The End of the Tunnel

Many people already know that I’ve suffered from (and kicked the butt of) generalized anxiety disorder, panic disorder and ocd since childhood.  I’ll talk about it openly and see no shame in this.  I try my best to not let this interfere with my daily life and, in fact, I feel like my struggles sometimes empower me because I know I can get through anything.  However, after giving birth, I was faced with a whole new, unexpected problem that hit me like a tonne of bricks upside the head and knocked me down for the better part of a year: postpartum anxiety.  If you’re like me, you’ve never even heard of such a thing before.  I suspect it’s more common than it appears but goes undiagnosed or is misdiagnosed as postpartum depression, which is an entirely different beast.  I just want to share my story so that other people know they’re not alone and that there’s a light at the end of the tunnel.

I’d had an enjoyable pregnancy with few concerns (I was that kind of pregnant lady you’d love to hate), my c-section went smoothly, my hospital experience was uneventful, and Jack was a happy, easy little guy.  Of course, there were the regular after birth annoyances like sleepless nights and not being able to find time for showers, but while these normal things were distracting me, this new evolved form of anxiety was drawing ever nearer.   

In the hospital, I was in a ward of 30 women and I was the only one with her baby rooming in.  I couldn’t imagine being away from him for even a second after he was born, but that seemed like a matter of personal choice or maybe a cultural preference.  I was in the hospital for 4 days and, despite recovering from a c-section (including severe referred pain in my shoulder), coping with the never-ending cycle of breastfeeding/diaper changes, and only having two hours a day to visit my husband (because visiting hours here are really that crappy), by far the worst part was walking around the corner to go to the washroom.  I had so many irrational fears about what could happen while I was peeing: someone was going to take him for vaccines and I wouldn’t be there to hold his hand, someone was going to disregard my birth plan and bathe him or give him formula, someone would switch him with another baby and another mom would leave with him but we wouldn’t notice for months or years (this was particularly irrational as he was the only white baby there).  It was always such a relief to get back to my hospital bed so I could be with him again.  Even at the time, I knew these thoughts were out of whack with reality, but rationalized it as crazy hormones running amok.  Really, the postpartum anxiety had started lurking in the corners of my mind.   

After I was released from the hospital, I had trouble leaving Jack, even with Harold (which is ridiculous because he’s the best dad ever).  It got to the point where I had trouble even walking to the other end of the room, let alone shower or take a nap, because I just couldn’t be that far from him.  It was the most intense separation anxiety ever.  Because of my c-section, I couldn’t get on and off the bed properly (it’s a pretty high bed), or lift Jack from the crib.  Not wanting to wake Harold for help every few hours, I created a little bubble where Jack and I stayed in the living room, him in his pop-up travel cot and me on the couch, an arm’s reach away.  This seemed practical and Harold respected the fact that I needed this bonding time.  I felt safe and comfortable with this, waking a million times a night to check his temperature, his diaper, the room temperature, or to make sure that he hadn’t died of SIDS or sepsis.  I figured this was probably fairly normal for a new mom and it was just sleeplessness playing tricks on me.  But this time, postpartum anxiety was ready to pounce.

While Jack nursed one morning, I opened my Facebook to see my newsfeed flooded with images of a drowned little Syrian refugee boy, washed up on the shore.  I could absolutely not handle it and that father’s pain became my own.  I looked at my boy, sleeping peacefully in my arms and that’s when my anxiety finally swept me away.  Actually, I still can’t write about it without crying, so I’m just going to leave it at that. 

After that, my need to be with Jack at all times only got stronger.  I cried in the shower, I freaked out while pouring a bowl of cereal, and I held him close at night, determined to protect him from all that was wrong in the world.  I initially only had ten weeks of maternity leave.  I was still trying to figure out my new role as a mother and I had to go back to work and spend the bulk of my day taking care of other people’s kids instead.  The guilt from that seemed insurmountable so I called my principal crying and told her I couldn’t possibly come back to work.  She was so understanding and supportive and told me to get a doctor’s note for a longer leave.  In the end, I had seventeen weeks, which was still nowhere near adequate, but I was grateful for any extra time I had with Jack. 

At my post-birth checkup at the clinic, I told them about how I was feeling and they set me up with a psychologist at the hospital.  I still go to appointments with her every few months and she has taught me about mindfulness and meditation.   

