In part two of Kayla’s story, she shares more about the postpartum experience. After giving birth to her son, Kayla experienced postpartum anxiety. She describes her symptoms, working with a therapist to overcome them, and how anxiety affected her second pregnancy.
“Kayla’s Story, Part Two: Postpartum Anxiety” – with Kayla Holtz
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Dr. Fox: Welcome to “High Risk Birth Stories,” brought to you by the creators of the “Healthful Woman” podcast. I’m your host, Dr. Nathan Fox. “High Risk Birth Stories” is a podcast designed to give you, the listener, a window into the life-changing experiences of pregnancy, fertility, and childbirth.
Let’s focus on that now. I wanna talk to you about mentally and emotionally after a birth like that, after pregnancy like that. Again, you’re well, your baby’s well, like, everything’s okay, but that’s a lot to go through. And what was that like for you in the initial stages after all that, and then now, you know, looking back all this time?
Kayla: Yeah, I think that I was in a little bit of denial right after Wesley was born because, you know, everyone’s like, “Oh, my gosh, you have a baby. Like, it’s healthy and happy, and isn’t this the best thing ever? The best day of your life?” And all those sorts of comments that you get, which are really just people trying to be nice and supportive. And so I think I was, you know, going through the motions of, “Oh yeah, of course.” Like, you know, everything’s all great. I did have a lot of support with my in-laws that were there and my mom who had stayed for a little bit. And I think I had a hard time pinpointing, like, what was so difficult for me. I really didn’t know about postpartum anxiety, and I think that was a big thing.
Everyone talks about postpartum depression, but really now having been past this experience, and my sister, obviously, who in her birth story, she talks about how she works kind of in the field of mental health. And she was huge, being able to talk to her about things and really helping me, like, pinpoint some of the things that were triggers for me, and then starting therapy myself and having somebody kind of validate the experience that I had and really talk about it as PTSD because I never… you know, you think PTSD, you think more like war vets and things like that. But I had a lot of, you know, flashbacks to these experiences, even now at right after I had my second child having panic attacks and things that I just could never put words to it. So I didn’t think it was anything. I thought it was maybe more normal or something that you don’t really wanna talk about with other people because it sounds, you know, you don’t wanna be that person that sounds crazy. You have this beautiful baby, but you feel disconnected, and everything is anxiety-producing and, you know, stress-producing. And having my husband be away was difficult too because I was by myself, and I was like, “What if something goes wrong?” And it was my first baby. So I didn’t know a lot about being a mom.
Dr. Fox: How did it even manifest when you say the postpartum anxiety? So, you know, you’re three, four, five, six, whatever weeks after delivery, what was happening to you, or what were you feeling?
Kayla: Yeah, the biggest thing for me was having a lot of stress… being very stressed and anxious about Wesley. Counting his breaths before he was falling asleep was a big thing because I was so terrified that he was just gonna die in his sleep. And it took me a long time to even say that out loud to somebody because I felt like it’s a crazy thing to say, and it’s a crazy thing to maybe worry about to other people. But that was, like, one of my biggest fears. So had a lot of sleepless nights of just sitting up being worried about his wellbeing. And he was fine. He gained weight fine, he nursed really well, besides those first couple days in the hospital where he had… you know, just that learning how to latch and whatnot. But I think I got into a lot of tendencies of, you know, making sure I’m timing perfect, like, thinking that there’s a perfect way to do these things in motherhood. And if I didn’t, if I messed up one of those things, that something really horrible was gonna happen to my son.
Dr. Fox: It’s so interesting that you mentioned that as sort of how it started. I don’t know if you had a chance to go back to our earliest birth stories podcast. But our first, our very first podcast, was with Deena Blanchard, who’s a pediatrician. And she basically spoke about postpartum anxiety, her own experience with postpartum anxiety. And what she said at the time, as I recall, the thing that sort of clued in other people or sort of in retrospect, she can see was the first sign, is she said she was hyper-focused on her child’s feeding, that just much more so than necessary. And again, she’s a pediatrician. Like, she knows all about this. This is not something that was, like, just from, like, lack of understanding. And she said that… and that’s a very common thing with postpartum anxiety, that it’s this hyper-focus on nutrition, or like you said, you know, sleeping or breathing, something that’s… It’s not inappropriate to be worried about your kid’s food, and it’s something that all parents sort of worry about, but taking it like 12 degrees past that, and that you had that, it is interesting.
