[encore] When Postpartum Psychosis Hits

Postpartum psychosis is a medical emergency. If you or someone you love is experiencing symptoms, Postpartum Support International's helpline is 1-800-944-4773 (call or text), and 988 is available 24/7.

If you're pregnant, postpartum, or love someone who is — send this to them.

Follow Ayana: @ayanagabriellelage | Missing Me → ayanalage.com/book

The Lindsay Clancy trial has put postpartum psychosis in front of a jury — and in front of everyone's FYP. Millions of people are hearing the words for the first time. We recorded this conversation more than a year before that trial began. While this is an encore episode, we feel like it's an important topic to talk about.

Ayana Lage is a freelance writer, content creator, and mom of two in Tampa. She's also the author of Missing Me: A Memoir of Postpartum Psychosis and the Long Road Back — and one of the one to two women in every thousand who give birth who experience postpartum psychosis. She did it after doing every single thing right. Antidepressant maintained through pregnancy. Therapist. Psychiatrist. Doula. A nurse for a sister. A loving husband. A family that never left. She knew the symptoms of postpartum depression cold. None of it stopped what happened ten days after her daughter was born.

She takes us through all of it: the strange euphoria in the first days, why not needing sleep is the warning sign almost everyone misses, the paranoia, the messages from God around day nine, the moment she told her family to get her to a hospital immediately — and the hallucinations that started the second she walked into the ER. She was inpatient for 17 days at the height of the pandemic with no visitors allowed. Her newborn was 27 days old when she got home. Doctors cycled through medications that didn't work and started discussing long-term residential care and electroconvulsive therapy before an old-school antipsychotic finally brought her back far enough to recognize that not everything she believed was real.

We also get into what came after: the guilt of missing her daughter's first month, taking a full year to feel like herself, and the four-year gap before she decided to do it again — this time with an overnight doula, formula from day one, and her husband on every night feed.

And Zara asks Ayana the question the Clancy case keeps circling and rarely lands on: whether a Black woman in psychosis would be given the same grace as a white nurse in a nice Massachusetts suburb. That answer, and everything around it, is the last ten minutes.

Ayana's memoir, Missing Me, is out now from Hachette. She built it from the notebooks she kept during her episode and from her own medical records — which means it contains the parts she couldn't access from memory alone. It's been praised by Publishers Weekly, Bustle, and the Tampa Bay Times, with blurbs from Kate Baer, Nora McInerny, and Jessica Zucker. If this episode hits you, the book is the long version. Order it here: ayanalage.com/book

This one covers postpartum psychosis, postpartum depression and anxiety, intrusive thoughts, postpartum OCD and rage, birth trauma and emergency C-sections, miscarriage and pregnancy loss, faith and mental illness, maternal mental health care in the US, and what it actually takes to survive the thing nobody warns you about.

Transcript

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Welcome And What Psychosis Means

SPEAKER_00 0:28

Hi everyone, we're here today for a really exciting episode with Ayan Lage. She is a freelance writer, a content creator, and a mom of two. And we are really interested today in talking to her about her experience with postpartum psychosis. She's been incredibly open and incredibly brave about talking about what she experienced after giving birth. So we are just so excited to talk to you today. Thank you for having me. I'm so excited.

SPEAKER_01 0:52

Of course. It's great to meet you. Can you tell us a little bit about postpartum psychosis? What is that? We hear a lot of things in the news, but I don't know if there's a lot of misinformation out there. But what is that?

SPEAKER_02 1:03

Yeah, so postpartum psychosis. I mean, I'll add a disclaimer that I'd encourage anyone to like look it up themselves because I'm no expert at, you know, I lived it, but I'm no expert. What's the condition characterized by delusions, hallucinations? Um basically a break from reality, what you think of when you hear the word psychosis that affects between one and two out of a thousand um women

Introduction to Ayanna's Story

SPEAKER_02 1:24

who give birth. So yeah, it doesn't happen super frequently. I'd never really heard of it outside of the terrible, tragic stories you hear about women who have a break from reality and hurt or kill their children. So I knew of it in that context, but not as anything that would ever happen to me.

SPEAKER_00 1:44

Can you take us back a bit? Because I know that when I read your story, I know you mentioned having a history of mental health conditions. Can you tell us a little bit about kind of how you prepared yourself to become a mom, how you prepared yourself for pregnancy and postpartum, knowing how vulnerable you are mentally in those periods?

SPEAKER_02 2:03

Yeah, I had a long history of depression and anxiety before getting pregnant. So one of the big choices that I made was to stay on an antidepressant throughout pregnancy. And I was just very, I felt like I was very on top of things. I was very aware of postphotum depression, aware of the symptoms, of the risk factors, of the potential for me. So that throughout pregnancy was something that I felt very on top of. I had a therapist, I had a psychiatrist, I had an amazing family, an amazing support system. And so I felt very prepared for whatever was going to come my way.

SPEAKER_00 2:39

Did you always know that you wanted children? Was it something that you thought of for a long time

Preparing For Pregnancy With Depression

SPEAKER_00 2:43

before you decided to have your first?

SPEAKER_02 2:45

Kind of. I I didn't like grow up so much like thinking, okay, one day when I'm a mom, which I know a lot of people do.

