Sleepless Days: One Woman's Journey Through Postpartum Depression

Sleepless Days: One Woman's Journey Through Postpartum Depression

by Susan Kushner Resnick

Paperback(Second Edition)


Product Details

ISBN-13: 9780312272272
Publisher: St. Martin's Press
Publication date: 02/28/2001
Edition description: Second Edition
Pages: 208
Product dimensions: 5.78(w) x 8.28(h) x 0.54(d)

About the Author

Susan Kushner Resnick worked as a reporter for various weekly and daily newspapers before becoming a freelance writer. Her work has appeared in the "Hers" column of The New York Times Magazine and in Natural Health and other periodicals.

Read an Excerpt

Chapter One

I don't cry. So it's unusual, as I lie next to my sleeping three-year-olddaughter the night before my son is born, that I taste a tear atthe corner of my lip. I watch her, remembering the adventureswe've shared, first child and first-time mother, the learning we'vedone together. We're very good at our jobs. She's avoided colic andtemper tantrums. I don't yell or slap, spoil or neglect. Still, like anywoman who will admit the truth, I have found motherhood frustratingand suffocating. But I have never doubted my ability to doit well. Mothering is the first thing I have ever done with such confidence,the first thing that has ever come so naturally to me.

    In other areas of my life—my work as a journalist; my roleas a wife, friend, daughter; even my ability to keep my house cleanenough—I am insecure. I spend most of my energy doubting andscolding myself, which leaves few reserves for accomplishing muchin life. I live with a constant battle waging in my head, my own civilwar. One side is constantly ambushing the other for the endless failuresI perceive. Later I will realize that my twenty-four-hour self-assaultis a symptom of low-level depression—dysthymia, they callit—that I've suffered all my life. But there is a lot I will learn afterI'm through with PPD and still more that will change about me.Even the confidence I feel about motherhood will shift. Eventually,I will feel far more confident in most areas of my life, though farmore vulnerable about my mothering skills.

    But right now, hours before my son pushes through mybody, I don't doubt that I will be as capable amother of two as Ihave been of one. Still, I will miss this team. On dark winter afternoons,Carrie entertains herself on the carpet, building zoos withplastic jungle animals and wooden blocks, while I slouch in a chairreading the newspaper. On Sunday mornings, I draw big black circlesfilled with squiggly lines and she fills the spaces with color. Wedig our fists into boxes of sugar-coated cereal when her father isn'taround to see, and share an attraction to books that he doesn't. Buttomorrow, a new player will be added to the roster. At best, he willtake away the joy of our dyad. At worst, he will cause such conflictthat neither of us will ever feel this content again.

    I rub the back of my finger across Carrie's plump cheek andrest my chin on her hair. The tears surprise me. But there is one explanationfor the magnitude of my sorrow. Sometimes, the bodyknows what comes next before anyone else.

The next morning, with my mother asleep on the pull-out couchand Carrie silent and peaceful in her bed, Dave and I drivethrough the dark to the hospital. When this pregnancy started, Idisapproved of inducing labor with artificial hormones for anythingbut medical reasons. Those convenience births, planned to accommodatea babysitter's schedule or a husband's business trip orto reserve the most desired doctor in a large OB-GYN practice,seemed like cheating. They also clashed with my belief of birth as anatural, spiritual event. There was one way to do it, I believed, andthat was to wait for God to crank open the cervix and spill out thebaby. Birthdays were predestined events, not something to be alteredaccording to the blank square in your doctor's appointmentbook.

     I do not see it yet, but I am as rigid a woman as they come.I am also fairly self-righteous, passing silent judgment on othersand myself about personal decisions like breastfeeding and takingantidepressants. PPD will break me of this rigidity. The disease willtake a brittle woman, break her, and rebuild her with flexible materials.But now I am still entrenched in my unyielding little world,where every event is viewed through a black or white lens, everyperson hated or beloved, every decision right or wrong.

