Six months after giving birth to my son, I walked into an Orangetheory fitness center in Gilbert, Arizona for a high-intensity interval training (HIIT) workout. My family had recently moved to Gilbert from San Diego, and we were eager to start our new lives.
During the workout, I put on a heart rate monitor. When the numbers flashed on the screen, the memory of my son’s delivery came flooding back. Suddenly, it was May 2018 and I was at the hospital in San Diego, lying in the recovery room with my mom and husband. I relived the moment when I first saw my blood pressure spike to something like 190/110 — so high that I could have been having a stroke.
Even now, nearly three years later, I still can see that blood pressure monitor. It's a reminder that I’m one of the 3 to 16 percent of women who have postpartum post-traumatic stress disorder (P-PTSD), a condition that's triggered by a traumatic event during pregnancy, labor, delivery or postpartum.
Early warning signs
If not for my mother, I might not be alive today. At 39 weeks pregnant, I was scheduled for an induction, but the procedure was elective. I only opted for it because I wanted my mom, who has stage 4 breast cancer, to be there for the birth.
Looking back, I wonder if I should have been scheduled for an induction even earlier. In weeks leading up to my delivery, I had a headache that never seemed to go away. I didn’t know it at the time, but I was experiencing one of the symptoms of preeclampsia, a serious pregnancy condition that causes a rise in blood pressure.
Three weeks before my induction, I had blurry vision so severe I couldn’t see my cellphone. It was the scariest thing I’d ever experienced, and I immediately went to the hospital.
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In triage, the doctors checked my vitals, but my blood pressure was only slightly elevated and I didn’t have any protein in my urine (another preeclampsia symptom). I kept insisting that I didn’t feel right, that something seemed wrong — but they assured me everything was fine, and shortly after, I was discharged.
A difficult delivery
I’ll say this for my delivery: I wouldn't have known that I almost died if the doctors hadn’t told me about it afterward. If anyone panicked, they did a good job of hiding it. Up until the moment my son was whisked away to the neonatal intensive care unit (NICU), everything seemed to be going smoothly.
As it turned out, my blood pressure was off-the-charts high — I was actually experiencing HELLP syndrome, a condition which can cause stroke, liver damage and kidney failure. (Women who have preeclampsia or eclampsia are at greater risk for developing HELLP syndrome.) Not only that, but my placenta was infected, and the umbilical cord had been wrapped around my son’s neck; he wasn’t breathing, and a tube was placed in his airway.
At the time, the doctors didn’t tell me any of this for fear that they would scare me — which would only cause my blood pressure to go even higher. But later, the doctor who stitched me up told me that I was lucky I’d had an early induction.
“Otherwise,” she said, “you would have been really, really sick.” She also told me that, because I didn’t have high blood pressure or protein in my urine before I delivered, I should be on the lookout for another sign of postpartum preeclampsia: a headache that doesn’t go away.
The next 48 hours passed quickly. My son was still being monitored in the NICU, but the doctors said I could go home. I didn’t want to leave the hospital, though; my ankles were so swollen they looked like elephant trunks, and I had a slight headache that was making me uneasy. I kept thinking back to what the other doctor had told me two days ago: Be on the lookout for a headache that doesn’t go away.
When I told the on-call doctor about my headache, she was skeptical. She looked at me and said, “Honey, I can’t keep you in the hospital for a headache.” That’s when my mom, who was with me in the room, intervened. She was adamant that I couldn’t leave — so much so that the doctor eventually relented and agreed to keep me another day.
That night, my blood pressure spiked again. All of a sudden, I was being rushed to a high-risk area of the hospital, where I was put on a magnesium drip for 24 hours and monitored for four days.
If I had gone home even a few hours earlier, I wouldn't have known to check my blood pressure levels or that I could have been having a stroke. In fact, I wouldn't have known that anything was wrong at all.
Living with memories of a traumatic birth
After that day at the fitness center, I started having flashbacks to the hospital. I’d had so much going on before that — taking care of a newborn, moving to a new state, returning to work — that I hadn't really processed that my son and I had almost died.
