Coming Apart
by Emma Dwyer
Being pregnant was something I had always wanted, without really interrogating why.
I remember the pain in the months of negative tests, unwanted blood on my knickers. When I peed on a euro saver paper test and it said it was positive, I didn’t believe it. I scoured the internet to find the answers I wanted: missed miscarriages; chemical pregnancies; evaporation lines; no such thing as a false positive. I kept the small slip of paper and examined it for the next day or two—it stayed positive. I bought a more expensive test and got the more expensive confirmation: pregnant.
During pregnancy and the post-partum period a mother’s brain has increased plasticity. There is a massive restructuring of grey matter volume. The amygdala, hippocampus, and prefrontal cortex change in volume and thickness. These regions are linked to the socio-emotional processing and regulation of stress, critical for establishing maternal abilities to care for a new born, as well as ensuring the baby doesn’t get rejected.
Over the next few weeks, turning into months, I had nausea and intense fatigue. I was living in a house share with friends, and I started to retreat. It felt so abstract. A small bundle of cells was growing inside me. As my body started to change, my life started to strip away. I moved to Cobh in Cork to live with my boyfriend Andy. I lost my job and moved to freelance work. I was isolated from family and friends. Then the things that were important to me started to change.
As my body started to change, my life started to strip away
I became determined to live a zero-waste life—I bought second hand cloth nappies, I ordered organic veg boxes, and tried to rehome stuff that I thought was no longer necessary. I was influenced by mothers in a Facebook group selling second hand organic cotton baby clothes which I became addicted to buying. It was adjacent to a gentle parenting group, a baby wearing group, and an extended breastfeeding group. I found a gentle birth podcast and listened to this daily while looking at the sea from our sitting room window. I dragged myself up a hill in Cobh to a coffee morning to ‘find my tribe’ but was disappointed to talk only about parenting, kids, creche places, and boobs.
Pregnant women experience heightened psychological vigilance to threats, which is echoed by heightened neural reactivity to threats. Hyper-vigilance to threats also increases the risk of excessive anxiety and in turn perinatal mood disorders.
She didn’t want to come out. She was due on April Fool’s Day, and there was no budge
My pelvis began to separate earlier than it needed to and I couldn’t walk further than a kilometre without being in pain. I was told I had a common condition, symphysis pubis dysfunction – SPD – and that I needed to keep my legs together as I got off the bed or out of the car. I felt like if I went too far, I could crack my pelvis apart. My movements became small and controlled. My face was bigger, my lips were swollen and the stretch marks were snaking across my thighs and stomach. I felt stuck, immobile, and began to get soft where previously there was muscle.
She didn’t want to come out. She was due on April Fool’s Day, and there was no budge. The hospital appointments increased from once a week to every two days. They booked me in for an induction. I went in on a Sunday and she was born on the following Wednesday. It was not gentle. It was a three-day drug filled bender: I was given pethidine to sleep, nitros oxide for the pain, and an oxytocin drip to ‘move things along’. They tried to break my waters twice and I got sick on Andy’s shoes. On one of the many internal examinations, I was contracting, and the consultant told me not to be a martyr and to get an epidural, so I did.
In a small sample of mothers, the overall brain size and volume decreased throughout pregnancy and was at its smallest at the time of birth.
I felt like I had lost, like I had failed. The midwife on the delivery ward when I finally made it there on Tuesday night asked me what my birth plan was; I said it doesn’t matter now and blinked away the tears. When the epidural was done, I sat up and had a cup of tea. The midwives kept track of heartbeats and contractions on monitors, and I snacked on fruit bowls from Tesco while Andy held my cup of water. They told me to push. I had practised this in the months before—I was going to breathe her out—but they told me to hold my breath and brace down. After about 40 minutes of this, her heartbeats became erratic.
They quickly took her away to examine her, cutting the cord before I could say I didn’t want them to
I was cut open and told to push again. There was a pressure. What was happening? Why did I feel like I was coming apart? Her head had come partially out— they told me to feel it with my hand. It was soft and it felt like part of my body, but numb. They urged me to push again and then they put on a suction cup to pull her out. She slid out and was put on my stomach. I rubbed her back; she was slick. They quickly took her away to examine her, cutting the cord before I could say I didn’t want them to. Everything was OK they were saying, she was OK. She was given to Andy, and I then realised I was being stitched up. At some point the room had filled with bodies in scrubs, I didn’t know that I was haemorrhaging.
A number of things happen to the new mother’s brain: increased activation in response to infant cues, particularly their own infant cues, in the reward/maternal motivation circuit which encourages bonding between the infant and mother; increased neural activation in the social information circuit helping a mother recognise and respond to the infant’s cues; and enhanced neural activation in the emotion regulation circuit which supports effective emotion regulation, to cope with high levels of stress.
Afterwards, I was told that my maternal great grandmother had the same complications; she died while giving birth. I spent three more days in the hospital – they replaced my lost blood, and the colour started to return to my face. I hadn’t slept for most of those days and was shocked at the intensity of breastfeeding. I cried while she cried. I kept trying to put her down but she wanted to be on my stomach and chest. The nurses told me it wasn’t safe to sleep that way, so I stayed awake. I gazed at the top of her head as she slept, Radie my baby, her soft white hair. I had merged with her, then separated from her, and a new me had formed. I had come apart.
Sources: Scientific American, & Nature.
Emma Dwyer lives in Cork and works in the arts.
