care as you progress through my story. It includes vivid descriptions of mental illness and of suicidal ideation. This account also includes details of self-inflicted death. Transparency is important, and so is safety and wellness. There is one spoiler that’s worth handing over now: the one about my recovery. I didn’t know exactly what was wrong, how it began, when it would end, or whether it would return, but I did feel better when I was able to say out loud what was rumbling through my mind. When I could identify that I’d changed from “regular” me to “not quite well” me, and ask others to carry me from that point on.

  With that in mind, if you’re struggling, I hope you’ll find the words to identify when you’re not quite well, and trust that if you reach out, others will carry you through. Don’t stop if the first person you share your thoughts with downplays what you’re saying. Keep saying it out loud. It’s not on you to fix your illness alone. We wouldn’t demand an unskilled self-treatment for any other type of illness. If this book triggers you, or if you feel unwell before you begin, give yourself permission to place those thoughts in someone else’s hands. Your thoughts do not define you. It will not be this way forever.

  Be well,

  Amanda

  Part I

  Birth

  June 16, 2014

  FOR AS LONG AS I can remember, I always imagined that I’d be a good mother. I would picture myself in a rocking chair, swaying slowly while I hummed a tune over my baby’s forehead. The breeze from the summer air would be soft. My sense of purpose alive and well defined. As a mother I knew I’d feel at peace, because motherhood is something I was destined to embody. And to thrive in.

  Today I’m nine months pregnant with my first child and I do not feel the euphoria I deliberately anticipated. I toss and turn throughout the night, cramming a stiff body pillow between my legs and under my huge belly, seeking any position that might give me enough relief to sleep for a couple of hours. I ignore the bladder pangs because when I get up to waddle to the bathroom, no more than a piddle trickles out, which is fairly anti-climactic after rushing out of bed afraid that I’m about to pee my pants. This morning started earlier than ever. I’ve been half-awake for the last two hours, before the sun even, not wanting to sit all the way up and kick-start the familiar heartburn-meets-nausea feeling that greets my morning routine. Gordon and I are still in bed when my cellphone rings, startling me wide awake.

  It is 8:00 a.m. on a light and bright June day. My hopeful almost-summer feeling is dashed away when I realize the person on the other end of this call is my midwife calling in a panic.

  “Can you get down here to the hospital, in the next hour? Dr. Skylar is here and she can try to see if we can get baby moving. This is your opportunity to try a vaginal delivery. Hurry up. I’m on the fifteenth floor. Meet me in triage.”

  The first decision I made when I was pregnant was to put my tiny fleck of a fetus on a daycare list, because I had been warned that in Toronto the wait would be years long, and I was keen to return to work as soon as possible after giving birth. The second choice I made, with my husband, Gordon, was to have a midwife as our primary health care provider, instead of an obstetrician at a hospital. It wasn’t difficult to decide to use a midwife — it fits well within our liberal-leaning, sometimes snobby, organic-values-driven lifestyle. As a couple Gordon and I share a passion for urban gardening, we seek out local food and suppliers, we shop with small businesses rather than big corporations, and we opt for vacations in wine country at the nearby N
iagara-on-the-Lake over all-inclusive beach resorts. The idea of deeply personalized care, with as little institutional medical intervention as possible in our childbirth plan, aligned well with our core values as a couple. I also loved the idea of a medical professional coming into our home right after I gave birth, and in the two weeks afterward, versus having to pack up and go to a hospital with a newborn. I have many ideas for how this baby will be raised. When debating whether this was the right decision, I’d think, Who would want to go to a hospital when you can stay in bed in your pyjamas right after giving birth? My plan was locked in before I told any family members I was pregnant.

