Another story highlighting our need for a Mother and Baby Unit in Wales. For Maternal Mental Health Matters Awareness Week.
32-year-old mum of two Toni Wells, was no stranger to depression but had always managed to function and bring up her son along with her supportive partner Ieauan. It wasn’t until she was pregnant with her second child that things started to get more serious. Here Toni shares her story of her experiences with Mental Health Services and her first hand account of life in a Mother and Baby Unit:
In May 2018, Ieauan and I found out we were expecting our baby girl Sarah. We had planned the pregnancy and I was over the moon. This would be our second child together. We always knew we only wanted two children. I knew this would be my last pregnancy and I wanted to cherish every moment of it, even the morning sickness. Despite my hopes, events in my personal life meant that sadly I wasn’t able to enjoy my pregnancy, and as the weeks went by the stress really started to take over. I realised I was struggling with everyday life. Luckily, I had an excellent midwife on hand to support me, and Ieauan. Having someone to talk to who I could trust was enough at the beginning, but slowly things started to get worse.
This resulted in being referred to Perinatal Response and Management Service (PRAMS). They were there to offer further support before things reached crisis point. Although I was scared to reach out to a stranger, I knew that I needed to. I didn’t want to harm the baby through stress and so I was willing to do whatever I needed to make sure of that.
Through tears I opened up about how I felt and told the PRAMS worker everything on my mind, especially my worries about taking medication in pregnancy. After a lengthy discussion, I was disappointed to hear it would be a while before she saw the consultant to discuss medication. This was Due to the huge pressure on Mental Health Services, unfortunately this isn’t uncommon. To ease my mind, the worker provided me with a website that I could reference for medication information in the meantime.
Instead of being reassured, I took in all the negative effects it would have on the baby, and considering my state of mind at the time it only made things ten times worse. I was promised a call from PRAMS the following week but the call never came, which was another huge blow. I was trying so hard to do all I could to keep my baby safe. By this point even if I had received the call, I had already made up my mind and decided I didn’t want to risk medication. I would try and get through the next few months with the help of Ieauan and my midwife.
Another appointment was arranged with PRAMS but this time it was a different member of staff, there had been no handover and I had to go through everything all over again. I left the appointment feeling even less hopeful than before. I felt my only hope was the medication I was unable to take, but I was determined to give birth to a healthy baby.
The next 10 weeks were torture and my mental health quickly deteriorated. I knew it was impacting my loved ones and felt there was no other way out than suicide. I was researching ways to take my life without harming the baby, I knew I had hit rock bottom.
The only thing that ever stopped me was the baby I was growing inside me. But was this enough?! How long was this baby going to keep me safe? Every day that feeling of leaving this world was getting stronger and stronger.
Consumed by guilt, I would start to argue with Ieauan as I felt I wasn’t a good enough mum to our 4-year-old son. One day in particular I recall ringing Ieauan and telling him I wanted to drive into a wall on the way to work. I had reached breaking point, and couldn’t see any other way out. As much as I struggled, the thought of my baby always stopped me, but it didn’t stop the feelings of worthlessness that were getting stronger by the day. I knew that the baby was the only thing keeping me safe and I feared what would happen once the baby was here.
Despite my struggles I continued to work throughout the pregnancy, and remained professional in work even though inside I was struggling to keep it together. In a way, work gave me some focus and kept me grounded. Most mum’s countdown to Maternity Leave but I was scared of not having work to keep me focused.
After speaking with my midwife, they agreed to weekly appointments which put my mind at ease. I was also referred onto the crisis team but again, it was someone different seeing or calling every time and I didn’t want to go through everything again, to different people. Still I persevered with the support on offer as I felt I had to do everything I could for my baby.
The Crisis Worker told me she was going to drop in the telephone numbers that evening, she didn’t but I wasn’t surprised.
