Ivana Poku’s eight-month old son snuggled in her lap and beamed at her.
She was at home, alone with her twin boys, waiting for a friend to visit. However, as her son smiled up at her, she felt a dark cloud descend.
‘I felt the strong urge to hurt him,’ Ivana admits. ‘It was horrible. And it scared me. So I strapped them both in their car seats and I locked myself in the bedroom.’
Ivana, 38, curled up and wept. She had hit rock bottom following months of stress, trauma and crippling feelings of failure following a difficult birth. Suffering from postnatal depression (PND), she felt too ashamed to tell anyone how she felt.
PND affects around one in ten women, according to the NHS, but Ivana believes that if she’d received better support after her traumatic birth, she wouldn’t have fallen so ill.
Babies Henry and Mason arrived with a bang in 2016. Six weeks early and unable to breathe unaided, the tiny pair were hooked up to machines in the hospital’s intensive care unit. The rush of warmth and love that Ivana had been told to expect failed to emerge. The promised early days of cuddles and sunshine were replaced with strip lighting, beeping machines and the cold clinical environment of hospital.
‘As soon as they were born, they were rushed away. When I did see them, I felt nothing. I was numb. Frozen.’
‘I immediately felt like a horrible mum,’ adds the author and blogger from Fife. ‘Like a failure. Those two weeks were the worst of my life.’
As the babies recovered and put on weight, Ivana went into decline.
‘When we got home, it didn’t get much better. I felt like I was falling apart for months. I cried a lot. It was the pressure; I just felt like I was failing. That I couldn’t be a mum.
‘I really believed that I was the only one feeling this way. That every other mum was happy. So I put a lot of effort into hiding my emotions. I put a mask on. I pretended I was okay. It was exhausting.’
When Ivana’s husband suggested she speak to a counsellor, she was put on a waiting list. Her doctor prescribed her with antidepressants, which she didn’t take.
‘I had never experienced depression. I felt like taking the tablets would make me a horrible mum,’ she remembers. ‘There was this feeling of shame that stopped me. I thought. “I shouldn’t need antidepressants. I should be happy because I’ve got kids.”’
Ivana is now calling for better education on postnatal mental health. She believes that antenatal classes are all about the baby, while postnatal care amounts to little more than ‘tick box’ exercises from busy medical professionals.
‘Women need more ante-natal help, and more from the hospital,’ she explains. ‘If the support we got was more about me and how I felt, it would have made a huge difference. Because then I could have got the help I needed sooner and picked myself up more quickly.’
With a recent report warning that more than half of maternity units are failing to meet safety standards, a number of women have also told Metro.co.uk they struggled with a lack of support postnatally – be it help with their physical or mental wellbeing.
Earlier this year, an inquest heard how a four-day-old baby boy died after his mum fell asleep on the sofa as she was in too much pain from her caesarean section to get upstairs.
His mum Emma, who was not offered any mobility support after being discharged from hospital, found a blanket over her baby’s head when she woke up. The inquiry found that heartbreakingly, the baby’s death could have been avoided if she was offered help with mobility at home.
Meanwhile, one mother-of-three, who had a vaginal birth, an emergency caesarean and a normal caesarean, tells Metro.co.uk that even before she left hospital, the postnatal support she received was severely lacking.
‘My emergency c-section in 2013 left me traumatised and unable to move unaided,’ she explains. ‘I had to ask to be wheeled in a chair to see my newborn baby, 12 hours after she was born. It was heartbreaking. She was on a different floor of the hospital, and I could only hold her little hand through the hole in the incubator.
‘There is no doubt in my mind that the lack of touch, feeding and support left me battling trauma and anxiety later on, and my daughter was extremely distressed too. In cases of emergency c-sections – which leave you feeling lost, out of control and helpless – women need so much more help, physically and emotionally.’
Another mum recalls: ‘I ended up with an emergency c-section and blood transfusion in 2018. I later found out my body went into shock and I was unable to breastfeed. Whilst hooked up to many machines, I was still expected to take full care of my daughter. I could hardly lift her. I had a horrific time recovering at home and my daughter was starving and screaming.
‘Let’s be honest, there is no real NHS support or aftercare. A c-section is seen as being part of the package of being a mother – put up and shut up is how I felt.’
Dr Karen Joash, consultant obstetrician and gynaecologist and spokesperson for the Royal College of Obstetricians and Gynaecologists, says that everyone ‘should have equitable access to support throughout the perinatal and postnatal period.’
She adds: ‘Access to help during and following pregnancy is essential to ensuring the health and wellbeing of both women and their babies.
‘Women should be at the centre of their postnatal care, not only their baby. It is vital that postnatal services use the opportunity of postnatal checks to support women with physical, mental and emotional issues, and refer them to specialist services for the right care in a timely way where needed.’
44-year-old Faustina Anyanwu feared for her life when she fell ill after delivering her first child Chelsea by emergency caesarean. As soon as the operation was over, Faustina was exhausted, had a fever and her wound site was bleeding.