  My midwife, Rose, is a beautiful woman who defies the midwife archetype. Her tall thin frame, with hair the colour of kitchen twine, complements the high-end A-line dresses and silver Tiffany & Co. bracelets that she shows up to work in, actively rejecting the image one typically associates with midwifery. Or vaginal exams. I remember wondering in our early meetings, Where’s the hippie who’s going to encourage an orgasmic delivery while I float in a birthing pool in my living room? Did I sign up for the wrong program? In one of our first monthly appointments, I sat up after the physical exam, pulling up the thick blue elastic on my maternity jeans. Feeling a bit embarrassed by my outfit choice, I sheepishly said, “I’m wearing these because it’s cold out, not because I really need these stretchy pants already.” Rose smirked but didn’t laugh, and I instantly worried she thought I was ridiculous.

  Then I asked, “When do you think I should start prenatal classes? I mean, I know I’m just five months pregnant, but taking them early means I could take more than one class if I wanted, right?”

  Rose chuckled with the kind of laugh that tells you she’s going to tell this story later around the lunch table. Whenever I asked that type of planning-too-far-ahead question, she’d look down at her designer watch and not answer. I took it as an implication that she was late for the next neurotic mother-to-be, and moved on.

  I’ve also felt her apparent boredom with my case throughout this uneventful pregnancy, and I still desperately want her approval. Looking for attention is my natural state. I imagine her complaining about me to her colleagues: another young, white, privileged woman in her early thirties, opting for a natural birth because that’s the go-to trendy labour approach for the Millennial parent generation. She has mentioned not-too-subtly more than once that her midwifery practice serves low-income single mothers who have difficulty securing a spot, “because of all the women who want an intervention-free delivery.” I made an early connection with a student who interned with Rose. She was at my first appointment, where she took long notes about my medical history. As she wrote, I noticed a vertical scar on the inside of her wrist. I didn’t ask her about it; that felt too intrusive, but I noted that she’d probably seen some dark things. I wasn’t worried that things could get that dark with me, but I felt comforted by her experience and presence either way. I was disappointed when her internship ended a month before my due date.

  Rose, on the other hand, often breezes through our appointments with ease. She doesn’t take the same level of notes that the intern did. She never needs to. She always utters, in her thick British accent, “Amanda, everything you are feeling is normal. You have yet to ask me a single question that makes me worry about this birth.” I’d show up to each appointment with a list of questions on my iPhone, to which she’d giggle and say, “That symptom is very normal, my dear. Not unusual at all!” I felt like I needed to complain about my nausea and inquire about my cramping to ensure the baby would arrive safely, but I’m not sure she saw things the same way. I never asked her, though. What made me feel better about my slew of questions was that no matter how outrageous of a birthing scenario I’d throw her way, or her student intern’s way, no one ever conceded that my fears were legitimate, but they also never said outright that I was being ridiculous.

  Rose is also a superstar professional; that much is clear in everything she does. Even the bored glances. On the day I arrived to hear the baby’s heartbeat, she told me that she wouldn’t consider pulling out the Doppler machine, explaining calmly that “too many sound waves early in the pregnancy can disturb the fetus.” Instead, she’d use her trusted stethoscope and find the heartbeat just by listening to my abdomen. It can’t be that simple, I thought, staring at her in amazement. A minute later, her stethoscope earpiece was in my ears and she encouraged me to listen for the rapid-fire heartbeat. I heard it. She was right -— it was that easy. My baby’s heartbeat was even faster than she said it would be. It sounded like the hooves of a racehorse galloping to the finish line. I never doubted her again. I took her lack of concern and easy attitude in our appointments to be a signal that my baby was safe, despite some lingering worry that the baby could pop out with three hands.

  I forget who it was who first told me that “birth is not a medical event,” but that’s my first thought this morning when Rose urges me to get to the hospital before this Dr. Skylar gets called into another emergency delivery. I don’t even know who Dr. Skylar is or why she’s important to my birth plan. Rose sounds confident in her, so I should be confident in her ... but it’s not what we planned. When I hang up the phone, I am overcome with those panicky, erratic thoughts that are annoyingly depicted in films with birthing scenes. Since Rose always dismissed most of my prenatal questions as inconsequential, I didn’t truly feel nervous before, even when our natural-birth plans went out the window ten days ago as the baby failed to rotate itself out of breech position. But yesterday I thought I was having a scheduled Caesarean section, and now we’re supposed to rush to the hospital to meet a new doctor who can get this baby out without surgery, without that degree of medical intervention, the way we once intended our birthing experience to be? I sometimes feel guilty for having tried to avoid the hospital route and even guiltier for how far the plan has strayed from the natural, medication-free delivery Gordon and I had ori-ginally planned. But now we’re in no-plan-land; not a place I like to be. I guess this is it. I’m going to have a baby today.

