Mummy can’t breathe

Mummy can’t breathe

Hi all – it’s been a long time – I wrote this over a year ago, and it has been sitting in my drafts gathering virtual dust. At the time it was incomprehensible that the coronavirus would continue to cause chaos in our lives. I’m sharing this because the story might resonate with someone, but also because I think it is time and a story that needs to be told.

On my first mothers day I woke up in the morning unable to breathe. After almost of week of feeling poorly with a cough and on/off high temperatures (? spiked by watching the news) I was sitting with my 9 month old baby singing nursery rhymes, and I couldn’t get past the “Old” of Old McDonald had a farm without gasping for air. You don’t need to be a medic to know that this state of breathlessness is not normal, so, reluctantly, I called 999. As I gave my name and address, I profusely apologised for “wasting their time” and, whilst struggling to speak still managed to say

“I’m (gasp) sure (gasp) its (gasp) nothing”.

A couple of hours later I was being blue lighted through the empty inner London streets in the back of an ambulance with a Respiratory Rate of 44, Temperature of 39.6 degrees Celsius, and an oxygen saturation around 85% – worse than a lifelong chain smoker (for the record, something I am not). When the ambulance crew arrived it was plain to see I was seriously ill – yet even with all my years of training and expertise I refused to go to hospital, because I refused to leave my baby. She needs me, I kept saying. We had not been even an hour apart since the moment she was born. Shes breastfeeding. “I can’t leave her” I gasped, over and over again. To this day I’m very thankful to the paramedic, whose name I cannot remember whom casually said “hey I tell you what – just come with us, let us check you out in A&E, make sure everything is OK and you will be back home in a few hours”. Obviously that was a lie, but one of those little white lies that saves lives that sometimes we have to do.

The next 4 days was a blur. I was placed in “isolation” – alone in a large magnolia coloured room with a small window that faced a red wall. Nurses came to check on me regularly, albeit from a distance covered head to toe in personal protective equipment. I was placed on oxygen therapy and given antibiotics. I was in such a septic rush that I didn’t pack anything in my hospital bag but some old pyjamas, a gym t-shirt (?), a small bottle of holy water from my mother that I’ve always carried with me whenever I travel, and a portable phone charger which was only 10% charged itself. I used my phone sporadically, only to face-time my daughter for a few seconds at a time before her naps. I didn’t pack a breast pump, the thought hadn’t even crossed my mind – until a few hours later when I was struggling with engorgement and doing my best to hand express into a kidney dish through the night to stop myself getting mastitis on top of everything else.

A few days later with improved oxygen saturations I was allowed to leave hospital as I was mostly better (on retrospect not fully recovered by any means – but I think they gave me the benefit of the doubt being a “sensible” doctor, whatever that means…)  I was told a few times that I should stop breastfeeding and be separated from my baby for a number of reasons – “coronavirus could be in the breast milk”, “you could harm your baby”, “you could infect her” , “the antibiotics might not safe” , and possibly the most patronising “well you have had a good run”, all of these claims totally false and founded in fear rather than facts, and although I knew it was false with my clinical expertise I was too weak to argue with them at the time so chose to save my (much needed) breath.

As soon as I came home, I gave my daughter a huge hug and she went straight back on the breast like nothing had ever happened. Since then so much evidence has come out about the benefits of breastfeeding and its immuno-protective qualities – something that needs to be shared more and one of the reasons I have chosen to share my own dual patient and professional experience. I have also written to our government and with organisations behind the scenes to support the often neglected needs of breastfeeding women admitted to hospital and separated from their children, both on a practical and emotional level.

It took some time to recover, but I am thankful to say that from a physical perspective I am back to normal and honestly it is a wonderful feeling to not only be alive, but to be able to breathe, talk and sing with ease again. Being unable to breathe is so anxiety-provoking, not surprising as the breathing control centre, stress and anxiety are intricately linked by the vagus nerve. Deprivation of the breath of life also conjures images of death – since writing this original article, the world witnessed the tragic murder of George Floyd in 2020, repeatedly stating “I can’t breathe” to his oppressors, igniting the black lives matter movement for the next generation.