Kayla: In the hospital, at first, I really wasn’t worried about myself. Like, right when Wesley was born, I was like, “Okay, all these things are happening. They’re monitoring me. I’ll be fine. I’m worried about Wesley.” But when I got home, I was really worried. I think because I had gone to the hospital, delivered a baby, come home, and then ended up back in the hospital. Coming home the second time, that was really nerve-wracking for me because I was like, “Well, what if this happens again? Like, how do I know that I’m gonna be okay this next time? And then again, what if something happens and my husband is gone, and what do I do with the baby?” And, you know, those sorts of things. So, and I had that again after delivering my second son. That was a big thing that came back up is coming home and just being terrified that something was happening to me and maybe I missed it, or, you know, I had that experience of coming home, thinking everything is fine, and then, you know, the rug kind of gets pulled out from under you and you end up back in the hospital sicker than you were before.
Dr. Fox: Yeah.
Kayla: So that was another piece of it too that I was, again, surprising to me because it just… I don’t know, it just wasn’t things I was prepared for. And I think it’s really important that people talk about it and not have it be a cliche. And I’m very open to talk about all those things with people when they ask me questions about postpartum anxiety and whatnot because I just think it’s really important for women to be supportive of each other and not judging if it takes you longer to bond with your baby, or if you’re having these anxious feelings or whatever it might be.
Dr. Fox: Yeah. I mean, there’s so much that you said that’s critical there. And when I asked you way back earlier when you’re talking about your pregnancy, that you really didn’t have much anxiety about anything, did you have any history in your life, before this birth, of anxiety or mental health struggles, or anything of that sort?
Kayla: Nothing diagnosed, but I definitely am a more anxious person, and definitely, a more, you know, perfectionist, you know, that type of personality. But nothing diagnosed, and obviously, think I was able to kind of function through. I wasn’t anxious about things going wrong, but I definitely was like, “Oh, I hope everything’s going okay.” Like, you know, I wasn’t super calm, but it wasn’t…
Dr. Fox: Right.
Kayla: There was one thing like, “Oh, I’m worried about developing preeclampsia or gestational diabetes.” Or, “I’m worried about having a postpartum hemorrhage,” or anything like that. It was more so just making sure I do this pregnancy the way, you know, “the way you’re supposed to,” like, eating right and exercising and all those things.
Dr. Fox: And after you delivered, how long did it take you until you or someone realized for you that this was, you know, not standard, that your anxiety was greater than typical, and that maybe, you know, it did cross the line? It’s, you know, actual postpartum anxiety or something needed treatment. Do you feel like it was pretty quick or it took a long time? Because you said you never really heard of it. I mean, you’d heard of postpartum depression, but you weren’t depressed, right? You didn’t have those symptoms. You had totally different set of symptoms. Was it recognized, sort of, timely?
Kayla: No, I wouldn’t say it was. It was definitely months later. And I think it was because I was so quiet about a lot of it because I was also trying to… I felt like I was a little bit in survival mode, not having… Once my family did leave, that was visiting and helping in those first couple months, and it was just my husband home with me who was kinda back and forth. And because I worked an hour away from where I lived, all my friends from work were also an hour away. And remember, they continued their normal lives going to work every day. So now, I was not only isolated from my family up north but I was also isolated from any family and friends I had kind of made because of where I lived. So it was actually my older sister, Ashley, who had… when I talked to her on the phone, and her talking about postpartum anxiety and symptoms I was feeling, and I was like, “Oh, that makes sense. Like, I understand that diagnosis. Those are the symptoms that I’m having.” And I did reach out to a therapist in Florida, but it was also at the time that we were starting to talk about moving back up north. So it was definitely months later. I mean, he was born in May, and I moved back up north the following May. And it wasn’t really until I was by back up here that I think I was… you know, I really was like, “Okay, I need to start talking to somebody about this, especially when we’re gonna have to talk about expanding our family again with another child.”