‘No one kept their promises. No one actually really cared about me. No one done anything they said they was going to’
I finally had an appointment with a consultant which was definitely a turning point in my journey. The consultant was amazing and clearly explained the statistics of the medication. If only I had this conversation at the beginning of my pregnancy things could have been a lot different but unfortunately, it was too late as I had already made up my mind.
After this appointment I started seeing the PRAMS team on a weekly basis, and although I was wary because of previous experiences, the worker I had now would always try her best and keep appointments, and so things were slowly starting to improve. Ieauan and I finally welcomed our beautiful baby girl in to the world on the 11th January 2019.
The support we received from the midwife was excellent, but despite that I was still struggling. The birth of a new baby is expected to be such a joyous time, but unfortunately for me this wasn’t the case.
‘I remember leaving Bridgend hospital and sitting in the back of the car with my new baby. I just cried and cried. I felt numb. I didn’t even know why I was crying. I wasn’t happy and I wasn’t sad. I was numb. Not a feeling I wanted to feel, going home for the first time as a family of 4. About to start my new life with my perfect family. A boy and a baby girl and a partner who loved me. Why wasn’t this enough? Why wasn’t I happy?‘
I still struggled daily with suicidal thoughts and was worried about how this was impacting my family. People say that suicide is a selfish act, but the reality was I didn’t want my family to suffer and thought that it was the only way. Friends and Family would text me eager to see the new baby but every day I felt worse. The only person I trusted was my midwife. I knew things weren’t right when one day I asked her to leave. This was unusual, as I usually felt comfortable around her but I felt confused and hurt and just wanted her to stop asking questions. I was a shadow of my former self. Nothing about me reflected the person I once was.
At this point I didn’t care about anyone.
I struggled to feel any emotional bond to my baby. I would go for walks, and contemplate jumping in front of a bus or lorry. I was no longer scared of dying, and that’s when I knew I had to get home before I acted upon those thoughts. Back home I realised just how bad things had become. I had hit rock bottom; the kids were unfamiliar to me.
I felt hopeless. Iuean desperately tried to get help and urged me to speak to the crisis team, I agreed but only if I had my midwife by my side, she was the only person I trusted to ensure things were done properly and only in my best interest. After speaking to the crisis workers with my midwife by my side, I began to make my way down to Ward F. Walking through the corridors of Port Talbot Hospital clutching my pillow, I wondered how it came to this.
Once I was on the ward I was taken to a tiny room with a bed and wardrobe. Stripped of anything that they thought I could harm myself with. I began to feel as though I didn’t belong here, It must have been some sort of mistake. I had completely forgot that just a few hours earlier, I was contemplating jumping in front of a lorry.
I asked Ieauan to leave to be with the kids, luckily my midwife stayed by my side. Still, I felt guilty and as though I was becoming a burden to everyone.
The first night was a blur and I refused to eat or drink. They wanted me to go into a communal area to eat food, but at this point I had only left my room to see the doctor. I walked into the communal room and there were 5 people sitting around 1 side of the table, they all started firing personal questions at me. I started to think this was a mistake. I felt trapped.
By now Sarah was 2 weeks old, and I wasn’t allowed to see her. If I had been away from her any longer, I truly believe I would have lost the bond I was already struggling with.
When PRAMS suggested a Mother and Baby Unit (MBU), I jumped at the chance and just said yes. The only problem was there was no MBU in Wales. The nearest available unit at the time was in Derby – miles away from the place I called home.
I felt so guilty taking the baby away from Ieauan and for leaving Harley, but I had no choice. I had to trust other people’s judgements, and I had to get better. My midwife came to visit me the day before I left for the MBU and noticed I was still in the same clothes that I was admitted in. She encouraged me to get in the shower and get dressed. She was the only one who seemed to care.
It was a long morning, waiting for a call or for someone to tell me what was happening. It got to 12.40 and one of the nurses came in, they had forgot to tell me that I was actually leaving at 1pm. I asked them if Ieauan knew and they reassured me he did. Before I knew it there was someone at the door ready to take me, and when I tried to reach Ieauan he was in Tesco’s, he hadn’t been told.