Psychologically speaking, I also feel very well and grounded – but even the process of writing this has raised a lot of questions for me; how mothers/daughters/women in caring roles default to “putting others needs before their own”, and how the line between doctors and patients is truly blurred in times of sickness and health. These questions are something I explore a lot with my patients, so pertinent in the perinatal period, but maybe we can talk about that another time.

I’m thankful to my husband whom looked after our infant alone in lockdown without any support from family or friends during that first (of many) lockdowns. 

I’m thankful to the lady on the end of that breathless 999 call who told me to take care of myself.

I’m thankful to that paramedic that told me a white lie.

I’m even thankful to the junior doctors whom did countless arterial blood gases on me (with and without local anaesthetic).

I had to make a split second decision about coming into hospital, and I’m thankful I made the right one.

.. and even though its taken me over a year to gain the courage to do so – I’m thankful I am able to share my story.

When ladies lose their temper : understanding postnatal rage

When ladies lose their temper : understanding postnatal rage

Hi everyone,

This topic has been on my mind to talk about for weeks (months at the time of publishing publicly) , and everytime I have tried to sit down at the laptop something else comes up (usually baby sick, actually) and the idea gets shelved in the corridors of my cortex. So here I am at 3am (yes – 3am) writing to you all about a hot topic, RAGE… and warning, it might make you feel a bit, well… angry!

Postnatal depression is by far the most common and well known of all the perinatal mental health conditions, and the symptoms of which are very similar to that of a “standard” non pregnant/postnatal depression – however – one symptom that comes up time and time again that is unique to the experience of postnatal depression for many women is that of increasing anger and irritability. In fact, it can often be the first presentation of postnatal depression, but many will ignore it as just “hormones” or “lack of sleep” or “expected”. Should you experience irritability or mood swings, particularly with the other core features of depression (will not list them all but examples such as loss of enjoyment in things, persistent tearfulness, feelings of guilt and worthlessness, or things are getting worse feeling that it is no longer worth living   then i would certainly recommend seeking immediate help as treatment IS available and DOES work.

In this post, however, I want to take a closer look at unilateral postnatal rage – when anger is the prevailing and only symptom, in the absence of any other mood symptoms. This may be controversial, but I would say that in this instance – rage is not an illness,

The more I have been thinking and reading about rage (as well as examining my own feeings of postnatal rage) I have come to understand that the topic is complex and fascinating in its own right. Women have been conditioned for centuries to hold their temper, to reveal such emotions was considered extremely “un-lady like” and the subtext of this remains strong in our society today. In fact, in the Victorian Era, melancholy was seen to be more “attractive” in a woman, as it evoked a sense of being a victim (thus needing a strong man to save her). You only have to refer to the media frenzy that occured when Serena Williams famously lost her temper in the 2018 US Open Tennis final against Naomi Osaka, which sparked a debate how men are allowed, even celebrated, when showing aggression whereas women are demonised and punished for daring to express themselves. Many asian cultures place greater importance on this, where women are often taught to be passive and subservient in nature.

There is also understandable rage in relation to the despair of not being able to meet the high expectations placed on women to “have it all” – to work in their careers like they dont have children, and to look after children like they do not have to work to pay the bills. Trying to have a decent work life balance can at times feel like shoving a square peg through a round hole and is enough to make anyone full of rage. Again, the stark contrast of fathers returning to work (with their body and life largely “back to normal”) can also be difficult to comprehend. The Feminist and sociological literature surrounding this topic is an actual delight and deserves a blog post all to itself, but in a nutshell within the patriarchal system within society reigns supreme and one must place the experience of rage (or rather, the perception of anothers rage) within this context.

There is also the concept of “vertical transmission” of female rage – whether that be because there is a lineage of strong, defiant women – or – rage “against the machine” so to speak of being at odds with the women that have come before you (something very pertinent to mothers learning to mother in the shadow of their own mothers, with the weighty expectations of the mothers before her) leading to friction within families about differences in parenting styles and practices. Although I am yet to find a paper discussing this, there is plenty on the topic of the vertical transmission of trauma, which, I believe is for many the core of their unexplained expressed rage.