Dr. Fox: Oh, so it was a year until you were… I mean, obviously, you had spoken to your sister and you had definitely an understanding of it, of what was going on, but it took a year until you were actually doing formal therapy for it.
Kayla: Well, actually, it took longer than that for me to do formal therapy, but it took like a year for me to really recognize that some of the things I’m doing are problematic and not maybe like a normal thing to be doing. Like, counting things and checking things and being so regimented about things and needing to be so anxious about… really just like the survival of my child. Like, that was a big thing.
Dr. Fox: I mean, it’s almost like OCD, in a sense.
Kayla: Yes. Well, that’s another piece of it. I’m sure, you know, my therapist could talk about all the different pieces of the diagnosis, but I’m sure that’s kind of in there as well, OCD, anxiety, some PTSD.
Dr. Fox: Yeah, but it all overlaps.
Kayla: It’s a lot. It’s complicated, yeah.
Dr. Fox: Listen, it all overlaps, it all meshes together. I’m curious from the time, you know, you said it took a couple of months after the birth so you sort of recognized, but then it was, you know, a year until you started the therapy. So that’s a, you know, 9, 10-month period from sort of recognizing that there’s something going on and getting something formal. Do you feel like just the recognition of it helped you improve and sort of get through it? In a sense, meaning, even though you weren’t getting formal therapy, you were talking to your sister, you did know what was going on, you had some realization that this was a diagnosis or a possibility. Did that help just that part?
Kayla: Yes, it definitely did. I think it was just really coming to the realization with other people and being able to talk about it as like, “Okay, you’re not crazy. This is a thing that happened to women.” And, you know, listening to a lot of other women’s birth stories and a lot of other podcasts and things like that were so helpful to me because a lot of women talk about that, and something they may not be able to discuss with their family, but they were able to kind of share it with others. So that was huge. I don’t think I ever really… and I still don’t think I’m, you know, past it or, you know, fixed, or whatever you wanna call it. But I was happy too. So I would have days where I was really happy and things were going well. And because I didn’t have really that depressive piece, I kinda felt like I could live my life that way, you know. And I had some coping skills that were not the healthiest, but I was still functioning. So I think I was kinda in denial as, “But you’re really fine because you’re able to do your, you know, daily life and get through things. It’s just maybe you’re a little bit hyper-focused on other things or anxious about things when you go to bed, but it’s okay because you’re able to continue,” you know.
Dr. Fox: Yeah.
Kayla: So I think I was just in denial that it was really an issue that needed to be fixed because I was still living a normal life…
Dr. Fox: Right.
Kayla: …if that makes sense.
Dr. Fox: What did Harrison think about this?
Kayla: There was so much going on between him being away. He definitely, again, knows that I’m a more of an anxious person, and he was really supportive and especially when I wanted to seek out professional help with therapy and whatnot. And I don’t know, I think that, unfortunately, I probably didn’t let him in on a lot of it. I think he knew some things that were going on in my head, some things I was worried about. But I don’t know if I was as open as I should have been, you know, and being able to tell him things, just not because of fear that he wouldn’t, you know, believe me, or accept me, or anything. Like I said, we’ve been together forever and I trust him with everything and I know he loves me, but I think, again, I was in denial and I just thought that I could fix it myself and it would go away and I didn’t need to worry anybody or anything like that.
Dr. Fox: Yeah. I mean, I think, you know, as a naval officer, he must have a lot of experience of, you know, folks with PTSD, right?
Kayla: He definitely has encountered some. He was in the Navy for a shorter period of time, and he worked with a lot of younger guys, but he’s definitely encountered it through people who probably don’t even realize, you know, that that’s what they’re going through as well.
