One to 5% of women experience a postpartum hemorrhage after giving birth.
[Trigger warning: This essay describes one woman's emotional journey with postpartum hemorrhage.]
It's my daughter's first birthday, and I haven't written in the journal I bought her since she was born. I picked it up around 20 weeks into my pregnancy when a doctor let it slip that I was having a girl.
Usually, words pour out of me. But the words in this journal start and end a few days before my daughter's birth. I told her I could feel she was ready, and we couldn't wait to meet her. How we would take a picnic blanket to the park and enjoy the blossoms.
But in the one year since her birth, I haven't been able to bring myself to write an additional word. How do I talk about how much I love watching her grow without addressing the shadow that reminds me, "You would have missed this"?
A year ago, I nearly died, and I don't know how to write that into a baby book.
Her birth could be described as everything I hoped for and worked towards. It was the opposite of my son's, which was an induction with heavy Pitocin, episiotomy forceps delivery and manual removal of placenta.
This time, I had the best team imaginable: doula, midwife, spouse and nurse. I was in a coveted room in the birthing center of a hospital in New York City. I had the birth pool, dim lights, hypnosis tracks in my headphones and all the time I needed. I also had the OR just a few floors away. Which is why I am here today.
One to 5% of women experience a postpartum hemorrhage after giving birth (classified as more than 0.5 liters blood for a vaginal delivery and more than 1 liter of blood for a cesarean). Severe hemorrhage is when you lose more than that, and it's the leading cause of maternal deaths worldwide.
Severe in my case was losing more than 2 liters of blood after the second stage of labor—the birth of the baby—and during the manual removal of my placenta (again). The average person carries 4.5-5.5 liters in their body. Such rapid loss of blood means your blood pressure plummets and you lose consciousness. In my case, it dropped to the lowest reading my midwife had seen on an alive person.
Suddenly it was all numbers, questions and beeping machines. All I wanted was to see my baby. There were transfusions, fluids and more numbers. "You're so lucky, you know," they said. "In any other time..." "You scared us." "Don't even think about having any more, okay?"
I was angry.
"Ms. Smith, you buzzed?"
"I just want to see my baby."
"When you are stable."
Let me tell you, there is nothing stable about a woman who can't see her baby.
If birth is primal, this feeling is savage. Twelve hours after she was born, I met her properly. As incredible and smushy-perfect as the pics my husband had been sending while I was in the ICU.
We chose a name that means "alive."
The first few months of her life were blissful and bubble-ish but not the kind I thought I'd journal about. There were no walks and no blossoms. I couldn't leave our 700sq ft walk-up apartment for six weeks. When I did, I bled more and slept for days. Ten weeks later I was craving nature, so took a train out of town only to end up in the hospital again, exhausted, but mostly, deflated. I bled for three months.
But I grew up in a positive mindset household so I switched on the gratitude version of my internal monologue: "I am grateful to be alive on this day. I am grateful that I have been forced to slow down. I am so very grateful to clean this smeary poop. I am blessed to drink this microwaved cup of coffee."
In my healing, I've learned that it's also okay to be sad, and frankly, angry that it happened at all. Bummed that I missed the first day of her life, and was so incapable for two months of my son's. Frustrated that instead of some kind of divine rebirth, the past year has felt like being only half-alive. Sorry that my husband has taken on the full burden of that. Angry there was no warning after my first birth that this could happen. Confused about what caused it. Devastated that if I was to have another baby, it could happen again.
More so, I'm heartbroken that this happens around the world every day. Every day, around 830 women around the world die of childbirth-related complications, 35% of which can be attributed to postpartum hemorrhage.
I can't give blood yet. I can't change the fact that this is such a huge issue around the world. But a year after picking up the pieces, I'm feeling ready to do something. Even if the first step is talking. And digging out the journal again.