While back at work, I initially cried daily, while attempting to live in the moment.  I was so jealous of Harold and all the time he got to spend with Jack so I would Skype them and text constantly, wanting to know every little thing.  I spent 2-3 hours a day pumping (and having a love-hate relationship with my pump because I was glad that I could supply for my baby, but hated that it wasn’t directly).  I also resented my job.  Those who know me know that I love teaching, but I couldn’t get into it last year.  I just kept repeating to myself “If I was home, I’d still be on maternity leave.”  Luckily, my co-workers understood this and gave me lots of support. 

Now it has been over a year.  A few weeks into motherhood, a friend (who is not a mother and could not have anticipated how anxiety would take hold of my life this past year, but is obviously incredibly wise) told me that the first year would be crazy, and nearing his first birthday, I'd feel the fog begin to lift and things would start to normalize. She was right.  I had the whole summer off to spend with Jack and if I was at home, I’d be back to work too so I’m feeling much less resentful of my job this year.  I’ve slowly worked my way up to being able to leave Jack, not just for work, but for my own self too.  The opportunities are few and far between (thus is the life of a busy mom) but I now feel like I can go to the spa or karaoke without feeling guilty.  Eventually, I’d like to go back to my writing group, rejoin the choir, or finish my cake decorating class, but I’m not ready to miss bedtime yet though or be away in the evening after working all day, so I know those things will come later. 

For now, the important thing is that I’m finding balance, I’m getting adequate time with Jack while still working (and providing for our family is an important job!), and the anxiety is not gone but is very much under control.  I feel at peace with things.

An April Update (Nine More Beautiful Months)

It’s true what they say, how the days are long but the years are short.  As of last weekend, Jack has now been on the outside longer than he was on the inside.  I don’t know why, but that’s an important milestone to me, like the probationary period is over and he’s really and truly a part of the world.  To me though, he’s not just part of the world… he’s my whole world. 

So what has Jack been up to lately?  Here's a quick rundown.

Jack never really did roll over or crawl but has gone straight to standing.  He cruises along the sides of furniture and can stand, unassisted, for about 30 seconds before he needs to put his hand briefly on the furniture again to steady himself.  He hasn’t put the walking and solo standing skills together quite yet, but I think he’ll be taking his first independent steps within a week (which means it’s time to baby-proof the house.  Uggggh!)

His favourite food is anything with bananas or carrots, but he's willing to try just about anything, so long as it's not prunes or peaches (which is weird because peaches were one of my biggest pregnancy cravings).  He’s allergic to dairy though, as of right now.  That’s supposed to be common in babies before they reach a year, so I don’t think we’ll try dairy again until then because we don’t want a repeat of our poor sick baby. 

Jack loves music.  His favourite songs are Seven Years by Lukas Graham and Stressed Out and House of Gold by Twenty-One Pilots.  He’ll dance and even try to sing along… and when the song is over, he protests until we put it on again (no other songs will do).   He loves going out in his stroller and looking at everything.  He has four teeth, and two more on the way.  He’s 21.7 lbs.  He can say “Mama”, “Dada”, “I love you” and “I love baths” and a handful of other things.  Jack is an affectionate little guy who likes to hug, kiss, and cuddle.  He also has a sense of humour; he blows raspberries on our arms (actually, just on mine) or makes funny faces pressed against his playpen mesh, then looks to us for approval.  He's just started being really shy with people, but he warms up to them quickly.

He’s now met both sets of grandparents.  Harold’s parents were here in November and mine just came over Easter.  He loves them all very much and we’re counting down the days (76) until we can see them again.  

Early Glimpses

I ended up with what I think is an unusually high amount of ultrasounds during my pregnancy.  I didn’t mind though because it was nice to keep an eye on Jack. 

The very first ultrasound was when I was only 5 weeks pregnant.  I had a bit of a scare so we went to the emergency room at the hospital across the street from my building.  The rushed me through triage and did an ultrasound to detect the heartbeat (not even a guarantee at this early stage).  Jack’s heart, however, was pumping strong and steady, safe within me.  It made me cry (along with pretty much everything else I was to encounter for the rest of my pregnancy).  There was no visual with this ultrasound, but I was really sad that Harold was in a different room for the first heartbeat.  The hospital, in a Hong Kong fashion that I have really come to appreciate, erred on the side of caution and zipped me by ambulance to a nearby hospital that has an antenatal ward (the hospital where Jack was born), and admitted me for the night so they could keep an eye on things.  Obviously, everything was fine.  (I went from being at my own home to having a bed at the second hospital in less than an hour.  I really can’t say enough good about the efficiency of the Hong Kong public hospitals.)