  Gordon and I shake ourselves awake, splash water on our faces, and rush downstairs to grab the hospital bag, which is packed and ready because we were scheduled for a C-section on Wednesday. This Monday was supposed to be like any other. I can barely discuss my feelings with my husband, because I’m so focused on getting to the hospital as quickly as possible. This is unusual, because Gordon and I have spent the last ten years analyzing every event, talking out our feelings, and thanking one another for being each other’s primary support person through difficult trials. I use his analysis of an experience to decide how inflamed I want to be about it. He is overly rational; I am overly emotional. When we’re together, it’s a decent balance of both.

  If I wasn’t feeling so panicked in this moment, I might say, “This is really scary; I don’t know what’s coming next.” But I can’t, because I can’t say anything at all. I’m paralyzed by fear and uncertainty. My thirty-nine-weeks-pregnant self climbs into the passenger seat of the car and we head to a hospital in the centre of downtown Toronto. I look at Gordon and hold his hand as he leans into stop-and-go traffic. We’re stuck in the morning commuter rush, but we’re distracted by the new birth plan, so neither of us complains (very unusual for Torontonians). My phone rings again. It’s Rose, wanting to know what is taking us so long to get to the hospital. Thirty minutes ago I was wrapped around a body pillow listening to the birds chirping outside my bedroom window. Birth is not a medical event, but it sure feels like an emergency right now.

  When the phone rings for the third time, with Rose again demanding to know what’s taking so long, I tense up, feeling like we’re failing our idyllic mother figure. Rose is offering a solution to my anticipated birthing challenges, and if we don’t hurry up and get to the hospital, we’ll miss the opportunity for that natural, blissful birth experience.

  “Why aren’t we there yet?” I snap at Gordon. “What’s taking so long? We need to get there now.” I’m not
sure why I’m being cruel to this man who has never wavered in his support of me despite the constant changes to our pregnancy plans.

  Vaginal breech deliveries are rare in Toronto. According to my midwife, there is currently only one doctor in the city who’s willing to perform a vaginal breech delivery, and she is ready to examine me first thing this morning, because my non-hippie, British midwife worked her professional connections to secure us an atypical meeting. Any fear I might have had that Rose was annoyed with me is washed away with pure admiration for her problem-solving skills. She is my kind of action-oriented woman.

  Breech means that the fetus hasn’t rotated head-down to face the cervix and vaginal canal. My baby has been in this breech position, head up and feet down, for weeks. There’s been some speculation that its head is somehow wedged under my rib cage. But it was only after I crossed the thirty-seven-week mark that we started to discuss alternate ways of getting the baby out, on the assumption that vaginal delivery was no longer an option. Breech presentations occur in 3 to 4 percent of pregnant women who reach full term (forty weeks). That translates to approximately 11,000 to 14,500 breech deliveries a year in Canada. In a 2009 study of Canadian breech pregnancies, “only 0.6 percent of women planning a Caesarean eventually delivered vaginally.”

  My birthing plan has flipped backwards in more ways than one. We step out of the car in front of the hospital, and, as Gordon helps lift me from my seat to a standing position, I ask, “Is induction and vaginal breech delivery safe? Are we doing the right thing rushing into the hospital like this? I’m nervous, babe. This isn’t how we thought today was going to go. Also, I’m supposed to be working later. This wasn’t supposed to happen today.”

  Gordon looks serious but kind when he responds. “The baby comes first. You do so much work for other people, now you need to do the work for the baby. Rose wouldn’t have brought us to the hospital if she didn’t think you could do it. We’re here now, let’s go see what’s up.” He grabs my hand and we walk into the hospital together.