Dr. Fox: Yeah, because it was interesting the first thing you mentioned before, when you said, “Well, how could it be PTSD?” Those are people who go through war. But the interesting thing is, right, the people who come home and have PTSD, they survive war, right? They’re home. And not all of them some of them obviously had major injuries or whatnot, but most of it’s people who got through sort of physically unscathed, they made it through, they got home, they’re safe, but the PTSD is not because they were physically harmed, it’s the experience, that emotional experience of it. And so it’s exact same thing, right? So you got through the birth, okay, but you went through a lot. And so the trauma is not the physical part, it’s sort of the, you know, the emotional reckoning, so to speak, of what happened or what almost happened to you and your baby in that. And so I think it makes a lot of sense that even though you’re perfectly fine and healthy now, and your baby’s perfectly fine and healthy that you could have PTSD because what’s the difference, right? It’s not the outcome, it’s the experience.
Kayla: And I think that I forever thought, you know, I was like, “Well the birth experience itself wasn’t traumatic.” I always separated the two, the birth and the postpartum. Like I didn’t have anything that happened. While I was in labor and delivering Wesley, everything went really well. So in my head I was like, “Well, it wasn’t a traumatic birth.” I would always kind of say that to myself. Like the birth wasn’t traumatic, but I really have to kind of lump those things together because the whole experience, you know, was traumatic. And I think it was just… It took me a while to even use that word when talking about it because I felt a little bit guilty as well, talking about the time, you know, bringing my son into the world as being a traumatic experience when it was also an amazing time, and you know, I would never take it back because I have Wesley here and he’s an amazing kid.
And then also I think the other thing is just again, the denial piece of it because you have everyone around you being like, “Oh yeah, that must have been hard, but you’re okay. And the baby’s okay.” And I don’t think they do it. They’re not trying to be, you know, dismissive of it, but they just don’t know. And you don’t know the right things to say and whatnot. And I’m sure I’ve said that to somebody before, but I always kind of took that as, “Okay, they’re right.” Like it wasn’t that bad. Like I wasn’t really that sick and I didn’t have a lot of… I had a tough experience at the first hospital. Even though it was the hospital I worked at and I knew the practitioners and I really did like them and respect them, I think that there was some things that were unclear and it was just trying to get an idea of how severe things were, I guess in my head I downplayed it a lot and never thought I was really that sick. And so going back now and revisiting this and I’ve had to give myself a little bit of validation and say, you know, “You did, what you experienced is real and what you experienced was severe and you don’t need anybody to tell you that it was the worst thing that they’ve ever seen, but it can still be traumatic for you regardless of what the healthcare providers believe.” So that was another thing that I’ve worked through.
Dr. Fox: It’s all true. I mean, first of all, it was serious. You were very sick. So, this is an outsider opinion. You were very sick. And so it is a big deal and it could have gone in a way worse direction than it went. So, you know, it is… you’re not lucky that it happened to you, but you know, you’re fortunate that you pulled through okay. But ultimately, you know, there’s always this tension. I have a lot of these conversations, not just on the podcast, but this is what I do for every day, talk to women who are pregnant or delivered or about to… all this. This is my world. There’s always this tension either within the woman herself, or sometimes with the people around her or hearing her story between, on the one hand, you know, the, and sort of the like naysayer side of it, like, “Oh, you know, why would you call it trauma? Why does everyone have to be a victim?” Like, “You’re okay, you did fine.” Like, “Why are we doing this?” Like don’t, “Don’t harp on it, don’t done on it.” Just like, you know, “You’re okay. You know, thank God. You’re fine. And move on.” And on the other hand, this is like, “No, you went through a real trauma. This is not easy, this hard to cope.” Like, “We have to be supportive and thoughtful.” And there’s always that tension that people sort of feel both of those. And, you know, they get both of those. It’s not that the people on one end don’t understand the other and vice versa. There’s a real tension because they’re both true, right? Yes, you did get through it and you are okay, but on the other hand you did go through an experience that different people respond differently to it.