Understanding Postpartum Psychosis

SPEAKER_02 2:53

I I knew like innately that like eventually one day this will be what I want to do. So I um so I had a miscarriage before I had my daughter. Um, and so I got pregnant at 25, had a miscarriage, and then had her when I was 27. Um, but yeah, I I had an idea, especially after the miscarriage, of how much I wanted to have a baby. So I was very, very happy to be pregnant.

SPEAKER_00 3:24

Did you experience any depression after your miscarriage?

SPEAKER_02 3:28

Not, I don't know how much of it was grief, honestly. I was in grief counseling for a little bit, but I don't know that it was a diagnosable depressive episode, but I definitely struggled. I had a hard time. I feel like my whole journey with fertility has been a little bit harder than I expected. Just the whole getting pregnant, staying pregnant, giving birth, all of that has just been a little bit more tricky than anyone told me it would be.

SPEAKER_01 3:54

Yeah. And that's why we're here, is because nobody told us how hard it all is.

SPEAKER_02 3:59

Yeah, no, I love it. I love the name of the podcast and I love what you guys are doing.

SPEAKER_00 4:03

Thank you. I think I was obviously familiar with your story, but I didn't know you were so young when you had your miscarriage. I had a miscarriage at 29. And I think one of the things that I really felt in that moment was how isolating it is to have a pregnancy loss or a fertility challenge in your 20s when everybody around you is either actively avoiding pregnancy or getting pregnant immediately, because there is a relationship between age and fertility and age and pregnancy outcomes. Was that something that you experienced as well?

SPEAKER_02 4:36

I definitely felt looking back, I was so young. And so that's what strikes me about the whole thing. Like through that at 25, I'm like, I was, I was just so young. Just that's just all that I can think. But yeah, it was very isolating because I didn't know until I opened up and started talking to people about it. I felt like everyone around me, like you said, either kind of had their happy, perfect family or were well on the way, or were like nowhere near thinking about having kids. So it was a weird time for me overall.

Preparing for Motherhood with Mental Health History

SPEAKER_02 5:10

So I can I can relate to what you experienced for sure.

SPEAKER_00 5:14

Yeah. It's so crazy to me how regionally there are so many differences in timeline. Sam, I'm guessing that for you, it was probably everyone around you was doing it later. I am amazing.

SPEAKER_01 5:26

Her friends are just starting to have kids, and my kids almost five.

SPEAKER_00 5:29

Yeah, and I think I'm probably somewhere in between. I was in Chicago when I was going through the whole getting pregnant and being pregnant thing. And Chicago was very

Miscarriage And The Isolation Of Loss

SPEAKER_00 5:38

much like when you turn 30, you have a child, and you there's mass exodus for the suburbs with everyone in the city, but it's so funny.

SPEAKER_02 5:47

Yeah, I feel like for me, granted, I live in the suburbs. I grew up evangelical Christian, so that definitely plays a role. But um, I had my, I just had my son last year at 31 and having kids, so my second and my last. And I felt I didn't feel obviously 31 is not old to have a baby, but looking around at the people that I surround myself with, I was like, everyone had babies in their 20s. Either a lot of my friends are still at the point where they're like figuring out whether or not I want kids, or they, you know, already have kids. But a lot of my mom friends were done having kids by 30, which I know is like not a universal experience.

SPEAKER_01 6:22

So this makes I I binged mom talk or what the secret lives of more this weekend. I didn't watch season one. I caught a couple of clips and I was not interested, but I had friends who were like, you have to sit down and watch it. I was shocked that some of them had children when they were like 15 or 16, and you have like four kids by the time they're 25. It's so to your point, Zara, the different regions just within the US of how how different it is. Yeah. Um, so you had your second child. Do you have any struggle, mental health struggles like prenatal or postpartum with your son?

SPEAKER_02 6:56

I had a lot of anxiety. I think honestly, I still might have more anxiety than I had before getting pregnant, but I think because the first experience was so remarkably bad that it's still it just paled in comparison. So I felt like even though I wasn't doing great after having giving birth, I literally told everyone I was like, I feel amazing because I, again, I felt so bad the first time. And that was my only experience or reference. So even though the second time was a little bit challenging, I still was so grateful that I wasn't in psychosis again. So, yes and no, I guess depends on how you look at it.

SPEAKER_01 7:33

So, for people who maybe don't know your story, can you just tell us a little bit about that first pregnancy and you know, oh, you realized you were in psychosis because sleep deprivation, I know for a lot of new moms, you start questioning your reality. And so I'm curious to hear it from you for the audience.

SPEAKER_02 7:49

Yeah. So I think the interesting thing, honestly, the dangerous thing with postpartum psychosis, at least in my experience, is that things are weird after you have a baby. You might act strangely, you might be thinking strangely at baseline. It's normal to not feel like yourself acting with a baby. I had my daughter, I went into labor spontaneously at 36 weeks, then I had an emergency C-section. So it was overall a very terrible, traumatic

How Age And Region Shape Parenthood

SPEAKER_02 8:13

experience. So I think that the people around me maybe waited a little bit longer than they would have if I wasn't postpartum to kind of flag or sound the alarm, like, hey, something is might be seriously wrong here. It's all that to say that I was hospitalized 10 days after my daughter was born because of it. I was in a psychotic episode.

SPEAKER_01 8:35

It happened that quickly.