Upon discharge, I was put on bedrest for an amount of time I just can’t remember now (again, erring on the side of caution).  I missed two birthday parties and one Christmas party, and went back to work for one day before heading to Canada for the holidays.  In that time, we wanted to see our little guy to make sure everything was still alright and I kept crying because Harold hadn’t heard the heart yet.  Many obgyns here have their own ultrasound machine in their office so I went to my private doctor and had an ultrasound.  Jack was doing great and we could see his little heart beating away.  For anyone who happens to come across this in a web search, if you are looking to supplement your public hospital care with a few private scans and checkups, I highly recommend you go to the New Territories.  It’ll be a fraction of the cost. 

My picture is the one on the right.  I was comparing it to the left one of twins on the internet because I thought mine looked like twins too.  Spoiler alert: it wasn't.

At 12 weeks, we had a standard scan at the hospital.  At this point, we found out that Jack was a boy.  Super early, but super obvious!  I also found out I had an anterior placenta, which means that everything is fine, but the placenta was attached to the front of my uterus instead so I’d be less likely to feel Jack.  However, I ended up feeling my super active boy very early on (I think it was about 14 weeks).   Through the whole pregnancy, except for the last few weeks, I did go for days at a time without feeling him because all the action was cushioned by the placenta.  For some really weird reason, they won’t print out a copy of the 12 week scan for the parents to keep.  However, they do give you an envelope to bring to another area of the hospital, so if you’re really careful with the opening the envelope, you can take a picture of the picture before delivering it. 

12 weeks <3

At 18 weeks, we had another standard scan (this time privately because the hospital was overbooked).  We got to count his little fingers and toes.  <3  The whole session was being recorded but I didn’t realize, so we actually have a video of it.  Unfortunately the video has audio and therefore captured me asking stupid questions that only a derpy pregnant lady would think of like, “Whoa!  Are those his brain waves?” when referring to a close-up of blood flowing in an out of the heart.

Structural scan.  How cute is that femur?

 At 25 weeks, I had some serious cramping so I went to emergency again.  Within about 10 minutes they had me in for a scan and I saw him happily sucking his thumb and hiccupping.  He had the hiccups ALL THE TIME in those days and still gets them quite often.  No pictures of that scan.  

At 30 weeks, we went to Annerley Midwives Clinic for a 4D ultrasound.  We actually ended up going twice (once for free) because Jack wouldn’t cooperate.  He faced backwards so we got a lot of really good shots of his spine, and we must have caught him during his afternoon nap.   The second time, I chugged a lot of orange juice before we went and it did work to make him move around but he was still facing backwards for most of it.  When he turned around, he was playing with his umbilical cord or putting his feet in his face, so we could see his very active personality, but seeing his face was going to be a lost cause.  These were the closest we could get, but they were just fleeting moments.

Only eight weeks to go…

Public or Private

When you find out you are pregnant in Hong Kong, the first thing you need to do is visit a doctor (any clinic or general practitioner will do) to verify your pregnancy and get a referral notice.  The next step is to decide if you want to use this referral notice to navigate the private or public hospital system.  There are pros and cons of each.  You can only go to the public hospital in your region but you can go to any private hospital.  It’s all about weighing those pros and cons and deciding what is important for you and your family. 

 

The hospital I gave birth at, Tuen Mun, has a bit of a reputation for being awful… so much so that people get their utility bills or bank statements sent to a friend’s house so they can register at a hospital in a different region.  Tuen Mun’s bad reputation is a bit outdated.  It is one of the closest hospitals to the Chinese border so it used to be very overcrowded with Chinese ladies wanting their children to be born in Hong Kong.  There are now measures in place so that only Hong Kong residents can give birth at the hospitals here (unless there is an emergency), so the extreme overcrowding is no longer an issue.  I have friends who switched to different public hospitals for other reasons, or chose to go private, and I fully support them.  However, overall, I was pleased with my experience at Tuen Mun and I’d do it that way again.  

As a Canadian, I can’t wrap my head around paying for healthcare, so that was a huge factor for me.  (Prices I talk about are in US $ because that’s a currency most people are familiar with without having to look it up.)  This is just my experience and I know it varies widely between hospitals, and even between patients.  I know everyone has their own reasons for choosing certain things and if the end result is a healthy baby and mommy, that’s what matters.

My view from the hospital

Public Pros

It’s pretty much free.  I paid about $10 US per night in the hospital, and that included absolutely everything (medicine, dr fees, anesthetic, shots, etc.)  I had a few overnight stays while I was pregnant too, and that was also the same price.  All my antenatal appointments were free at the hospital and all Jack’s and my follow-up appointments are also free (including all his vaccinations) at our local clinic.