    This one is wrong, I believe, as I get ready to have mybaby's birth artificially induced. But I have to get him out. I still feelguilty about it, and weak for not being able to hold out untilMother Nature pushes the start button. But I can no longer bearwaiting to see if this baby will come out healthy. Before this pregnancy,I'd lost two others. They were early miscarriages—one ateight weeks and one at five—but still losses of children I had alreadyimagined grown and happy. I mourned the first one, the onewho was supposed to be born in August, with weeks of tears. Thesecond one, who could have had the same birthday as Carrie, Ididn't bother to grieve. It hurt too much to say good-bye again to ababy I'd never hold. And I didn't have any energy left for facing aloss. My mother-in-law's impending death, which hovered over usuntil she finally died when Max was two, sapped all my emotionalreserves.

    Soon after the second fetus bled out of me, an infertilityspecialist determined that I lacked the progesterone necessary tocarry babies to term. For the first twelve weeks of Max's existence,I inserted capsules filled with progesterone into my vagina twice aday so I wouldn't lose him, too. Once the threat of miscarriage hadended, I began worrying about a recurrence of my other pregnancycomplication: early labor. During Carrie's stay in the womb, I developedpreterm labor—the uterus contracting before the baby isready for birth. After holding her off for a couple of weeks withdrugs and bed rest, she was born three weeks early, scrawny, buthealthy. Ten weeks ago, when I first felt lower-back cramps, I wasput on the medical community's version of a short leash to preventa more severe premature birth this time. My activities were restrictedto standing only long enough to make a quick dinner anddriving Carrie to preschool. I was not supposed to walk if I felt anycramps, but once a week I cheated and strolled every single aisle ofa small drugstore.

    Despite threatening to open early, my womb stayed still,during and after the restrictions. At thirty-eight weeks, I had falselabor: real contractions five minutes apart that stopped the minuteI crossed the threshold of the hospital's electronic door. I walked thehalls from five to eight in the morning, begging my body to startcontracting again so I wouldn't have to suffer the humiliation anddisappointment of going home without a baby when everyone inmy family was waiting by the phone to hear news of a birth.

    Through all this waiting, I obsessed over infecting my babywith Group B strep, an infection in the birth canal that is harmless tothe mother, but can cause meningitis and other deadly infectionsto the baby during birth. Even before official labor, if the amnioticsack has ruptured, the infection can seep up to the baby. I had beendiagnosed with this malady, too, when I was carrying my daughter.Once a woman is diagnosed with it, she is always considered a carrierand is at high risk during each delivery. Whenever I felt moistureon my underwear during those last weeks of Max's womb life,I imagined the sack had a slow leak, and that the infection I carrywas gradually killing him.

    When Dr. Laly Haines offered to put me out of my miseryand induce me one week before my due date, I surrendered my self-righteousposition. Haines, a bubbly woman in her early thirtieswho always made me feel safe with her wisdom and her knack fortreating me as if I were her long-lost best friend, entered the examiningroom one afternoon in February holding a black leatherbook. She told me the next day she had free, a day convenient forher, not me. It wasn't as if I picked a day that sounded good to me.I wasn't tempting the fates. She chose my son's birthday. The sixth.Today.

* * *

We arrive at the hospital at seven, sign some papers in the admissionsoffice, then wait on a couch in the brand-new atriumedand glass-elevatored lobby. It takes twenty minutes beforeanyone comes to fetch us, precious minutes, during which we havethe luxury of spending time alone in this public space. Dave stickshis fingers under his glasses to rub his tired eyes and I slump downso my huge belly, covered by my faded black-plaid flannel maternityshirt, sticks up like the top of a submarine. We watch thenurses clutching car keys and the interns balancing tall coffee cupsas they come on and off their shifts. These characters distract us,and inspire us to play that "who are they and what are their liveslike" game. She hates all the doctors, I say about one nurse, thengoes home and ties up her husband. He was a dork in high school,Dave says of a doctor, and now he drives a BMW to make up for it.There is no pain, no scribbling of contraction times, only softlaughter and impatience.

    We didn't get this the last time. Labor started naturally.One minute we were watching sitcoms on a Thursday night and thenext moment I was hanging from the towel rods hissing with pain.I screamed on the way to the hospital, screamed in the admitting office,screamed when I thought I would pop out a baby before Davefinished parking the car. But this time, as our daughter awaits a siblingat home and our son lives his last moments of fish life inside myuterine aquarium, we are civilized, controlled.

