29 | Amelia
“I knew something wasn’t right, but I was too afraid to kind of share exactly what was going on, I guess, for fear of what could happen, as in, my baby’s going to get taken or I’m going to get locked away and the stigma around mental illness. It took about eight weeks, actually, to get properly diagnosed and properly medicated.”
After her dream physiological labour and birth, Amelia’s world was turned upside by a sudden postpartum haemorrhage that whisked her away from her husband and daughter.
From the moment she awoke from the surgery, Amelia was consumed by mania and insomnia. Over the next eight weeks, her postpartum psychosis escalated but Amelia was able to hide most of her delusions and hallucinations from her care providers. That is until finally she made the brave call to ask for help and present to her local hospital.
Three years on, Amelia is expecting baby number two and shares openly about all the supports that are in place to protect her mental health this time around - given the 50% chance of recurrence.
Join me as Amelia discusses the overall lack of awareness around postpartum psychosis, her initial misdiagnosis of PTSD, what worked for her and what didn’t, and the incredible support she did eventually receive.
Please note, this episode mentions suicidal ideation. Go gently.
“I was pregnant in 2020 - so we're talking Covid year! And I guess my underlying kind of mild to moderate anxiety my whole life just really got exacerbated that year.”
“And with all the telehealth and not knowing what was going to happen or what was coming or what Covid meant for pregnant women, I definitely felt overwhelmed and scared and I wasn't expecting the huge kind of mental illness that did eventuate. But yeah, it was definitely a year of pretty full on feelings and emotions and struggles.”
“We had a pretty amazing labour and birth, actually, and I was with the group midwifery practice here at my local hospital, which was just incredible. And yeah, we laboured at home for about 6 hours and then I went in and it was about midday when I arrived at hospital. And then by 3.30, Norah was born.”
“It was a very kind of physiological, no pain relief, beautiful kind of birth, and we were just kind of lapping up her and this amazing experience we'd just had.”
“Maybe like 6 hours post having her, I started to bleed. That was very traumatic and resulted in emergency surgery. So I got whisked away and left my husband Sandy and baby Norah, and not knowing what was going to happen or what they were even going to do, it was just, let's stop the bleeding quickly.”
“Waking up from that surgery, I immediately felt something was off and I was very straight away very manic and my thoughts were just kind of all over the place and, yeah, the trauma of that kind of event, despite having such a beautiful labour and birth, set it off.”
“With the group midwifery practice, you're kind of encouraged to go home pretty much straight away. So my plan was never to be in the hospital, but then after the surgery, I stayed for five days on the postnatal ward. And, yeah, my whole world, I guess, had just completely shifted.”
“I wasn't, I guess, present in my mind and I was having hallucinations and delusions and hearing things and seeing things and feeling things and, yeah, it was all really scary.”
“Initially it was to do with the surgery, so I was telling the doctors and nurses, ‘I can feel snakes all over me’. And they were saying, that could have been the wires and things that were on you during the surgery. And then I said, ‘I can feel people, like, choking me’. And they said, when you get intubated, this is what happens. And so they explained it and it made sense.”
“So, yeah, those were the kind of initial things and I had enough insight at that time to be like, this isn't real, even though it feels real. And then I guess gradually the thoughts changed and, yeah, I couldn't kind of differentiate between what was real and what wasn't.”
“They were talking about PTSD, and because my mind was just so manic, I wasn't sleeping. So for the five days that we were in the hospital, I was having maybe 2 hours of sleep a day, which I’ve come to realise that can really bring on some very severe mental illness.”
“A lot of my memory is obviously kind of gone or very fuzzy, but I do remember even when she was asleep, I had to do stuff. I was journaling frantically. I was doing all this skin care regime, which I don't normally do. I was checking for things. And, yeah, I just wasn't able to relax at all.”
“For some miraculous reason, I was able to breastfeed. And they were really shocked, I guess, because of the blood loss. Lots of women, unfortunately, don't end up being able to breastfeed after a PPH [postpartum haemorrhage]. So that really helped my bonding and experience with Norah.”