SPEAKER_02 8:36

Yeah. So it does come on very quickly by the time that you are most episodes occur within the first six weeks postpartum. So I was actually with my second child at six weeks postpartum. They were kind of like, okay, this probably won't happen again. So it is usually the first days or weeks of postpartum that someone would experience an episode. So for me, it kind of started a couple of days after giving birth, was first really, really happy and just like feeling on top of the world. Like I remember telling one of my friends, like, why did anyone tell me that giving birth was hard? The first two days I was recovering from the c-section, I was miserable, I was all the things you'd expect to be after kind of a difficult birth. But after a couple of days, I felt amazing. And I started to wonder why people said that my c-section scar was gonna be or my c-section incision, all that was going to be hurting, like why I was gonna be having trouble walking and moving and all of that. So that was kind of where I was at. Uh the big warning sign, I guess, is that I didn't feel the need to sleep. I was just up all night, even when my daughter was sleeping. I was just up. I was on my phone, I was doing different things, I was watching TV, I was sending people pictures of my daughter. I was just kind of living my life. But things took a turn probably around five days postpartum. I started to have really

The First Signs After Birth

SPEAKER_02 9:53

weird big mood swings where I was hurled into a ball on the ground, like crying, and then I was totally fine. And again, I think that for the people around me, this amazing support system that I have, so much of so much can happen postpartum. No one's thinking, okay, she needs to go to the hospital because she's crying. So again, it was just, I think, chalked up to maybe this is a depressive episode, maybe there's something weird happening, but no one knows. So my behavior just became more and more erratic. I got paranoid. I didn't want anyone around my daughter but me.

SPEAKER_00 10:27

Iron, right? You didn't want your head.

SPEAKER_02 10:29

Yeah, no one, I didn't trust anyone. And I just had like a deep feeling that some a deep kind of deep down feeling something bad was going to happen to her. And then around eight or nine days postpartum, so leading up, the hospitalization is kind of on the horizon because things were getting progressively worse. I started to hear messages or say that I was hearing messages from God. And that was, I think, the um point where things just took a turn very rapidly for the worst, some the worst. I don't know, I just was kind of losing control of my grasp on, you know, reality. So I think once I started hearing messages, I um I my family realized okay, something is seriously wrong. They took away my phone, they didn't allow me to be alone with my daughter. Um, so I kind of was in this weird limbo where

The Onset of Psychosis

SPEAKER_02 11:22

I was seriously experiencing something, but they didn't know what to do. And then so for context, I had my daughter in August 2020. So this was the peak of the pandemic. So I'd been hospitalized before for mental health reasons and had a very traumatic time. And I think that my husband especially knew that if I he felt like I would never forgive him if they took me to the hospital and I couldn't see my daughter because of pandemic restrictions. 10 days postpartum, what mother wants to be separated from their baby? But um, I suddenly, again, I was pacing the house, just very louding things, very erratic. And I remember all of this. And I had a moment where I said, I need to get to the hospital right now. And I said that out loud. And I think because I was all over the place, my family was like, Okay, you're gonna be okay. We're gonna, we're gonna talk to your psychiatrist, we're gonna work on medication, all that. And so I said to them, I'm going to kill myself if you don't take me to the hospital right now. I'm going to kill myself. And obviously, I think that that just something just changed in that moment, and the like severity of the moment became very clear. So they rushed me to the hospital. And once I'm in the ER, that's the moment that I start to hallucinate. So I honestly look back at that and I always say that it felt like, you know, God, the universe, fate, something in me knew that things were about to get much worse and that I couldn't be at home when things got bad. And maybe that's just me romanticizing the situation. I mean, I wasn't completely coherent, so who knows why I said it. But once I got to the hospital, I immediately was just completely incoherent, not at all aware of what was happening around me. And then, as I mentioned, hallucinating. So they sedated me when I got to the hospital, and then I basically woke up in the psych ward.

SPEAKER_01 13:05

Well, what were the hallucinations like? I've only ever

ER To Psych Ward Treatment Choices

SPEAKER_01 13:08

hallucinated on like mushrooms, so imagine it's a pretty different experience.

SPEAKER_02 13:12

I mean, so I've never I've never done any sort of drug that would cause hallucination. So I can't compare it, but I I mean how people describe like a bad trip, I imagine that that's probably similar to what I was feeling. The voices of everyone around me were distorted, their faces were floating in the air. It's even hard for me to remember or explain.

SPEAKER_01 13:30

Shadows and things.

SPEAKER_02 13:31

Yeah. I was just, I was just, I felt like I was in a horror movie. Oh god.

SPEAKER_01 13:36

Your intuition knowing to take you there. I I feel like our intuition is really, really strong, especially women. Um, to just know, hey, I have I have to do that. How long, how long were you in the psych ward? So and was your daughter allowed to visit?

SPEAKER_02 13:50

No, no visitors. Yeah.

SPEAKER_01 13:53

What did they did they diagnose you with anything there and try any new medications?

SPEAKER_02 13:58

They cycled through a lot of medications to try to stop the psychosis. Um, and it just nothing was working. So they were starting to consider the long-term residential situation or electro, god, I don't remember the official term, but electro therapy, electroshock therapy. And then they tried me on an old school antipsychotic called Haldol, that they put me on a ridiculously high dose of. My psychiatrist says, Yeah, this is the highest dose I've ever seen of someone on this medication she's been practicing for a long time. And then that was enough to not even fully break the delusions, but to bring me back enough that I was able to recognize, okay, some of this isn't true. Not everything that I've been feeling or saying is true.