    We are, after all, veterans. We believe we know what'sahead of us and are sure we can handle it. Dave expects it to be aseasy as I do.

    "It'll be like the three of us plus a baby," he says. "Nothingdifferent."

    Finally, a nurse approaches. She asks if she can take me tothe room first, then retrieve Dave. I don't like this separation, but Ifollow her into a gently lit hospital room with a clear plastic infantcrib in one corner and a rocking chair in the other. She sits down onthe single bed in the middle of the room and pats the space besideher white polyester thigh, inviting me to join her. I obey, wonderingwhat this intimate positioning has to do with my appointment tohave a baby. I want to get down to business: strip, tie on a gown,give blood samples, take laboratory-manufactured hormones, andshove out a son. I don't want to chat, which she seems to sense.

    "We ask everyone to do this," she explains. "It'll just takea second."

    She asks about my due date and my pregnancy history,facts she could easily glean from the file she's holding, then getsdown to the real reason for the solo trip: "Do you ever feel afraidin your relationship that your husband will hurt you?"

    "No," I answer, the real part of me shocked that she wouldthink such a thing about my tender husband, the social activist inme glad that the hospital has set up this system to protect womenwho could answer the question affirmatively. They worry that themother will leave with a baby and put both of them in danger, as ifthat is the only danger the pair could encounter. If the nurse hadasked the opposite question, "Are you confident in your relationshipthat your husband will save you?" I would have said yes. Iwould have been right.

    She brightens up, now that the uncomfortable question hasbeen answered comfortably, and hands me a cotton frock.

    "I'll go get your husband," she says. "And your labor anddelivery nurse will be Barb today."

    "It's not you?" I ask. I've been worried about what mynurse, the one professional who will spend most of the labor withme, will be like. It's been said that a good or bad nurse can make orbreak the birthing experience. This one seems kind. I'd like to keepher.

    "No, I just do check-in," she says with a smile. "You canchange in the bathroom."

    Barb, who tells us that she is divorced and about to go onvacation to Florida, is as cold and bitter as the weather she's escaping.She is tall and thin, with bottle blond hair that is blunted at hercheekbones. Because I am being induced and because I will need antibioticsduring labor to fight the strep B, she prepares an IV line formy hand. "I've never had one before," I tell her, "I'm nervous." Shejams the needle and plastic tube into my skin without looking atme. After the fluids have started flowing and I am strapped to a fetalmonitor, Dr. Haines comes in to break my water. She prods thesack with a white plastic stick that looks like a knitting needle,pushing and twisting at the tough membrane until finally I feel hotliquid gush over my thighs and rear. Like someone with bladdercontrol problems, I don't feel it coming out or have the ability tostop it. It seems endless. It keeps coming and coming and I panic,realizing I have no say over what my body is doing.

    Contractions, sharp and sudden, begin soon after Barb andthe doctor leave. Barb stands at the nurse's station, talking, while Iscream into a pillow and beg for painkillers.

    "It's too soon," she says, annoyed, as she looks at the stripof paper regurgitated from the fetal monitor that indicates thecloseness of contractions. "You have to wait longer."

    When she leaves, I ask Dave if he can convince her to getDr. Haines. My husband is a short, trim man with a self-describedface of a rabbi. He has salt-and-pepper hair that gets saltier by themonth and sea blue eyes that hide behind strong glasses. He is thetype of person that everyone loves. His manner—sweet, genuine,funny, and devoid of bitterness—draws people to him. I don't thinkhe has ever had or will ever have any enemies. I joke that he is anew soul, free of the baggage from a previous life that causes shadowsand dark crevices in most of us. He is as strong, confident, andcool as I am flailing and emotional, which is probably why we getalong so well. It also helps tremendously that he brings me waterfrom downstairs in the middle of the night when I'm thirsty and listensto me worry whenever I ask for his ear, all without ever steppingon my independence. Sure, he has some flaws, such as notbeing honest about his anger, extreme sloppiness, and possibly beingthe slowest man on earth when it comes to getting dressed orpreparing a meal. But for the most part, he's golden. It's this personalitythat makes it so easy for him to talk the steely nurse intogetting my doctor without offending her.