You don’t get to choose whether you have postpartum anxiety, OCD, PTSD. It’s not like a choice to say like, “Oh, my birth sucked. I’m gonna choose to have PTSD.” Like, that’s not what happens. Some people go through that completely unscathed. They just say, “Yeah, I’m great. Everything’s fine. That week kind of sucked and I’m perfectly okay,” move on. And other people, it takes them years of therapy and treatment and medication to go past that. And why is that? We don’t know. Right? Why do some people get postpartum depression, some people don’t? Why do some people get diabetes and some people don’t? We just don’t understand it. And the point is not to try to, you know, take someone from who’s, you know, dismissive of it and make them feel traumatized by it or take someone who’s traumatized by it and make them dismiss it, it’s to take people where they’re at. And so like, if we spoke and you said, “Ah, the week was great, I’m awesome. It’s all fine.” I’m not gonna try to, like, beat you down until you’re traumatized, and vice versa. If you have trauma from it, and you’re recovering, I’m not gonna try to dismiss it because it doesn’t make a difference. You are who you are, and your brain processes it in the way it does and you have really no control over it other than to try to work through it if it is traumatic, which is what you’re doing.
Kayla: Yes. Yeah, and I think that’s what I would recommend to… I’m a huge believer in therapy just in general, and I really think that’s been a big, big change for me. And I owe a lot to my therapist for working through all these things with me. And, you know, I didn’t go into therapy until I was pregnant again. And it was really actually towards the end of my second pregnancy, and I was like, “Whoa, whoa, I’m about to have this baby.” And that’s why I started having these feelings kind of come back, I think that some kind of subsided a little bit, and then towards the end of pregnancy, I was like, “Wait, now I have to do this again?”
Dr. Fox: Yeah.
Kayla: And worked up again over it and… not worked up. But, you know, just bringing back those memories and kind of flooded again for me. And I was kind of terrified. I was like, “Oh man, what’s gonna happen this second time around from a medical standpoint, but also from a mental health standpoint.” And luckily, that second pregnancy or second birth was very different in a lot of ways, and in a lot of good ways too, so.
Dr. Fox: Right, your second birth was up North?
Kayla: Yeah. It was up North, and it was really quick, I mean, because I had all the complications before I saw a maternal-fetal medicine specialist, they put me on aspirin, they did some baseline labs, growth scan in the third trimester. And I was walking around at 6 centimeters dilated at 39 weeks, and they checked me and they’re like, “Yeah, you’re, like, gonna have this baby anytime now.” And that day I ended up having contractions, went in, they broke my water, and he was born 40 minutes later.
Dr. Fox: Wow, that’s so cool.
Kayla: So it was very, very fast. And it had its own… I don’t wanna say traumatic because I don’t really think of his birth as traumatic per se, but it happened really fast, really quick, and it was really intense. And then coming home definitely had some of that same postpartum anxiety and a lot of panic attacks and flashbacks to things with Wesley and just being worried about things happening, going wrong, and whatnot. But I had tools and resources that I had been working on ahead of time that were really helpful. And then, of course, continuing with therapy has been really helpful as well, so.
Dr. Fox: Yeah. Was it hard to make the decision to have another baby?
Kayla: Yes and no. So after everything with Wesley, this first thing, my husband was very scared for my own health and was like, “I don’t if you even can have more kids.” Like, we don’t wanna do this again and have it be worse the second time.
Dr. Fox: Yeah.
Kayla: We both come from… he’s one of three and I’m one of five, so having an only child was, you know, not something that we ever really thought of. We kind of thought of three kids. And then after Wesley, we were like, “Okay, well, we really want him to have a sibling,” but that would probably be it because even if everything goes perfectly the next time, we don’t know what a third time would then do, you know. So I don’t know if it was a hard decision to have a second, I think I’m still on the fence, you know, of course when you have a baby, it’s like, “Oh, you have this beautiful baby,” and so much of it, I love. And I’m like, “I’d be so hard for me to think this is my last baby,” whereas my husband is right. He’s like, “Okay two is perfect. We’re good.” We luckily got pregnant again decently quickly after that, and it wasn’t super complicated. They did find, just speaking of that, retained placenta that they had found at my 6-week postpartum appointment. When they did an ultrasound, they did an ultrasound for me before I got pregnant the second time. And they found some calcifications, they said, in my uterus. Nothing they were worried about. So that was the only thing up North, like, before I got pregnant. They said this might make it harder for you to get pregnant, it might not, and ultimately, it didn’t. So that was a blessing obviously.