SPEAKER_00 14:41

Wow. Is this something that always requires treatment, or are there cases where it kind of resolves when your hormones begin to stabilize?

SPEAKER_02 14:50

I think so. I mean, it's considered considered a medical emergency because specifically because of the danger that women pose to their children in that period. So I mean, I think maybe it can resolve without

Hospitalization and Treatment Journey

SPEAKER_02 15:01

medication. I mean, I'm not honestly sure, but I think that because you have no grasp on reality, if if your voice telling you to hurt your child, then I mean, you you know how the story ends. So I mean, I think that it's recommended or strongly, strongly said, to take someone to a hospital to receive treatment if you expect post-warum psychosis.

SPEAKER_00 15:23

I just keep thinking about how dangerous the lack of surveillance around new mothers is. So many cases, our partners are back at work, right, without paternity leave. The village hardly exists anymore. And as we talk about culturally, there is such a focus on making sure the baby is okay that no one's really looking out for the mother. And in, you know, stories like this, it just shows how dangerous that can be. But also, I mean, how lucky are you that you had people around you who were able to kind of hold you in that moment, right?

SPEAKER_02 15:54

Oh, yeah. I mean, my psychiatrist has told me you were the perfect example of someone who should not have been hospitalized after giving birth. I had a doula, psychiatrist, therapist, my sister is a nurse, you know, my parents are very involved, my husband is very involved. We had extended family, friends. There was nothing else that I can't think of anything, any other resource that I could have had, which is unfortunately not the case for most new mothers. So I think how much more difficult would it have been to go through this without the support that I had. Even um, this isn't a funny story, but it's just something that I always kind of go back to is that I found out after I was released that my dad had catered meals sent to both the day shift and the night shift, the hospital, because they were worried that I wasn't getting the care that I needed in a psychotic episode. And he said, People started returning our calls fast after, which is terrible. It's terrible. But I also like having people around me and in my life who were so involved and so concerned that they were brainstorming, what can we do to make sure

Support Systems And Intrusive Thoughts

SPEAKER_02 16:58

that they know that she has people who are in her corner, who love her, who are waiting for her to get home. Not everyone has that a lot. So it's it's I can't think of how much worse it would have been if I didn't have the situation that I'm in.

SPEAKER_01 17:12

I think like your case is obviously very extreme, right? Psychosis, but I think a lot of women, I know myself, there's a very fine line between the intrusive thoughts that you get and like how how close that can get you to the line of I remember being so anxious with my son that one time I was like, I can I can't watch him alone. I didn't think I was gonna do anything, but I was so scared I was going to. And it's like this really weird thing. And you're like, why, why do I think I'm gonna do something that hurts him? Like, I think a lot of women feel that way and nobody talks about it because I remember feeling very much like if I tell anyone that I'm having weird thoughts, they're gonna take away my child, and that's you know, and I I'd be, yeah. Have you heard since you've come out with your story? Have women told you similar things where they had weird thoughts too?

SPEAKER_02 18:02

Yeah, I've heard from a lot of people who were diagnosed with post-horm psychosis, which has been honestly just so great. I can't think of another word to know that I'm not the only one out there. After I had the episode, I joined Facebook groups, I read books, but having people directly message me to say, hey, I also went through this and I'm okay. My kids are adults now, or I had subsequent pregnancies were totally fine. That was so helpful for me to hear. But I've also heard from people who suffered from postpartum rage, postpartum OCD, all of these conditions that we don't know anything about. To your point about intrusive thoughts, if you are suddenly picturing what if I hurt my baby, then you think, oh my God, I need to be locked up. Who, what kind of mother would think about hurting their child? You know what I mean? So even apart from psychosis, there's so many things that you can go through that we just really don't talk about.

SPEAKER_00 18:53

Yeah. Even the the not sleeping, how you expressed that you really just felt like you didn't need to sleep. Did people chalk that up as just adrenaline?

SPEAKER_02 19:02

Yeah, I think that again, you get a lot of this is good. You get a lot of leeway as a new mother. In my case, it was not great because I think that I would have been hospitalized sooner had anyone really stopped to think, okay, this is really out of character for Aano. Something just doesn't feel right about this. I I mean, I don't fault my loved ones because after a baby, you're all over the place and you've got postpartum blues, you've got the hormones coming down, you've got sleep deprivation. So I think that yeah, I um I think that everything could easily be explained away until it couldn't.

SPEAKER_01 19:42

Do you know if this tends to psychosis impacts women who have c-sections more frequently, or is there no probably no studies on it? But do you know anything about that?

SPEAKER_02 19:52

I don't know. I know that I read something about traumatic birth experience can be linked more to postpartum mood disorders. So yeah. Um, so I mean right. I know three types of in your head.

SPEAKER_01 20:05

Yeah, you know, it yeah, it all varies, right?

SPEAKER_02 20:07

Yeah. Yeah.

unknown 20:10

Yeah.

SPEAKER_00 20:11

Do you know how rare postpartum psychosis is? Do you have any stats kind of off the top of your head?

SPEAKER_02 20:16

Yeah, so it's one to two out of um a thousand women who give birth.

SPEAKER_00 20:22

That's not terribly rare. Yeah. I'm sure postpartum depression and postpartum anxiety are far more common, but the amount more attention that we give those conditions culturally versus psychosis is it can be dangerous, right?