    Dr. Haines sticks a gloved finger inside me and orders Barbto shoot a syringe full of the narcotic Nubian into my IV line. I'mgetting close.

    I start to feel woozy and heavy and weak and before long Isee everything twice. Double vision nauseates me, so I close myeyes, hold Dave's hand, and ask him to tell me when he sees a contractionstarting on the monitor.

    "Here comes one," he says, over and over, in a voice bothexcited and soothing.

    "Oh, yeah," I slur. "It hurts. It hurts. Okay it's better now."

    I don't scream anymore, because I can't feel the pain directlynow. The contractions feel the same, but my brain doesn'tregister it as pain, or signal anything that reacts to pain to jumpinto action. The Nubian is like a cotton ball jammed into aneardrum: sounds come through, but not strong enough to elicit aresponse.

    The drug lasts about ninety minutes. As it wears off, andthe pain and my mind become clearer, Dr. Haines measures mystretched cervix and victoriously announces that it's time to push.Barb and Dave each grab one of my thighs and pull them towardmy head so I am spread as wide as possible. Dr. Haines stands infront of my vagina as if she's about to conduct an orchestra and ordersme to push. Suddenly that forgetfulness that Mother Naturecreated in mothers to further the species melts away. I remembereverything about Carrie's birth, particularly the sensation of beingturned inside out like a freshly washed sock while pushing her outof my body without the crutch of drugs. I realize I can't possibly gothrough that again. How can I get out of here? I think, trying tocome up with a plan. How can I slip out so these three don't notice?They keep bossing me around, as impatient and unsympathetic asbasketball coaches, so I obey. I push and push, pretending I'm tryingas hard as I can, until out slides a little poop. I am so embarrassedthat I shout, "Did I just take a shit?," and someone tells meyes, not to worry about it. Then I push with more spirit until I feelsomething tear. Not in the spot I'd expected, between my vaginaand anus, but in the front of my body, near my urethra. I feel as if Iam splitting, that something inside is tearing and that when thebaby's head comes out, it will keep tearing right up the front of me,like a zipper.

     Finally, the baby arrives, leaving only small, predictablesections of my bottom tattered. He is blue and motionless with partof the amniotic sack wrapped over him. Dave says he looks like aspace creature. He is terrified because he thinks the baby is dead,though he doesn't tell me this until months later. It is the Resnicktrademark to spare loved ones any ugliness. All of Dave's familymembers protect one another from the truth. I once called it lying,but now I see it as a form of love.

    They take Max to an isolette and rough him up a little toget him to breathe, put drops in his eyes, then bring him back tome. There is no magic moment of bonding. Dave cries and Dr.Haines praises me for getting it over with so quickly, but all I canthink is that I have go to the bathroom. There are photos of meholding Max and talking on the phone and smiling, but I don't remembermaking those calls or smiling those smiles.

    It is said that a traumatic or dissatisfying birth experience isone of the factors that can lead to postpartum depression. I gavebirth to Carrie with the assistance of a nurse-midwife, a hot showerto tame the pain, and a nearly dark hospital room in which to greetmy new child. After the pain and fear subsided, I felt I had accomplishedsomething courageous and breathtaking. Max's high-techbirth was defined by bright lights, IV tubes, straps that tethered meto the fetal monitor next to the bed, stupefying medication, and aheartless nurse. After he arrived, I felt as if I'd been through a harshmedical procedure. Had I experienced another noninduced, low-techdelivery, I wonder, would I have avoided PPD?

    A few minutes after birthing Max, we load my overnightbag, coat, pocketbook, and me into a wheelchair. Max, wrapped ina stripped flannel blanket and wearing a matching striped cap, liesin my arms. I still feel woozy and unstable from the drugs, as if I amabout to collapse. I worry that I'll let him roll off my lap onto thehallway or down the elevator shaft as we ride to another floor andour permanent room.

