A few months ago, I wrote about what it was like to discover I was 8 months pregnant while living in Tanzania. I gave birth to a healthy, incredible baby girl two weeks after we discovered I was pregnant. It was lucky, and a blessing, to have everything turn out so well. But as many mothers know, the journey did not end there.
There are a lot of reverberating effects of discovering that you are in your third trimester and then giving birth shortly after. I recently read an article about the post-traumatic stress many parents (particularly mothers) experience when they have premature babies, especially when they spend time in the neonatal intensive care unit (NICU). I read this article like it was a revelation; it clicked for me, then, the gradual understanding I've had since giving birth two years ago. It was an understanding that women do not always make immediate recoveries after childbirth. For many women, the effects linger, emotions are confused and sometimes, trauma persists.
The post-traumatic stress for me stems from having a surprise pregnancy, giving birth in a foreign country and having a birth experience that I had no control over. The latter detail didn't become clear to me until I went to a new OB-GYN here in North Carolina. She asked me about how I delivered in Tanzania, and I told her I had a C-section under general anesthesia, meaning I was "asleep" during the procedure. (As an aside, let me just tell you that when an anesthesiologist whom you've just met and can barely communicate with is putting you under general anesthesia in a foreign country to have surgery where your abdomen is cut open, you suddenly become very, very aware that you could die.) The OB-GYN's nurse's eyes widened and she choked up. "Oh honey," she said, in the kind of soft voice you use toward someone who's experienced something traumatic. Her eyes closed and then her voiced steeled with determination. "Next time you get pregnant, you will have the birth experience you choose," she told me firmly and kindly, her hand resting on my forearm. I had to blink away tears, for her kindness and understanding of what truly happened back in that surgery room in Tanzania had suddenly made me realize that I had missed out on so much. I hadn't realized I was allowed to feel traumatized. I had only clung to the belief that I was very, very lucky that everything had worked out. My baby is healthy. She breastfeeds. My scar healed. We made it back to the United States. I should just be grateful. But now I realize I am also allowed to have other feelings, too.
The two weeks that I knew I was pregnant before giving birth were surprisingly enjoyable. Most women in their third trimester, from my understanding, are very uncomfortable and are just ready for their impending arrival. But since I had just discovered I was pregnant, I was hoping the baby would stay in as long as possible. And I finally had a reason for feeling so sick over the last few months (aside from the vicious bacterial infection I'd had). That relief was nothing to forget! And even the slightly more embarrassing pregnant moments were not embarrassing to me. Frank and I went to breakfast at our favorite restaurant in Dar es Salaam, a Lebanese boulangerie called Epi D'or, with our nephew Liston, who was 8 at the time. Midway through my scrambled eggs and toast, I realized I was going to throw up. I knew I would never make it to the bathroom down the hall, and so I pulled up my napkin and quietly threw up into my napkin and onto my plate. Liston stared at me wide-eyed and I worriedly wondered if they would ever let us eat there again (they did, and as far as I know, Liston wasn't scarred by it).
It is well-known that premature babies often have "corrected ages" when considering milestones and growth. I learned that my family had to have a corrected age as well due to our surprise baby. We could hardly adjust to the idea of pregnancy and parenthood before Grace arrived. I now realize the value of nine months of pregnancy; it gives everyone time to adjust and mentally/emotionally prepare. We didn't have that. My parents had to have time to grow into the role of grandparents; my husband and I were thrust into a position where suddenly and quite quickly, our hearts were torn out of our bodies in the form of an infant. It was terrifying and wonderful.
I feel robbed. I feel as if an important moment was stolen from me -- that I missed out on a valuable experience, a priceless chance to understand my body, to treat myself well. Instead, I was running all over tropical Dar es Salaam, sweating and tired and nauseous, in a new country dealing with a foreign bureaucracy. I wish I had known I was pregnant so I could have enjoyed the experience instead of trying to ignore my symptoms. I could have rubbed my belly and tried to get to know my baby. When I saw my family first when I was almost three months pregnant, and again when I was about seven months pregnant, when they came to visit us in Tanzania -- I could have celebrated with them. My aunt died when I was in my second trimester; I regret so deeply that she never knew I was pregnant, that I talked to her over the phone all those times, knowing that she was fading but not knowing about the new family member who would join us.
There are a lot of things I did that I might not have done if I'd known I was pregnant: Traveling to Zanzibar, snorkeling, flying to South Africa and Kenya, traveling by (very unreliable) bus nine hours to remote villages. There was the occasional beer or coffee -- and all the times I pushed myself in the equatorial heat when really I should have been cutting myself a break and resting in the shade.
And while our daughter was very, very wanted, the pregnancy happening in Tanzania was not as planned. I still know relatively little about maternity in Tanzania, except that it isn't great, that death at childbirth is still common, that there are a lot of reasons why my doctor advised me to try to get to Nairobi or even London to deliver. I learned that I was lucky in many ways in terms of my delivery, even if it was not how I would ever have wanted it to go; I had a whole room to myself and there was a spare bed that Frank could sleep on for an additional charge, and Gracie was born healthy and strong (although she was barely 6 pounds, all Tanzanian women there proclaimed her to be a "big baby"). I learned that my C-section in some ways was inevitable, as that is what hospitals there tend to do for Westerners; I learned that I had to advocate for myself completely because my Tanzanian doctor just assumed I would talk to American doctors in the States with any questions.
In fact, advocacy is a huge lesson I learned after this experience. This is especially true because I am a woman, and often society tries to place low priority on our needs. When I was in Tanzania, I just assumed they had given me pregnancy tests because they took repeated urine samples, and in my experience in the U.S., most urine samples are also treated with a pregnancy test. I was naïve, of course, and unfamiliar with life outside the United States. This is not a mistake I'd make again, I vowed. We made the decision to move to Chapel Hill, North Carolina, the town where I grew up. I had always felt strong here, and when we moved back, my daughter suddenly started speaking. Her words just exploded out of her mouth like she'd been waiting all along to speak. It was overwhelming in the best sense, and I knew I'd found a place where we could have a voice. As a mother I must not only be my own advocate, but I must also be an advocate for my daughter, so finding a place where I felt I could do so was important.
We named our daughter Grace, by the way, because to me, it represented a reminder to always treat myself with grace (that is: kindness, mercy, forgiveness) -- and it was my supplication to the universe that my daughter would treat herself with grace as well. Kindness and self-forgiveness are the best balm for trauma, I find. It is with grace that we recover.