SPEAKER_02 20:39

Yeah, you know, I think that if you hear of a one in one thousand chance of something bad happening, you feel comforted. I mean, I would have felt comforted.

[Ad] Smells Like Humans

SPEAKER_02 20:47

Even when I had my miscarriage, I miscarried at 13 weeks. So the risks of miscarrying were very, very low. And I felt comforted by that statistic until I wasn't anymore. You know what I mean? So it kind of just reminds you that these things can happen to anyone at any point. You know, none of us are really immune from just having really bad luck.

SPEAKER_01 21:08

Yeah,

Preventing Recurrence With Sleep Planning

SPEAKER_01 21:08

yeah. For for your second pregnancy, you you mentioned you struggled with some fertility. Did you have secondary infertility?

SPEAKER_02 21:16

Nothing diagnosable. Honestly, it wasn't, it wasn't really, I shouldn't have probably used the word fertility. It was just more so with my daughter trying to have a baby after the miscarriage. It was just every period just felt like a reminder of I should be this this far along, and I'm not, and I didn't get pregnant this cycle.

(Cont.) Hospitalization and Treatment Journey

SPEAKER_02 21:36

So it didn't take a terribly long time to get pregnant the second time around. But I think that I just felt like it was so unfair that I wasn't pregnant at the time that it had a really big impact on me.

SPEAKER_01 21:48

Yeah, that makes sense. And so was there a difference between your two pregnancies once you um between your son and your daughter, I should say, um, that you felt like was one easier, one harder?

SPEAKER_02 22:02

I think that my second or my third pregnancy, right, with my son, my second child, was I had a lot of worry about postpartum psychosis that I, you know, so with my daughter, I was, as I mentioned, preparing for postpartum depression and thinking about it, but it was still this very far off. You know, there was no recurrence rate for me to think about. There's no me having an existing child who relied on me thinking. Thinking what will happen if something bad happens again and I have to leave her. So I think that I was just really, really anxious about all of the things that could go wrong. I um I prepared with my son as much as anyone could ever prepare for anything. So I think that I felt comforted by that, but then also so much is out of your control, um, just in life, but especially with pregnancy and childbirth.

SPEAKER_00 22:50

What do those recurrence rates look like?

SPEAKER_02 22:53

Gosh, um, I don't know off the top of my head. I want to say fine. I want to say 50 up to 50%, but don't quote me on that.

SPEAKER_00 23:04

Was there anything you did specifically to try to mitigate that risk?

SPEAKER_02 23:08

So the big one was that we hired um an overnight duo, an overnight help to watch the baby so that you know we could sleep. And then my husband handled all of the night feeds for the first month so that I could sleep uninterrupted. Honestly, my most well-rested month ever was the month after giving birth to my son because I wasn't getting up for anything at all. Um, and then I also didn't try to breastfeed, which I think I went straight to formula, which I think was really, really good for me. I struggled to breastfeed with my daughter, and I don't think it contributed, but it was just another added stressor that um I'm glad I didn't have to worry about the next time around.

SPEAKER_00 23:49

Yeah, and I think we also don't know enough about what the hormones of breastfeeding do to incidences of perinatal mood conditions, right? I don't think we really have any information about that.

SPEAKER_02 24:02

Yeah, yeah, no, it's definitely something.

SPEAKER_01 24:05

I'm now in a rabbit hole about postpartum psychosis episodes and like things that they say um are common. And it says women who have a sister who has bipolar are 10 times more likely to have a psychosis,

Recovery and Rebuilding Relationships

SPEAKER_01 24:18

postpartum psychosis, which is interesting. And people with bipolar. Yeah, so it's it's interesting because it's even with the studies. I had HG, which obviously is very different. No, and not even in that place, but there's just such little research on, and I know Zara had PUP, which I had never heard of before, I didn't know what any of this stuff was. There's just so little research that when you see these things, it's like, oh, well, it's caused by this. Oh, well, it's this, and there's no real true answer.

SPEAKER_02 24:45

Yeah, it's very discouraging, even with like the recurrence rate situation. Yeah, this study found this, and this study found that. I mean, for me, just knowing that it could happen again and that it was more likely to happen again was enough for me to freak out a little bit.

SPEAKER_00 24:59

Yeah. Did you wait a while between your two kids? You didn't need time to sort of wrap your head around everything.

SPEAKER_02 25:06

Yeah, there was a there's a four-year gap between my kids, and um, I wasn't sure that I wanted to have another just because of everything. And so for the first two years or so after having my daughter, I was very much like, you know, I'd always thought that I wanted more than one child, but if I didn't have another child, I would be fine with it because I just I didn't enjoy pregnancy. You know, childbirth was very stressful, and which I mean it always is, but with the emergency C-section, her being born early, then postpartum was hell.

SPEAKER_01 25:36

What finally got you over the hump to have another one?

SPEAKER_02 25:39

Honestly, so cliched. I think it was just time and me feeling like, okay, I I could prepare for this, you know. I I um it's possible for me to for there to be a good outcome for me to picture like a situation where things work out for the best.

SPEAKER_01 25:59

That's awesome. I'm so glad that it did. Is your work situation different than it was when you had your first one? Do you have a different job or different type of work?