Evenings were the hardest. During the day, I threw myself into work and taking care of my son, but after everyone was in bed, I'd be alone with my thoughts. My mind would start racing. I'd recall everything that had happened: the delivery, HELLP syndrome, postpartum preeclampsia, the NICU stay. I didn't tell my husband that I kept reliving my traumatic delivery; it didn’t make sense to keep talking about it, I thought. He was there, he knew what had happened. Instead, I kept everything in and cried myself to sleep.
This went on for months, until one day I came across an Instagram page dedicated to survivors of preeclampsia and HELLP syndrome. I had been researching the two conditions, trying to understand what had happened to me; I didn’t get any closure — or even much information — from my doctors at the time.
As I read the women’s stories, I learned that many of the mothers had experienced P-PTSD. Like me, they were having flashbacks, anxiety and trouble sleeping. That’s when I realized: What I went through was real trauma. Although it would be another two years before a doctor would diagnose me with P-PTSD, at the time, I recognized it for what it was.
That recognition gave me some closure. It gave me permission to feel sad and upset about what I had experienced. And it validated that I hadn’t been crazy after all. Those symptoms were real, and they were serious. Once I accepted that, I began to heal.
When P-PTSD reappears
As the years passed, my PTSD symptoms faded. But they’re always there, under the surface, and can reappear even when I least expect it. (Once, for instance, I caught a bad chest cold and had to take steroids, a medication that can increase your heart rate. I checked my blood pressure with an at-home monitor constantly during that time.)
One feeling that didn’t fade, however, was my longing for another child. My husband and I both felt that having another little one would complete our family. But I won’t lie — I was terrified to get pregnant again. I didn’t know whether I could go through it a second time.
Eventually, I decided I was ready. In July 2020, I sought out a doctor who specializes in high-risk pregnancies, and together, we made a plan. If I did get pregnant, I would be monitored by maternal fetal medicine (MFM), a group of doctors that specialize in complicated or high-risk pregnancies. As it happened, I didn’t have to wait long: I got pregnant one month later, in August. And, perhaps unsurprisingly, my P-PTSD came back in full force.
Coping with P-PTSD during a second pregnancy
Things are different this time around: I have a high-risk doctor who I love and a care team that I feel very comfortable with. This time, I’ll be induced at week 39, and my son will be born in mid-June. But just because I have a plan doesn’t mean that my anxiety is gone.
Around week 25, I started getting headaches again. So I did what I always do and reached for my blood pressure monitor. The numbers were the highest I’d ever seen outside of my hospital stays: 143/93 mm/Hg. I panicked, and went straight to the hospital. It was the second time in two weeks that a headache, followed by high blood pressure levels, had sent me running to triage.
Once I got to the hospital, the doctors hooked me up to a monitor only to find that my blood pressure was 117/70 mm/Hg — totally normal. Not only that, but another test showed that there was no protein my urine. That’s when I lost it. I had a breakdown right there. I cried for 15 minutes straight, so hard that couldn’t even speak to the nurse. I was scared, but also embarrassed. There were women on that floor who were actually in labor, and here I was, completely fine. I felt that same, reoccurring question flare up again: Am I going crazy?
After I’d calmed down, one of the nurses suggested that I might want to take some medication to help with my anxiety. My doctor eventually recommended the same, so I took his advice and started on a low dose of anti-anxiety medication. That’s when he also told me that I was still experiencing some PTSD from my prior pregnancy. I wasn’t surprised, but it still felt good to hear him confirm it.
My P-PTSD isn’t gone. I don’t know whether it will ever truly go away. It’s scary to question yourself, and your body, or to wonder whether everything is fine or if there’s something truly wrong. But one thing is for sure — this time, I’m not staying silent.
I didn’t always advocate for myself during my first pregnancy. Even now, I’ll replay those conversations with my former doctors and wish I had said something. That won’t happen now. I’m not making that mistake again.
— By Jordanne Pallesen as told to Maria Masters
If you or someone you know is suffering from a perinatal mood disorder, remember that you’re not alone and help is available. Check out these resources for more support and information:
- Office on Women's Health (800-994-9662)
- National Library of Medicine, Medline Plus
- Postpartum Support International (800-944-4PPD)
- National Alliance on Mental Illness (800-950-NAMI)
- What to Expect's Postpartum Depression Group
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