Top-notch medical care.  Even if you are in a private hospital and something goes wrong, they will transfer you and/or the baby to a public hospital.  Many of the public hospitals are teaching hospitals so the standards are very high. 

Pro-breastfeeding and rooming in with the baby.  There are signs all over the hospital stating how very in support of breastfeeding they are and it really is true.  They had lactation consultants checking on me all the time and the nurses were so excited that I was breastfeeding.  However, the majority of the Hong Kong population still thinks that formula is best so, in my ward of 30 women, I was the only one with my baby in my bed, breastfeeding on demand.  The education on breastfeeding here is somewhat lacking (but this goes for the private hospitals too).  Many women here intend to breastfeed but turn to formula in the first few days because their milk hasn’t come in yet (and they don’t realize that’s normal).  Then when it came time to discharge us, they almost weren’t going to because they said Jack had lost too much of a percentage of his birth weight.  By formula standards, he had, and that is what the hospital goes by in their charts.  I had to prove to them that the stats are different with breastfeeding babies.  Eventually, the nurses brought in a pediatrician to confirm what I was saying and we were allowed to leave.  So while the good intentions are definitely there and breastfeeding is encouraged, a bit of education is needed in this relatively new field for them.  

Public Cons

Very bureaucratic to the point where they have trouble thinking outside the box.  This is just Hong Kong in general, but it’s all the more frustrating when you’re full of hormones.  I needed a c-section for medical reasons and it was very stressful that they wouldn’t confirm it “in case something changes”, despite my condition being chronic.

You stay in a ward with other women and babies after the birth.  This didn’t bother me a bit, but it may bother others.  In fact, it probably did bother the others in my ward because I had referred shoulder pain (common after abdominal surgery) so I spent the first night wailing.  Sorry, ladies!

Not focused on the father’s involvement.  This was probably the most troublesome con.  Fathers can only come in the delivery room when the mother is in active labour and the baby is crowning.  For my c-section, we had a meeting with the hospital staff ahead of time to beg for Harold to come in.  He still couldn’t (because it had never been done before so there wasn’t a protocol for it… see above statement about not thinking outside the box) but we compromised on him coming into the recovery room immediately after.  They also let me bring a CD into the operating room, made especially by Harold as my birthing soundtrack. 

Crowded waiting rooms.  Public system waiting rooms look worse than they are.  They are actually organized and efficient, so you just have to ignore the mass of people surrounding you and listen for the bastardization of your name to be called over the intercom.  “Step Blank”, “Lynn Le Stifny”,  “Father’s name: Stephanie”

The crappiest visiting hours EVER, with only 3 hours at night and 1 hour during lunch.  The Middle East and Asia were having an outbreak of potential pandemic proportions (that never escalated in our area) so visiting times were scaled back even further while I was hospitalized. I hate that they don’t value family time, but we tried to look at my hospital stay as just a few days out of our lives and stay focused on the big picture.  Visiting hours were chaotic anyway, so I can kind of understand not wanting that to happen all day long.

Getting prepped for the c-section

Private Pros

You are the patient of a specific doctor, so you don’t have to explain the same things over and over, or wait for someone to read your chart. 

More personalized service where patients’ needs are accessed on an individual basis

Rooms have been compared to a luxury hotel

There is an ultrasound at every appointment (could be a con though, as you are paying for this and the effect of having so many ultrasounds is unknown).

Private Cons

You know that down-payment for a house you’ve been saving for?  Consider it gone. (Seriously, about $21,000 US, on average)

High pressure to schedule a c-section.  Hong Kong has a very high c-section rate, but in the private system, many patients and doctors alike prefer to schedule a c-section for non-medical reasons.  Also, the threshold at which emergency c-sections happen is a lot lower than other countries because Hong Kongers really like to err on the side of caution.  This can actually be a pro if you really want to schedule a c-section for some reason.
 
Some hospitals have babies stay in a nursery where the mom can only visit at specified breastfeeding times.  I have a friend who had a c-section and couldn’t get out of bed for the first few days.  She had wanted to breastfeed but no one would bring her baby to her and she couldn’t make it to the nursery so the nurses just started giving her baby formula.  Again, if your focus is on getting yourself relaxed and rested, this can actually be a pro.     

So there’s the admittedly biased pros and cons list.  I couldn’t go into too much detail for the private hospitals because I only have other people’s stories to go by.  And I kind of lost steam about halfway through writing this.  

Mommy and Jack, shortly after birth

Welcome to the world, baby Jack!