    After a nurse bathes and diapers Max, and changes the padand ice pack between my legs, Dave goes home to get Carrie. Whenhe brings her back, there are presents to open. After peering quicklyat the being who will later become her beloved playmate, she tearsthrough the wrapping paper. My tiny girl suddenly looks huge tome. She wears a T-shirt that declares I'm the Big Sister over herpink turtleneck. Even her new Richard Scarry figurines seem sophisticatedcompared to the stuffed gray horse she gives to Max.

    After some playing on the bed and reminding her fatherthat she was promised ice cream when the baby was born, theyleave. My first obsession starts. Though we knew we would nameour son Max as soon as we learned his sex (Dave had made mepromise to name our first boy after his grandfather the Russianfruit peddler during our second date, and had held me to it), it is upto me to pick a middle name. I know I want something that startswith J. From a long list, Justin, Jacob, Julian, and James have madethe final cut. I love them all, but each has a drawback. Though fourof his great-great-grandfathers were named Jacob, I find it too ethnicand predictable, especially next to Max. Dave hates the nameJustin. Julian is the middle name of another boy named Max in oursmall town and James is one syllable too short. The birth certificateoffice needs the name before I leave the hospital in two days, so Ispend every moment I am alone over the next few days obsessingabout the decision. Order always gives me a sense of control whenI am insecure or anxious, so for my entire hospitalization, I keepstraightening my room, then returning to the list of names and tryingeach one out in my head. I throw out wrappers from pain pillsand stool softeners, toss soiled newborn T-shirts in the hamper,change the pad on the diapering cart, push the flowers my mothersent to the center of the window sill, place my slippers next to thebed, climb under the sheets and recite: Max James, Max Justin,Max Julian, Max Jacob over and over until somebody calls or visits.It is so important and final, so crucial that the name be perfect.But I can't rest on one combination. I've often had trouble makingimportant decisions, and I've been pondering this middle namequestion for months, but it's never possessed me like this. My mindruns in circles, day and night, until the birth certificate lady callsand in a panic I choose the safest middle name, Jacob.

    Obsessing isn't the only postpartum symptom that's uniqueto this birth. After Carrie's arrival, there was celebration, visitors, abouquet of pink balloons tied to a chair in the hospital room. Thistime there is on-and-off weeping. I blame it on the loneliness. SinceDave has to spend time at home with Carrie, and she's bored aftera few minutes in the hospital, he only visits for a couple of hourseach day. Except for mandatory blood pressure checks twice a shift,the nurses neglect me because I'm a second-timer. My best friend,Kelly, can't visit me because there's a big snowstorm predicted andher babysitter cancels. Dave tells me the storm will be so bad thathe doesn't even know if he'll be able to pick us up after we're to bedischarged.

    Late in the afternoon, one day after Max's birth, I wanderthe circular hallway of the ward, looking for someone to talk to.We aren't allowed to carry our babies in the hallway, so I push himin his Plexiglas rolling crib. I peek into rooms filled with happy relativesand pass couples walking their babies together, the fatherwith one arm around the mother and the other pushing the crib. Noone seems to see us, though there are tears in my eyes and, I imagine,a beseeching look on my face. I walk to the dead end of a hallway,stand by a window, and watch the snow whip past me. Itblows the coat off the back of a lone pedestrian down on the street,and covers the roads so thoroughly that curbs and fire hydrantscan't be distinguished. I look at Max, who is sleeping, and I try tofeel how special this should be, just me and my new, new babyagainst the world. But instead I feel homesick and more alone thanI have in years.

    As a little girl, I was always lonely. In second grade I wroteand illustrated my first book. The stick-figure girl on the cover wasfrowning. Inside, I told the story of a girl who is rejected by her entirefamily. Everyone is too busy to play with her until her fathercomes home and takes her to the park on his shoulders. My teacherentered the book in a contest, but it didn't win. When I was thirteenI started collecting poems that other girls published in Teen magazine.I pasted them into a book I made out of loose-leaf notebookpaper and kitchen string. On one page I pasted a poem I'd writtenmyself, in blue magic marker.

    "I dream, and make all bad things good again. But when Icome back to reality, nothing has changed. Except after I dream, Ihave more hope and courage to really make the bad things goodagain."


Excerpted from Sleepless Days by Susan Kushner Resnick. Copyright © 2000 by Susan Kushner Resnick. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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