Dr. Fox: Wow. How are you right now?
Kayla: I’m good. I mean, besides being tired with the two boys, two and a half, and seven months, I think that I’ve been working really hard in particularly the last seven months since Theo has been born working on myself mentally, physically too. I also have been going to pelvic floor PT which is huge. I wish it was something I did after my first. I think that everybody should go and do it, but I think that I’m in a much better space and I’m more open about talking about all these things. And I have my sister and my other sisters as well to talk to and friends and my husband, and I think I’m able to better cope than I was after Wesley was born.
Dr. Fox: That’s amazing. I mean, listen, hearing your story, there’s so many important parts to it and for you, it’s great to get to sit down and give you an opportunity to tell your story and talk about all this just for yourself. I think it’s frequently therapeutic just the process.
Kayla: Yes, for sure.
Dr. Fox: Yeah, but also for people listening again, you know, some people listening are those who are gonna have babies and this might freak them out a little bit and scare them. But these are not common complications, but they happen. And just to know that most people have them even with pretty bad, they’re gonna get through it okay. But also to know that sometimes when you go through something like that, it is gonna leave a mark on your psyche for a while, and sometimes it won’t. It’s hard to know these things, but to know that it’s a possibility. And some of our listeners either have their kids, or never gonna have kids, or whatever it is, but everyone knows people have babies. And just to know that this is always a possibility and like you said, you know, people are saying, “Oh, your baby’s fine. You’re fine, you know, it’s all good.” It’s well-intentioned. I mean, people…
Kayla: Of course.
Dr. Fox: …you know, they’re just trying to be positive and trying to be friendly and it’s all true, and it doesn’t mean you shouldn’t say things like that, but just recognize maybe the person listening isn’t on the same page you are. They may not be feeling the exact same glee over the experience that they went through as you see as an outsider. And it’s important to talk about this like you said. Just to be more open about it and that this is a reality for so many people. There are ways to get through it and sort of have it behind you, so to speak, but it’s challenging for a lot of people in different ways.
Kayla: Yeah, and I really do think that listening to Birth Stories and listening both of your podcasts were really tremendously helpful to me. And I didn’t realize until, especially, after my sister went on it, I was like, “Wow, this was a huge part of my healing process.” And so I hope that somebody can take this information or story and relate to a piece of it, or maybe, you know, put some tips in their brain for when they have their kids, if they have kids and just, you know, advocating for yourself the importance of support systems and not being afraid to seek that professional help if you need it. And even if you don’t have a traumatic birth, birth in general, is a big thing to have happened to become a mother and even if it was the most beautiful scene of birth ever. If there’s something to be, you know, talked about. And yeah, so I’m that I was able to share, and thankful that you guys do this podcast and give everybody the opportunity.
Dr. Fox: Well, I really appreciate it. Thank you so much, Kayla, for coming on the podcast. I hope that you are able to get some sleep in your life over the next 16 years or so. And…
Kayla: I hope so.
Dr. Fox: …get your energy back, but thank you. It really is great to talk to you.
Kayla: Thank you so much for your time.
Dr. Fox: Thank you for listening to “High Risk Birth Stories” brought to you by the creators of the “Healthful Woman” podcast. If you are interested in telling your birth story on our podcast, please go to our partner website at www.healthfulwoman.com, and click the link for sharing your story. You can also email us directly at email@example.com. If you like today’s podcast, please be sure to check out our “Healthful Woman” podcast as well, where I speak with the leaders in the field help you learn more about women’s health, pregnancy, and wellness. Have a great day.
The information discussed in “High Risk Birth Stories” is intended for information and entertainment only, and does not replace medical care from your physician. The stories and experiences discussed in our podcasts are unique to each guest and are not intended to be representative of any standard of care or expected outcomes. As always, we encourage you to speak with your own doctor about specific diagnoses and treatment options for an effective treatment plan. Guests on “High Risk Birth Stories” have given their permission for us to share their personal health information.