How about the biological argument ? The concept of Maternal aggression has been studied for many years in animals. I recently learned that the agapornis (commonly known as love birds) are widely misunderstood as “needing” to be in pairs, where in fact they are better suited to being alone – the female can become extremely aggressive particularly when hormonal and is at risk of killing the male species (!)As we know in the postnatal period the mother is a flurry of oscillating hormones re-calibrating themselves to their pre-pregnancy state, whilst, at the same time, with the understanding that they never be the same again. Having a baby releases a rush of hormones including oxytocin, vasopressin as well as seretonin and CRH (cortisol releasing hormone) which most recently has been linked to levels of maternal aggression – that protective “mama bear” instinct where a mother would do anything to protect her child from harm. So yes, it could be your hormones playing up – but that is only one piece of the puzzle, and I am always wary of the minimisation of symptoms “just because of a hormonal imbalance”.

So we appreciate that rage can have social, familial and biological roots, but how can this help us in our modern day, rage inducing circumstances ?

R = Reflect on your narrative

How was rage expressed (or not) whilst growing up? Do you come from a family used to having shouting matches across the dinner table, or a home where expressing ones disagreements were frowned upon. How about your partner, your colleague or your parents? how were they brought up? Much of the conflicts we find ourselves in can be found in the spaces between us – the differences of opinion as well as the differences in managing moods. You will soon learn this if you are the type to want open dialogue about every issue and the other is someone that prefers to bury their head in the sand!

A = allow yourself to feel angry

The expression of anger is such a taboo in our society, especially in the virtuous, ever-sacrificing mother. As long as you are not putting yourself, or others in harms way – it is acceptable and even at times advisable to let go of some steam. Sublimation is a mature defense mechanism of transferring an unwelcome socially unacceptable impulse into a positive and accepted behaviour. A good example is taking out that frustration in a kickboxing class! channelling all that energy into something that  will make you feel good but at the same time will expel that nervous energy, which if left inside may implode. If all that sounds too strenuous (especially whilst caring for a teething baby…) there are plenty of other positive ways to channel your emotions – and even just acknowledging them out loud ” I Feel angry because….. (Fill the blank)” can often be enough to address the moment to allow it to pass unscathed.

G = Go to sleep 

Sleep deprivation is real, and is the number one reason why you probably have a shorter fuse than usual. I remember before having a baby, I would naively advise in clinics to “sleep when the baby sleeps” – but now being on the other side I understand that this is not always possible. The “downtime” of naps are often when mothers try to accomplish everything on their never-ending to do list (try being the operative word – many of us just revel in mindless scrolling …)  I would however urge you to put the list (and phone) down. If you are at the end of your tether, the vacuuming can wait one extra day. For me personally I make sure to take at least 2 nights a week where I go to sleep early the same time as the baby. This guarantees me a few solid extra hours (which would probably be sat in front of the TV mindlessly) to recharge, and I am a better parent the next day for it.

E = eat well and exercise

Eating for wellness and exercise sounds boring but is absolutely essential, and trust me I have heard (and personally used) every excuse in the book, but it does not make it any less true. The reason why I’m including this in the management of rage is because part of the reason rage is surfacing is because there is a significant loss of that internal locus of control and power, and if left to linger will result in deep resentment. The rage presents itself as a response to the panic within us when there is a threat. The arrival of a newborn is not a threat per say, but it is a perceived threat to the life you once had – your brain is now in overdrive on constant HIGH ALERT caring 24/7 for a helpless individual that is your responsibility – but what about you? who is looking after you? We as women often lose ourselves in the “Caring” role (whether that be for our own children, our parents or our clients) but are the first to neglect ourselves. To eat well and to exercise, in whatever form that takes, is the acknowledgement to yourself that YOU MATTER. It is a form of selflove a respect, and brings back a sense of routine when feeling overwhelmed.


I hope this is helpful for whatever stage of life you find yourself in to take from it what you need.

Much love