SPEAKER_02 26:07

No, it's actually the same. So I'm still um self-employed. A little bit of this, a little bit of that, as anyone who's self-employed knows.

SPEAKER_01 26:14

Zara and I know a thing about that, the mental fortitude that you carried through. I have to acknowledge that because to me, that is just you're so mentally strong. I'm sure people tell you this all of the time, but um, I'm really curious what motherhood has looked like for you.

SPEAKER_02 26:30

In the first year or so with my daughter, it was really difficult. I resented myself for missing her first month of life, basically. And then when I got home, I had to recover, which was a month-long process. I didn't really, which I know it's normal to not feel like yourself until you're, you know, however long postpartum, but I truly did not feel anything like myself until over a year. And so I felt like I'd kind of blacked out a little bit and not given her the experience that I wanted her to have. So that was really difficult. But overall, I mean, I think that motherhood has been more enjoyable than I expected with all my anxieties and just thoughts about all the things that could go wrong. Overall, most things have gone right. And I try to remember that.

SPEAKER_00 27:14

When you came out of the psych ward, were you was that an adjustment to kind of get to know your daughter over again after those 17 days?

SPEAKER_02 27:23

Yeah, for sure. I mean, I was still heavily medicated, so that was a problem when it came to lynching normally. And I um, she was obviously seven days old when I when I got out. Um, and I definitely

Rebuilding After Psychosis And Shame

SPEAKER_02 27:38

felt like everyone else around me kind of had a bigger or more significant connection with her than I did, which wasn't necessarily true because she was a literal newborn baby with no grasp on any of that. Yeah.

SPEAKER_00 27:50

Just a little potato.

SPEAKER_02 27:52

Yeah, I think I was still really worried about what my separation might do to her long term.

SPEAKER_00 27:58

Did you, you shouldn't, but did you blame yourself at all? Did you feel any guilt or any shame around that?

SPEAKER_02 28:05

I did. I think that I kind of it was in therapy that I had to accept that, okay, if you want to be a parent who protects your child, what can you do in that situation other than remove yourself? You know, if I'd stayed, anything could have happened. I never had any voices or messages telling me to hurt my daughter, but I think that I could have possibly tried to hurt anyone who I felt was going to hurt her.

unknown 28:30

Yeah.

SPEAKER_02 28:30

So it just would have been a really bad situation. So I kind of try to remember that. In what world would I have been able to say? It would have to be an alternate universe.

SPEAKER_00 28:39

Yeah. And I keep thinking about parents who have NICU babies for a 17-day or longer period. I do think that when you have a NICU baby, there is a level of guilt and shame too, because you feel you failed in some way. But I don't think it's to the level that maybe you experienced. And it just says so much about our culture where it's okay if you're doing something to take care of the baby, but we have this idea that when you become a mother, it's not okay to do something to take care of yourself. Yeah. And I think your story is such a powerful example of how taking care of yourself is taking care of your kids, right?

SPEAKER_02 29:15

Yeah, for sure. I think that I had no choice but to put myself first, which was it as a mother, you sacrifice. And I don't, I a lot of that is true, but I also think that we can glorify the idea of giving all of yourself for your children until there's nothing left. And so I was forced to learn that lesson very early on that sometimes you have to come first.

SPEAKER_01 29:38

Yeah. Did you have a V back or did you have a scheduled C-section for your son?

SPEAKER_02 29:42

I did a scheduled C-section, and the main reason for that was that I wanted as few unknowns as possible.

SPEAKER_03 29:48

Totally. Yeah.

SPEAKER_02 29:49

So I was worried about sleep deprivation. If I did end up with a really long labor, I was worried about another emergency C-section. And so yeah, I struggled with the decision to have a repeat C-section, which is so silly to struggle with, but I still felt like I might be making the wrong choice. But it was definitely the best thing I could have done.

SPEAKER_01 30:10

Zara and I are both C-section moms, and I remember having so much shame. Like, why I read Aina May's book that was like, just loosen your sphincter and you'll be fine. And I remember having so much shame. Like, why couldn't my body do this? And so it's like no matter what happens, whether it's an emergency section or planned one, or there's always something, or if you do give birth

Decision to Have a Second Child

SPEAKER_01 30:32

vaginally and something goes wrong. But I have heard women who have a planned c-section, it tends to be less traumatic. I don't know if that's true or not, but anecdotic and how do you say that word? Anecdotally Zara, yours was yours was planned and then not, right?

SPEAKER_00 30:51

Mine was yeah, planned and then it just happened earlier than was planned.

SPEAKER_01 30:55

Yeah. Um is there anything that so your recovery obviously was different mentally after your second birth, but physically, how was that recovery from that second c-section?

SPEAKER_02 31:08

So interestingly enough, it was worse than the first time around, only because I think there was so much going on. And then obviously I was in the state where I wasn't feeling any pain and felt invincible. So physically, the first time around, I don't the first two days I remember it being really, really difficult post-c-section. And then I have no recollection of the pain because yeah, it was just very low in the totem pole of things happening. But I emotionally I definitely felt just more even keeled and just more ready. So that was nice being able to prepare and have all the c-section recovery pillows and you know binders and all of that ready so that way I didn't have to I didn't feel thrown into it. I felt like okay, I know what's coming.

SPEAKER_01 31:50

Yeah. Yeah. I Zara, how was your recovery? Was your recovery?