“Every time I held her, I felt calm and it really grounded me and brought me back. It was just the moments of in between I guess and I thought, you know, I was superwoman and I was going to change the world and I had all these plans of starting charities and yeah, it was completely wild.”
“My dad's actually a retired psychiatric nurse, so my thoughts around mental illness had been very influenced by his experiences, I guess. And so I knew something wasn't right, but I was too afraid to kind of share exactly what was going on, I guess, for fear of what could happen, as in, my baby's going to get taken or I'm going to get locked away and the stigma around mental illness.”
“It took about eight weeks, actually, to get properly diagnosed and properly medicated.”
“I was starting to have suicidal ideation by now and getting scared that Norah wasn’t a baby. Like, I would look at her and think, ‘oh, this is a robot, and they’re recording me and there’s people watching the house’. And so it had turned very dark and scary.”
“The group midwives actually would come to my house still for home visits, which was probably one of the biggest things that I guess helped and supported us in the end, because it was on one of these visits that the midwife kind of questioned a bit of some of my behaviour.”
“And I didn't know, but she called Sandy once she'd left and say, ‘is Amelia okay? I noticed these things. Should we look into it a bit?’ So that was probably the thing that got the ball rolling in terms of getting in some more mental health support.”
“It was only two days after coming home and my mother-in-law was here kind of napping. Norah was asleep, Sandy was having a nap. I should have been napping. And all of a sudden, I just had this overwhelming feeling that I'd overdosed on, they'd given me some sleeping tablets to try and help bring on some more rest, and I needed to call MotherSafe straight away. It was like this urgent, dire situation in my head, but being a weekend, that line was closed.”
“So then I thought, I'm going to call healthdirect to get advice. And obviously, her job is to ensure that my health and the baby's health was all good. And she advised me to kind of rouse Norah using cold water from her beautiful nap.” This was because there was a fear that if Amelia had overdosed then baby Norah may have received this high dose of sleeping medication via breastmilk. “So this moment of terror crosses Sandy's mind and my mother in law's mind, and they're going, like, ‘what is going on?’”
“We ended up going back to the hospital for an assessment. And then I got readmitted onto the postnatal ward again, just for two nights. And Norah was a rooming baby, so she wasn't actually admitted, but she was able to stay with me. And that's when I saw a psychiatrist.”
“But still, again, no one could determine exactly what was going on. And I guess I wasn't being forthcoming either, or I just didn't realise what was real or what wasn't, what was going on for me.”
“So that's the next two days and then we get discharged again. But this time they've put us or referred us to a community psychology service. And as part of that team, we had a perinatal mental health nurse and she was amazing and she came to our house and she was also a midwife and she had years and years of experience, so it was like having an aunt or a grandma, but, yeah, she really helped and I would just keep in touch with her, call her whenever I had a concern or anything.”
“Obviously with a newborn, you're still having very fragmented sleep. But I'd started to be able to wind down a lot more easily and I don't know how much sleep I was getting, but I was functioning. The sleeping tablets made me feel very out of it and I guess just foggy and fuzzy, but that was kind of going on anyway… I didn't really take the sleeping medication for long. And it was like when I had that moment of, oh, my God, I've overdosed, it was too hard for me to take it again.”
“So a few weeks kind of passed and we were all doing okay. I was still obviously not well, but well enough that no one was concerned - We saw my GP and the mental health community team would come to the house and, yeah, saw the child and family health nurse.”
“It got to about around Australia Day and I think I'd been driving and I was starting to have suicidal ideation by now and getting scared that Norah wasn't a baby. Like, I would look at her and think, ‘oh, this is a robot, and they're recording me and there's people watching the house’. And so it had turned very dark and scary.”
“Luckily I called, I think, PANDA first and spoke to someone there and then my perinatal mental health nurse.” It was her perinatal mental health nurse who suggested Amelia present to the hospital. “It was more like, oh, we'd just recommend that you go and have a chat up at the hospital.”
“I had to call Sandy and say, ‘you have to come home from work.’”