‘I began to shiver and my temperature was so high,’ she remembers. ‘After the surgery, I thought the nurses and the midwives would help me get out of bed, show me how to do things. But they didn’t really come to my aid that way. I was trying to do everything as best as I could; get the things I needed, clean myself.
‘But the pain got worse. I was worried something was seriously wrong.’
Faustina, CEO and founder of events company Divas International Women’s Forum, was given a scan and told that she would get better with the help of antibiotic injections, so she trusted medical advice. But things only got worse.
‘They gave me injections and the pain didn’t stop,’ she explains. ‘I was getting worried. I was wondering if I was going to die. At one point I was hallucinating and thought I could see wet clothes hanging in the room – so asked my husband why he’d done it. He told me; “We are in the hospital, there are no clothes here.” He was scared too.
‘The pain was so bad, I was groaning and calling out for my mum – who was at home in Nigeria. It was so intense; unbearable. Blood kept coming out of the operation site and my husband had to pad it for me.
‘No-one was monitoring how I was feeling, or if my situation changed. I was neglected and left there.’
Faustina drifted in and out of consciousness, but after a week of agony, she decided to check her own medical notes. She had spent six years as a nurse, so knew what she was looking at.
‘Blood tests showed there was e-coli in my blood, which can be resistant to an antibiotic – the medication I had been prescribed. When I saw it, I couldn’t understand why they were giving it to me.’
Faustina was given a new prescription, and within two days the pain, the bleeding and the fever all disappeared and she was sent home, where she made a quick recovery and didn’t need any further support.
‘The whole experience was so traumatic. If I had basic, proper medical care they would have spotted that I had e-coli and I could have had the right medication.
‘I am thankful that I came out alive. But the doctors and nurses failed me.’
Nicole Ratcliffe’s first labour saw a combination of poor care, insufficient information and inadequate medication that left her distressed and traumatised.
The natural birth she had hoped for was complicated by the fact that the baby was back-to-back. But as she laboured in agony in hospital with her first child in 2016, she wasn’t given either of these pieces of information.
The 40-year-old from Manchester experienced 23 hours of excruciating contractions and the discomfort of an oxygen clip on the baby’s head before she was told she would have to have an emergency c-section. 17 minutes later, baby Sofia was born.
‘It was such a traumatic experience. She was whisked away as soon as she was born and there was no skin-to-skin contact,’ she remembers. ‘I was in and out of consciousness from the pain and exhaustion.
‘Afterwards, I was taken up to a ward where it was impossible to get any sleep or rest because it was so noisy; people having phone calls at 3 in the morning. I was in so much pain. I was begging midwives for relief, but it kept running overdue.’
Nicole was left immobile by the pain of the operation, which she found hugely upsetting.
‘You want to hold your baby, but you can’t do it yourself. I didn’t get to do her first bath. I couldn’t comfort her, I couldn’t breastfeed when I wanted to because I couldn’t get into the positions because it hurt so much,’ she says.
‘I couldn’t do anything. I felt absolutely useless.I cried a lot.’
Like Faustina, Nicole had an infection that made her ill. But she was sent home and left to fend for herself.
‘Health visitors would come round, but it was all about her birth weight and feeding, it wasn’t about me,’ she recalls. ‘They would check the wound, but I ended up so unwell I went back into hospital, and then I got sent home again. I knew something wasn’t right. Back at home, a week later, the GP came out because I was in horrendous pain. He looked and said: “Oh yes. It’s infected.” And I just didn’t know why they didn’t know that from the beginning.’
Nicole was then prescribed antibiotics and was able to recover. Although she didn’t complain to medics at the time, the hospital has since told Metro.co.uk that she was still more than welcome to raise the issue with their Patient Advice and Liaison Service, if Nicole felt it might be useful.
Jess McMicking, obstetrician and lead medical adviser for women’s healthcare charity Naytal, says that problems are more likely to occur once women have left hospital, no matter what type of birth you have had.
‘Once women are discharged, there are potential gaps in the care and support they receive,’ she explains. ‘Local community midwife reviews are conducted however the system can be pressured at times, and the frequency as well as availability on demand can be challenged.
‘Further efforts can be made in the following areas to help assist women following their caesarean section birth include greater education during pregnancy on caesarean birth recovery – what to expect, what assistance may be necessary in the home, greater availability of obstetric or medical reviews postnatally if concerning symptoms, whether through GP or community clinics.’
Ivana says that she has found sharing her experience with others helped her heal from her terrifying experience.
When she spoke openly for the first time to her friend who found her locked in her room, everything changed.
‘I started to speak to more people about how I felt,’ she explains. ‘That was the best medicine.’
However, for Nicole, being unable to leave the house for the first three weeks of her baby’s life due to what she calls ‘horrendous aftercare’, has left its mark on her.
‘You can’t put it into words about how it makes you feel when your birth doesn’t go to plan. I felt like a failure,’ she says. ‘I’m angry that the system is so broken.’
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