SPEAKER_00 31:55

I don't really remember. Yeah. I think that's relatable. Yeah. I don't think it was as painful as I thought it was gonna be. But I think similar to you, I think it the pain was kind of low on the totem pole because I I had a very complicated postpartum. I think that that in some ways, I was like, I don't, I'm not even worried about my incision right now. Yeah.

SPEAKER_01 32:18

I remember I had to get a stool to put my kid in the crib because I did not know until he was out of his crib that they drop down and come up. Like we had I had no idea. So I had a stool, and for the first few days, my husband had to put him in because I couldn't, I'm very short and I couldn't put him in, and I was like, this hurts so bad to put him in. And then so for anyone listening, those cribs go up and down. I wish I would have known that.

SPEAKER_00 32:43

I think we're all very short in this conversation. Really? Yeah.

unknown 32:47

Yeah.

SPEAKER_00 32:47

I I feel like we talked about this actually last time we spoke, Ayana. Yeah. Are you? I'm five-one. Yeah, I'm five two.

SPEAKER_02 32:55

So we're we're in it together.

SPEAKER_01 32:57

I like to say I'm five three, but I'm five two and a half. Probably shorter since pregnancy. My feet got bigger and I got shorter. How has how has your relationship been with your husband through all of this? I mean, you guys have been through so much, I don't know how long how long were you together, and did you have a solid foundation? I just asked you like 15 questions in one.

SPEAKER_02 33:13

No, it's fine. I can answer, I'll answer them all in a couple sentences. So my husband and I are going on 10 years of marriage. We got married when I was 22, which is like kind of wild. I don't know that I'd recommend that to like as a general rule, but it worked out for us. So we've basically been together our entire adult lives. And he um was just incredible throughout all of it. Um, he basically raised our daughter for the first, I mean, I would say three or four months without very much help from me. So I definitely feel felt so grateful and so appreciative and and loved him even more because we've been through so much together. Um, so yeah, I think that also I can't honestly, like this is kind of I don't know, it's probably easy to say because no one will ever be in this position. But I think that I rather be in the hospital or in his position, knowing I'm in the hospital and not knowing if I'll get better. Honestly, I think I would have rather things stay the way they are because I cannot imagine how excruciating it is to kind of not be able to see your spouse or your partner know that they're in a psychotic episode and have the hospital telling you they may need to be transferred to a long-term care facility. Um, I I don't know how I would have done that. So I not that, you know, not that it has to be either or, but I he was in a really I was in a bad position, but he was in an even worse position, in my opinion. So I really admire him for that.

SPEAKER_01 34:42

Yeah, I can't imagine that either, being told your spell you have this brand new baby. Yeah. And the how, because I know they put you on that high dose of medication, but that's a pretty stark change from being like she's gonna need to go to a long-term residential facility. How quickly did that happen between those two decisions?

SPEAKER_02 35:00

Well, I think that their whole thing was that if the medication doesn't break the delusions, then the next step is going to be got it, the shock therapy. And then I think that that was also hand in hand with the long-term care because the psych ward is not designed to care for someone for weeks and weeks and weeks and weeks. So I think the mentality, at least the one I was in, was more of an emergent. I mean, most of the people were there for only a couple of days. Um, and you know, in and out, in and out. So I was there for longer than most of the patients that I was with. So I think they wanted somewhere more equipped to care for me long term if I needed that. But when I got home, I still wasn't well, I don't think. Just looking back at it, I think I still there were delusions from the hospital that I still couldn't shake, that I still had

Motherhood After Trauma

SPEAKER_02 35:41

a kind of just nagging feeling of, okay, this might have been true. Someone could have been trying to hurt my daughter. I don't know, no way of knowing for sure. So I had some of those moments where I still wasn't 100%, but I was able, and my psychiatrist tells me that this is a sign that I was got better because I didn't tell anyone that I was having delusions. So she was like, There was a part of you that recognized, okay, this might be irrational. I'm not going to shout it out. Um, at one point I remember I wrote a note to myself toward the end, and I was like, I need to shut up. I need to stop talking. And that honestly helped me get out as well.

SPEAKER_01 36:19

Interesting, just being like, nope, we're not gonna entertain that. It is hard though, because it was telling Czar this last week when I was postpartum. We had just gotten moved into a new house. We got new blinds in the house, and when I got home with my baby, I realized they all had the cords on them. And I was like, oh no, that's not gonna happen in my house. And I told my husband, I was like, replace all of these now. And so he did. He got somebody in there to replace them all. And I mean, that's actually a pretty big hanging threat to your child as they get older. I think it was once he once he started crawling, that's when we replaced them. But I think there are so many threats that we see as mothers, especially, and it's hard to distinguish. Okay, this is a real one, so it's really good that you had the people in your life to help you distinguish. For me, I had my husband being like, Oh, yeah, that is a pretty big threat. Let's get that, let's get that fixed. Just yeah, another funny one that I had. I don't know if you guys will think this is funny, but I am a 90s baby, so I'm 41, so I am or an 80s baby. So I grew up in a time where a lot of the movies now, as I'm going back and watching them with my son, they have instances of babies getting stolen out of windows. And I never realized that. But so after

Race Privilege And Public Empathy

SPEAKER_01 37:23

I had him, I refused to let anyone have a window cracked. We had to get an alarm system, we put door things, and my husband's dad was the same way, so he was like, Oh, this is normal because you always have to have it. And so, but his sister was like, You guys are crazy. What is wrong with you? No one's gonna steal your baby from the window. You're on the second floor. I'm like, but they could. And then once we start watching movies, I was like, ah, this is where it came from. And there was a case of a girl who was my age getting abducted through her bedroom window. I don't think it all played in.