“I just have this vision of an ambulance kind of pulling up behind the car, but I don't know if someone had kind of organised that or if that was just happening because we live in a city. It was just in my head, like, oh, they're taking me away and it was up to me to go and present to the hospital for an assessment, or I guess I would have been scheduled in hindsight.”
”We were lucky, though, that Sandy's sister and brother in law were visiting, so we could leave Norah with them. So at least Sandy didn't have two of us to be worried about.”
“I was feeling really safe about the hospital and the experience we'd had so far, so I felt comfortable going there.”
“And, yeah, we went up to the main hospital where I'd given birth, and basically, they don't have a psychiatric unit there. And I guess the phone conversation, it had been lost in the communications, which hospital they meant for me to go to. So there's another local hospital that has a psychiatric unit.”
“So we got to the main big hospital, and they had to kind of, ‘this isn't where you should be’. And at that time, I'd kind of gone to this place where I thought I was dying. So they'd sent me into the hospital to die, basically.”
“And it was terrifying for Sandy. I can't imagine what was going through his head. And I was in two minds about just getting out of the car and running. I don't know where I was going or what I was doing.”
“He managed to get me back into the car and get to the other hospital, and I don't know how long we were there, but the assessment, they must have decided there that it was, in fact, a psychotic event. And that's when I was given the antipsychotic medication for the first time.”
“I'm so lucky that Sandy is such an amazing support and partner. And then we also had family around. They said, ‘we're comfortable with you going home’, because there's no MBUs where we live. And there actually wasn't any publicly funded MBUs at that time.”
If going home wasn’t an option, Amelia would have been admitted alone without Norah, and her breastfeeding journey would have ended suddenly.
”I'm so grateful that we were in a position to come home and have the community support come to the house.”
“So that kind of began the medication journey, and that completely changed my mind, what was going on in my mind and what was happening for us. So, yeah, from then on, I gradually got better and obviously there's ups and downs with mental health and it took a long time to properly, I guess, feel like me again. But, yeah, the medication definitely helped massively.”
“We didn't use any sleeping medication with the antipsychotic Olanzapine. It's a sedative, and a night-time medication, which obviously has side effects. And I guess for the first while, while I was getting used to it and they adjusted it and things, I didn't feel safe driving and it just affected my mood and what was going on, but it completely zenned me out and calmed me.”
“So it's safe for breastfeeding, which was amazing. I'm not sure what other people, what other doses people have been on. So the dose I was taking was safe. So, yeah, that was great. And my breastfeeding journey only ended with Norah when she was two and two months.”
“I feel like I missed out on so much… I’m grateful for technology and we’ve got amazing videos and photos from when Norah was a newborn. But, yeah, there’s been a lot of healing.”
“I should also say I was put on an antidepressant and I can't remember when that was started. I think it was before the Olanzapine. So that really numbed me out and made me quite emotionless. And the psychiatrist has since said, ‘I'm not sure why you were put on that’. I guess at the time, the GP thought she was doing the right thing and they thought it was severe depression.”
“I think I was on the antipsychotic for between, like nine and twelve months. I'm not actually sure. And then the antidepressant for 18 months to two years, and it was like a slow wean, which is the suggested thing.”
When Amelia reflects on her journey, she describes a grieving period. “I feel like I missed out on so much… I'm grateful for technology and we've got amazing videos and photos from when Norah was a newborn. But, yeah, there's been a lot of healing and I've seen various psychologists for a long time.”
“Just like adjusting to a new kind of me and how I was engaging in the world and, yeah, that also brought up a lot of things because I guess I didn't feel like myself for such a long time. And the huge hormonal shift that happens when you're a mother anyway, despite everything else, you change as a person. So, yeah, it was a lot of coming to terms with things and healing and grieving and, yeah, I'd say it definitely took probably until the end of last year to feel like everything's cool and back to the old Amelia.”
“The initial psychology service that I was referred to was a community based one, so I didn't have to pay for that. And I was going very regularly and would just take Norah and it was just kind of processing and talking about things and checking in.”