I felt awkward already, these people had to wait for me. We were waiting for Ieauan to get here and then Sarah needed feeding. It was all such a mess. Nothing was planned properly which only furthered my fears and anxiety about going. I remember Ieauan going to pack my stuff in the car, and the next thing I knew I was saying goodbye and I was in a car full of strangers, with a baby I had barely spent any time with. What the hell was going on? Was this actually me and my life!!
The chaperones would try and talk to me but I wasn’t really in a talkative mood. I just didn’t understand what was happening. I just stared out of the window, not really thinking about anything. I wasn’t sad, I was scared… I just didn’t understand. I was numb.
We finally arrived at the mother and baby unit, at this point I started to get scared. This was my home for the next 2 weeks (or so I thought). How am I ever going to trust anyone? I missed my midwife and Ieauan so much.
I slowly walked in to the unit, holding Sarah in my arms. I was greeted by a nurse called Bryony. She told me that she was new too and we could be new together. The chaperones brought my stuff in and said their goodbyes. Although I didn’t even know them, I didn’t want them to leave. They were home to me. I knew once they left, I really was on my own in a different country with different people. Another nurse started going through my stuff, again I felt like I wasn’t trusted. They took some stuff away from me but I didn’t really care.
A nurse asked me why I thought I was there. I told her I didn’t want to talk about it and her response was “Well you are going to have to talk about it at some point”. It was unbelievable, I hadn’t even unpacked yet and already I was being asked personal questions by people who didn’t know me. I thought what on earth have I got myself into. I really missed my midwife now, she knew me. She wouldn’t have asked me such a personal question.
An on-call doctor came to see me, more questions. He had prescribed me some sleeping tablets and they took Sarah from me at 10pm so I could get a good rest.
I woke up confused and not knowing where I was and what I was doing. I walked around to try and find my baby and she was in the office with the staff being cared for. I took her and headed back to my room, not really knowing what I was doing.
Nurses, nursery nurses and Health Care Assistance would all come in to introduce themselves when they came on shift. I was allocated a Nurse and Nursery Nurse for Sarah. We had a care plan in place that the staff would take Sarah from 10pm until 6am so I could catch up on sleep. Which was very important to me as I felt so tired, physically and mentally.
Every Monday we would have ward round. You would have to go into a room with 2 Doctors, a Pharmacist, Psychiatrist, Nursery Nurse and a Nurse. Sometimes they allowed students, but you were always told you can ask people to leave if you wished. Most of the ladies I spoke to in the unit would say they didn’t feel comfortable asking people to leave, but found the who process very daunting. I do think if it was the absolute minimal people they would get more out of patients.
I refused to leave my room, again I wouldn’t really eat and that wasn’t for the staff not trying. They tried every time they came to see me. They were all very lovely but they weren’t my midwife and I didn’t trust them. I had already put my faith in others before and this was shattered. What was different about these people. How will they help me? I just stared at the wall for days. I wouldn’t eat or would eat the very bare minimal just to keep people of my back. I wouldn’t have the TV on. I just sat in silence holding Sarah, trying to get my head around this new life because this is what it felt like. I was away from everyone and everything I knew. This was a whole new life with a baby a barely knew. I didn’t want to talk to anyone, I didn’t want to interact with anyone. I didn’t have it in me to speak. My mouth physically wouldn’t let me. So many times, I would reach for the phone to call the one person who I thought really cares about me. My Midwife.
I would be in ward round and the doctor would ask me a question. I would be in the middle of answering this question and forget what he had asked me. I felt confused. I didn’t understand what was happening to me. I wouldn’t talk, I wouldn’t eat, I couldn’t even answer a question. It’s like my brain cells were numbed. I was just clueless.
The Occupational Therapist (OT) and Nurses would continue to encourage me to do things and to try and come out my room. There was a communal area to eat but after my experience in ward F there was no way I was eating there. I didn’t know what any of the other ladies were like. I didn’t want to give them a chance. I thought it was just like ward F.
