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Brain not included: how Norway’s birth care leaves Perinatal Mental Health in the dark

 

In 2016 I accidentally fell into a black hole. I was 29 years old, healthy and happy. My husband and I were trotting up and down the corridors of Norway’s largest hospital, excited to soon be welcoming our first child. Together we breathed through my steady contractions. Things were looking good.



In 2016 I accidentally fell into a black hole. I was 29 years old, healthy and happy. My husband and I were trotting up and down the corridors of Norway’s largest hospital, excited to soon be welcoming our first child. Together we breathed through my steady contractions. Things were looking good.


Forty hours later I came to myself in a recovery room. My body was beaten after a long and difficult birth, culminating in an emergency C-section. I remember the disturbing feeling of wondering where my baby was, and whether this had all been a bad dream. Later I would learn that several things had failed during the two-day long ordeal. Fundamental things, like adequate pain relief, lines of communication, patient autonomy and informed consent. Harmful consequences were caused not by the hands of the personnel, but by the pressured system they were working under.


Four days later I could finally leave the hospital. I brought home a healthy baby and a battered mind. I could not speak of what had happened. I knew no words for it. When asked by friends and family, I replied horrible and burst into tears. My husband and I did not speak of it. We knew just by looking at each other. Never again. Never.


Like a broken record the birth experience got stuck on my mind, playing over and over again. At night I would wake up kicking and fighting, feeling strapped to my bed by invisible belts. Gradually, I avoided sleeping. I stayed up through the night, watching Netflix with our baby sleeping on my chest.


Soon the nightmares showed up at daytime. Out of nowhere, flashbacks and anxiety would overwhelm me. I started retracting from social life. I was losing myself and I didn’t know how to fix it. Eventually, I realized I needed help.


At the Health Center, the Public Health Nurse informed me that the center no longer had any Psychologist available due to budget cuts. She suggested I go back to the hospital to ask for help. Long story short, I spent the next few months emailing, calling and knocking on doors to various public institutions and volunteer organizations. Some offered help by pointing me in other directions. Others invited me in for a chat, but with a disclaimer that my case fell outside their field of competence or programs.


Finally, I went to my General Practitioner, explaining how this birth had felt like a near-death-experience and that it was now taking over my life. I told him I was barely sleeping, and I was afraid I was going to lose it all together. Where could I go? He noted that giving birth can probably feel overwhelming. Becoming a parent is hard for everyone. Had I tried sleeping when the baby sleeps?


Fast forward to the good part. My baby was nine months old when I finally received the help I needed. During my first consultation with a therapist, I was diagnosed with PTSD after birth trauma. Apparently, I had all the textbook symptoms. The therapist told me I was not alone – lots of mothers suffer similar experiences. I received trauma treatment, and within a few months I was gradually finding back to myself. Slowly our little family got back on its feet.


I am one of the lucky ones. My story has a happy ending. I was lifted out of the black hole. I went on to have another child. This time I received good birth care, including mental support. We decided to name our second child Våge, meaning to dare. Daring to go through another birth is the bravest thing I have ever done.


The bad part is that mothers and families keep falling into this massive black hole every day. Some of them never get out. In Norway, between 6.000-12.000 mothers suffer serious Post-Partum Depression every year, a condition demanding specialized treatment. Suicide is a leading cause of maternal deaths. For fathers and partners, the numbers are still in the dark.

Where are the national systems for screening and interdisciplinary care? Where is the National Knowledge Center for Perinatal Mental Health? Where are the education programs? Where are the Mother-Baby Units?


Norway keeps claiming the title as The Best Birth Care in the World. However, physical care should only account for half the trophy. Babies depend on having mentally safe and stable parents. This is also their fundamental human right. Childhood lasts for generations, and prevention starts before birth. By not providing necessary support to parents, we are depriving babies of having the best start in life.


As we speak, a Representative Proposal regarding Prevention in the Critical 1001 Days is up for debate in the Standing Committee on Health and Care Services. May the sitting Government make history by putting Perinatal Mental Health into system in Norway.


I am writing this to encourage professionals to shine a light into this black hole of Norwegian birth care. We must dare to talk about anxiety, depression and eating disorders during pregnancy. We must dare to talk about birth trauma, PTSD, PPD, OCD, and all the other mental challenges that so many families experience in the 1001 Critical Days.


For the sake of mothers, fathers and partners out there, for the babies and for the generations coming after us: Please acknowledge this black hole, and do whatever you can to fill it with light and knowledge.


Thank you. □

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