As the end of my first trimester came and went, nausea and fatigue persisted.  My hopes for the burst of energy that so many books predict for the second trimester were bludgeoned, but this time I was not exactly surprised, as I had missed out on this mid-pregnancy bliss while pregnant with Landon as well.  At twenty-two weeks, my nausea finally began to subside, only to be quickly followed by a reoccurrence of the sometimes debilitating pelvic pain that had plagued my second pregnancy.

I re-visited the physical therapist with whom I had worked less than two years prior and began the same set of “pelvis stabilizing” exercises that I had been somewhat diligent about performing when I was last knocked up. (Don’t you just hate that term?  Me too, but I couldn’t resist it here.) 

I hoped that by being a good and responsible patient, I could get a jump start on an exercise routine that included therapeutic movements with names like “tail wags”, “supermans” and “hip hikes”, and stave off the worst of the pain that had been a source of great frustration and discomfort in my not-so-distant past.  I hooked up with a trainer at the local gym who added exercises such as “wall angels” to my regimen, and I was hopeful that the remainder of this pregnancy would pass uneventfully.

But shortly after resuming the physical therapy program, I was blindsided by a  mid-pregnancy bout of prenatal depression and I became unable to properly look after Ellie and Landon.  I stopped eating and drinking and gradually, day by day, slipped further into an emotional catatonia.

Although the majority of this period of my pregnancy quickly became a blur; memorialized in my mind are snapshots of crying spells, emotional and physical despondency while my children milled around me, casting anxious sideways glances in my direction, and an overwhelming sense of hopelessness that I could handle the challenge I was soon to face in simultaneously mothering three young children.

Despite the ghost-like images that float in and out of my recollection of this portion of the pregnancy, I distinctly recall the Thursday evening that Andrew returned home from work to find me silently weeping, crumpled awkwardly around my protuberant belly into the corner of the living room couch.  Ellie, wearing nothing more than a strawberry juice-stained t-shirt, and Landon, a soggy diaper,  were busily searching the kitchen for the snack I had failed to prepare for them hours before.

“Honey, are you okay?  What’s wrong?”  I remember him asking, standing over me, blocking the sunlight from the south-facing windows of the room.  I couldn’t answer.  I couldn’t tell him why the kids’ hair hadn’t been brushed, why they were ravenous, and how long I’d been stuck there, pressed heavily against the cushions that now conformed to the outline of my tired body.  Head buried in my hands, I just continued to cry.

“Come on.  Let’s get you back to bed.”  He lifted me from the couch, carrying my motionless weight back to our bedroom where I remained for the next 36 hours.  After getting Ellie and Landon settled into dinner, he returned to check on me.  Sitting on the edge of the bed next to me, brushing the hair from my face, he took in whatever image of me he had left an hour before.

“What can I do to help?”  It took me a few moments to muster enough energy to answer him.

“I need my parents,” I croaked through a dry mouth and throat.

I heard snippets of the phone calls that ensured over the next hour—several to the students who were scheduled to attend class with me that evening, letting them know I was “sick, and unable to teach tonight,” and finally, to my mom and dad.

“Kimmelin’s not doing well….she needs you out here…how soon can you come?”

Traci and Meredith came the next day to look after Ellie and Landon, and me, while Andrew went to work for a few hours to tie up loose ends.  During brief awakenings, I heard the din of dishes being washed, meals being prepared, and all five children, theirs and mine together, playing happily and rummaging through the toy box in the adjacent living room, accompanied by the hushed voices of their concerned mothers.

“Have you gone in to see her yet?”

“No, not yet.”

“When did this start?  I had no idea.”

“I don’t know, he just called last night and said he needed us over here today.”

“When did Andrew say her parents are getting here?”

My mom and dad arrived the next day, and my mother, having arranged for a substitute teacher to take over her third grade classroom, would remain with me for another week while I recovered.

After my experience with postpartum depression following Landon’s birth, I had not yet weaned myself of the antidepressant medication prior to my third pregnancy.  As I began to worry about the potential affects of Zoloft on the baby, I made a guilt-induced executive decision to take myself off the medication. Because I made this change without telling my doctor or Andrew, neither of them fully understood my sudden emotional demise until I confessed to having gone off the medication the month before.  Andrew and I had taken a brief trip to Las Vegas together, in conjunction with a work-related speaking obligation of his, and having forgotten to bring my medication with me, I used the four day break as a starting point for discontinuing the prescription I’d wanted to be rid of anyway.

During my appointment with her a week following my break-down, my doctor questioned if I was still taking the medicine.

“No,” I whispered, unable to look her or Andrew in the face.

“Why did you stop taking it?” she carefully inquired.

“I didn’t want to hurt the baby.”  Even amidst my private rejection of the pregnancy, I had confusingly clung to a thread of devotion to the life forming within me.

“How long has she been off it?” my doctor asked Andrew.

“I didn’t know she was off it either,” he answered, the two of them now talking as if I wasn’t in the room.  The anger in his voice betrayed his demeanor of concern.

“Will you start taking it again?” the doctor probed, launching into an argument for my resumption of the antidepressant.  “When you’re in this kind of state, the baby’s not healthy either, and you can’t take care of the kids you’ve got at home.”

“I know,” I murmured.  I was made to promise I would resume the medication, taking it faithfully from that day forward.  “But what’ll it do to the baby?” I struggled.

“We can’t worry about that right now. We’ll cross that bridge when we get to it.  You were on such a low dose anyway…there’s probably not too much to worry about.  Right now we just need to get you back on your feet.”

Andrew’s silence was palpable and I dreaded the discussion awaiting me on the car ride back home.  He was hurt that I hadn’t consulted him before discontinuing the medicine; that I hadn’t trusted him enough to let him in on the gradual demise I had set myself up for.

Although I was acutely aware of the signs and symptoms of postpartum depression, as well as how prevalent it was in our society (current statistics place it at 10-20% of the population), I did not anticipate a similar occurrence during pregnancy.  I would later come to understand that the incidence of prenatal depression is equivalent to that of postpartum depression. The difficulty in diagnosing and treating prenatal depression, as with its postpartum counterpart, is in admitting the problem exists in the first place.  Most people who suffer from depression, pregnancy-related or not, will tell you they find it extremely challenging to discern their depression while in the thick of it.  Whether it is a matter of skewed perception or of successfully disguising their symptoms to the point that they don’t even see it themselves, depression can creep up on even the most informed individuals, as it did me.

I can’t help but believe the overbearing doubt I felt as my third pregnancy progressed, about what life with three children four and under would be like—and the effect it would have on me as an individual—had much more to do with the depression than the discontinuation of medicine.  It wasn’t another child I was resistant to, it was what I would observe within myself—mothering three children while still unsure of my capability and suitability for Motherhood—that scared me.  Struggling with the assumption that pregnancy is supposed to be a joyful time and that I of all people, being a Childbirth Educator, ought to adore the process of pregnancy, made my self perception hideous.  I began to feel like a fraud and a monster.

In the end, the journey of dipping into a prenatal depression, re-medicating myself, and recovering was a six week ordeal.  The relatively short duration of this nightmare made me lucky.  My vain hope that things could only improve from that point forward, however, did nothing but set me up for a greater fall.

Continue onto Chapter 28 - Parental Instincts