The next ward round I had, I had a very direct doctor tell me that they can only do so much to help me, but I have to help myself. I left the ward round and return to my room feeling angry at him, thinking he has no idea how hard I find things and he just proved what I already thought. No one gets me. He told me I had to start getting out of the room. But how was this going to help me? Whether I was sitting in my room or sitting in the lounge I still felt the way I felt.
Nurses would tell me that one day I will feel better and I will leave this place feeling a million miles away from what I feel now, but I honestly thought I was beyond help and this was just my life. What made it worse was that they couldn’t tell me how long until I was going to be better. What was it that would make me better? I needed a clear plan in place because I just didn’t believe it was possible. I had already been there 10 days and I felt no better for it.
I called Ieauan and I told him about what the Doctor had said about how I needed to get out more. I told him that I didn’t understand how going around the table doing arts and crafts with the other ladies is going to help me? I’m not 10 years old. Ieauans’ advice was to prove it to the Doctor. He encouraged me to go into the lounge at dinner time so that at least on the next ward round I could say that I did it. The stubbornness in me came back a little and I thought that’s exactly what I’m going to do.
Sunday night was Buffet time. There was me and two other patients. It was the hardest dinner I have ever had. I ate half a sandwich and ran back to my room, but I did it. The next day I went into the sensory room with Sarah. This was on my own and only for 10 mins but I still did it. I spoke to Pam a Nursery Nurse and before I knew it, I found myself telling her how I felt. It was the first time I didn’t feel alone. I was a long way from home and I had no one I could speak to, but was all this about to change.
I remember being in my room and thinking, I really need to make the most of this mother and baby unit. If it wasn’t for Sarah, I would still be in ward F being pumped full of medication. Something had changed for me and thankfully I felt a little more hopeful. The more I got out the easier I started to find it. I was constantly putting myself in awkward situations. The OT taught me about fight or flight with anxiety, and I knew I had to keep fighting. I would go out for a walk with one of the nurses and before I knew it I was telling her about Harley and his fits and how it has affected me emotionally.
I had started to make friends and I was smiling, actually enjoying arts and crafts. Speaking to other patients was a lot easier than speaking to professionals. We didn’t judge each other. Whatever we said to each other we had already probably thought of or done. We didn’t scare each other. I still found it difficult to trust the staff. There was probably one or two I trusted to speak to. This wasn’t due to them, it was due to me, my personality and my previous experiences.
I remember having an altercation with one of the nurses and I went to see my psychiatrist straight after. I told her I wanted to hide away and I didn’t want to talk to anyone. All those emotions came back from before and feeling let down, hiding away in my room. She told me that this is my brains way of dealing with arguments or an altercation, the same as when you smell coconut you think of holiday. My brain feels danger or an attack and I want to hide away and I had to try and break that pattern. Again, I continued to break out of my comfort zone. I took her advice and did it. My whole day ended differently. I had a great afternoon and it taught me not to let one thing ruin the rest of my day.
Over time I had built some great relationships with staff and patients. I was mindful not to get too comfortable there. I had to remind myself this was not real life and although I’m safe guarded there, I will be faced with real situations on the outside world. It’s easy to fall into a safe place when you stay in an MBU and I can understand why some patients don’t want to leave. The transition of home leave was a lot different for me as I lived so far away, but going home for a week was definitely an eye opener and made me realise the triggers and things I need to work on when I got back to the ward.
When I got back to the ward, a few days in I realised after speaking with other patients and being able to give advice and talk about my experience, I no longer belonged there. I was ready to go home. You know when you are ready to leave, there is a difference in being scared of leaving and not being ready. I was just scared.
The doctors really leave the control in your hands and would never push you to leave or stay. The unit couldn’t teach me anymore. I had to teach myself the rest.
The mother and baby unit gave me all the tools and got me onto a level where I was willing to learn. Never in a million years did I ever think I was going to be happy again. Yet here I am typing up my experience in a completely different place to what I was 3 months ago.