“Then once that, I'm not sure how many sessions they kind of provide, that was for a good while there, and then I got referred to a private service and I still go there regularly now, especially since becoming pregnant this year again and processing the lead up to our next baby and labour and birth and postnatal period.”
“So that's been hugely important and we've done a lot of different, she's offered kind of more mindfulness, CBT, and I guess just talking about things and learning to let worries kind of slide and not buying into the anxiety and what's going on, waiting to see what the reality actually is.”
“We’ve put a lot of effort and energy and supports in place to kind of ensure things are different this time.”
Now, nearly three years since the birth of Norah, Amelia is due to give birth to baby number two shortly. ”We're really excited and I guess nervous. We've put a lot of effort and energy and supports in place to kind of ensure things are different this time in a positive way.”
“As soon as we found out I was pregnant, the GP straight away kind of put the referrals into place and I got linked up with a midwifery group called Family Support, so they’re for more vulnerable women and families. And it's kind of like the group midwifery practice, in that I see the same midwife and she comes to my house. It's just that she won't be there for the birth, but then she'll come postnatally for six weeks as well. So that's been really great, because that continuity of care is such a massive part of good practice… I don't know if it's offered everywhere, but at our local hospital, that's one of the free models of care.”
“And then I've seen a psychiatrist privately and then also since becoming pregnant, she works through the local hospital as well, so she's managing the antipsychotic side of things. And, yeah, for this birth, we'll be having a five day stay, give or take, depending on how things go.”
“I guess some people might not know, but once you've had a postpartum psychosis, there's a 50% chance of it reoccurring.”
“I haven't had to go on any medication in the pregnancy, but I will be taking Olanzapine pretty much as soon as the baby is born, prophylactically, for maybe I think they've said at least three months, but it could be six or twelve months, we'll just see what happens, and that's just to ensure things kind of stay well and good.”
“That was a big decision to kind of come to terms with having already taken the medication and knowing what changes it made to me and my mind and my body. But, yeah, we kind of decided that the risks outweigh the benefits. And I'm happy to start that, especially because it's safe with breastfeeding.”
“I've been seeing the same psychologist again, which has been really helpful.”
“Sandy and I have done, we did hypnobirthing, actually, with Norah, with Norah's pregnancy, and kind of kept that mind frame for this labour and birth. And I've done some debriefs and kind of just more mindfulness practise and yoga and meditation.”
“I engaged with, as probably lots of listeners know about, B from Core and Floor Restore. So she did an amazing one and a half hour debrief and birth prep session with me, and that was incredible. So I'm really grateful for that experience, too.”
“So Norah's turning three next week. Wild. It's just weird, the timing as well, with this next baby, because we're going through similar things at the same time of year.”
“It’s not you, it’s an illness, and there’s no shame in getting help and support and speaking about what’s going on for you...”
“I actually studied midwifery for two years straight out of high school - so over ten years ago - but postnatal mental illness, and especially postnatal psychosis, was never mentioned, so I had no idea that it was a thing. I'd heard of postnatal depression and anxiety and yeah, having kind of had episodes of depression and anxiety in my teens and even panic attacks, I was already aware that things could potentially turn for the worst, I guess, in the postnatal period. But, yeah, the psychosis just came out of nowhere and really flawed me.”
“So I think it's really important that, not to scare people, but just for people to be aware that these things happen.”
“It's like any illness, you would go and get help for a physical injury or illness… It doesn't mean you're just the illness. If you've had a psychotic event, you're not a psychopath. There's a lot of support and healing and recovery and you will get better and you're not labelled forever as this person with this illness.”
“So I guess my main message for people is it's not you, it's an illness, and there's no shame in getting help and support and speaking about what's going on for you. I think since going through it all, I found some positives in that my relationships with people are stronger.”
“When you share your vulnerabilities, other people feel safe to kind of open up and, yeah, I think just knowing that there's help out there, people generally want to help. There's nothing worse than sitting on these kinds of thoughts and feelings alone. So, yeah, definitely reaching out and getting that support earlier is really important.”
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