SPEAKER_00 37:50

When a lot of us think about postpartum psychosis, we think about Lindsay Clancy.

SPEAKER_03 37:54

Yeah.

SPEAKER_00 37:55

Who the woman who I think she was in the Boston area and she killed her three kids in an episode. And I believe she sent out the window.

SPEAKER_01 38:04

The one who sent her husband to go pick up food or something like that was fairly recently. Yeah.

SPEAKER_00 38:08

Yeah. And I think I remember at the time really feeling like we, as we should, gave her a lot of grace, right? I think we were able to understand that something was going on that was just completely out of her control. But I really wondered what would have happened if she had not been a white woman. And I wanted to ask you, as a black woman, have you felt that you are more vulnerable to stigma and to criticism with everything you've been through?

SPEAKER_02 38:37

Yeah, I think that I got lucky and that I have a pretty, I mean, I don't want to say inspirational, but a pretty linear story, I guess, of like I got sick and then I got better and nothing really bad happened. But I mean, yeah, I mean, to your point, I think that a white woman living in, I think that it was a wealthy suburb, but if not, a very nice suburb in Massachusetts who's a nurse and who has kind of all of this going for her is going to elicit more sympathy because I feel like people feel like, oh, I can see myself in her in a way that a white woman may not feel that way about a black poor woman unless in the same situation. That was a really interesting, heartbreaking case. Even now I think about her, and because I think now she's injured still. I think she might be paralyzed, or because she jumped out of a window after. And so just and I think New York magazine, this is a tangent, but just did uh it was one of those, either New York magazine or the New Yorker did a profile on her husband, and it was just so heartbreaking just reading uh his perspective and how he's handling everything. But yeah, I definitely feel like the more privileged you are, the the more slack people are gonna cut you.

SPEAKER_01 39:50

Yeah. When I was growing up, Andrea Yates, I don't know if you've ever heard of Andrea Yates, but she was not given any grace. I think this is before we knew anything about postpartum psychosis or because she was also very religious, right?

SPEAKER_02 40:03

She was, yes.

SPEAKER_01 40:04

Interesting. Um I'm so I'm so glad that you've shared your story. I have sent it to a few friends who are planning to get pregnant, um, where I'm just like, hey, keep this in mind. Like, and I think the more we talk about all this stuff, the more people around someone going through this can be prepared and know one of the signs. Cause I think I I wouldn't have known like what is going on.

SPEAKER_03 40:28

Yeah.

SPEAKER_01 40:30

Yeah. Um, we have talked about a lot of really, really heavy stuff today. So, and I again I thank you, but on the other side of it, um, what is an unexpected joy that motherhood has brought you?

SPEAKER_02 40:46

Honestly, I think I'm surprised. This is gonna sound bad, but I think I the part of me is surprised at how much time I love spending with my kids because I think that beforehand just being around other people's children and

Unexpected Joys And Parting Advice

SPEAKER_02 40:58

like I was never a kid who babysat or anything, as I said. Like I never felt maternal. The first diaper I changed was my daughter's in the hospital, a nurse had to show me. So I think I had this fear of whether I was gonna be good at it or get bored of it or burn out, and obviously all of those things are very real realities that I've lived. But yeah, especially having two kids now, it's just it's a lot of fun. And I look forward to my evenings and my weekends in a way that I didn't expect to. It's just really lovely.

SPEAKER_01 41:26

That's awesome.

SPEAKER_00 41:28

Yeah, I love that. And then if your if a friend of yours came to you and said, I am about to have a baby, what advice would you give them? What's one thing you wish you had known before you had your first?

SPEAKER_02 41:40

I'm very passionate about this. And that is to take time for yourself, which is a privilege, and not everyone has a supportive partner or people, you know, a village, as you mentioned. But if you have the opportunity to do something for yourself by yourself, go for it. Like the guilt is um so easy to fall into, but I um I feel like I have never really I mean, I've struggled with it and I do feel guilty sometimes, but I have made a point to like one day a week I go to lunch by myself and it's just completely glorious and silent and it's just great. And then I'll take weekend trips with my husband or go on girls' trips, and I feel like that has helped me be as well-rounded as I feel that I am when it comes to parenting, um, that I don't routinely feel like exhausted by it just because I have opportunities to recharge. So again, I know unfortunately not everyone has the ability or opportunity to do that. But if someone says, Hey, I'll watch the kids, go do this, I would say if you have the desire to do it, just to do it.

SPEAKER_01 42:46

Yeah. Yeah. I agree that I think that's great advice. Even if it's I'll watch the kids, you go upstairs and nap. Right.

SPEAKER_00 42:54

Yeah, it doesn't have to be big. It doesn't have to be big. But yeah. Yeah, go watch a reality show upstairs. Yeah. I got the kids.

Unexpected Joys and Lessons Learned

SPEAKER_01 43:00

Yeah, exactly. Well, Ayana, thank you so much for sharing your story again and thank you for being here and taking the time to chat with us.

SPEAKER_02 43:08

Yeah, thank you so much. Thank you.