Our childbearing years are a time of deep vulnerability and transformation. Those who support women on this journey have their own stories and carry with them the stories of those they support as well. Often there are challenges and sometimes there is trauma. The reverberations of these experiences are felt throughout our lives. Nan Nassef, a doula and Birth Story Listener, shares how her own healing process brought her back to herself while also building her capacity to support others.
In my work as a birth doula, I often come across people who have been traumatized by an experience of birth, people who are stuck in a moment of a previous birth that requires compassionate attention and people who are afraid of embarking upon a childbearing journey because of some deeply negative exposure to birth through experience or story or both. As a result, last summer I began looking for some tools and strategies to help others find places of healing and solace around birth.
As luck would have it, Pam England (author Birthing From Within, and founder of the BFW movement), and Virginia Bobro (BFW’s Managing Director), were offering a tele-course in Birth Story Listening. A program designed to provide doulas and other interested birth professionals with precisely the set of techniques I was looking for. What an opportunity! I took care of the logistical details, completed the requisite pre-reading, and in no time, found myself at the start of the course. What began as professional development, a little tele-course designed to enhance my service offerings, ended up changing my life.
Isn’t that where all meaningful change waits to find us? In the places we least expect?
The course structure was simple. We would first share our own birth stories with Pam, one-on-one, to experience the Birth Story Listening process first-hand.
Then, through readings, conference calls and practice sessions, we would learn to become Birth Story Listeners ourselves. Ten minutes before my scheduled call, I got a little nervous. I guess I was star-struck. I would be talking to the Pam England. But, mere minutes into the conversation, I was able to relax into the call.
Pam asked me if there was anything in my previous birth experience that I was stuck on, anything I wanted to see forward motion on. I took a deep breath, searched my birth story and replied honestly: No. I have zero birth trauma. The only thing I wish was different about my first birth is that I wish I had photos of that magical time before my son emerged. Knowing that I am a doula, she asked me to think about all the births I’d attended, was there anything I was stuck on there? I flipped through one birth experience after another, the uncomplicated ones, the difficult ones, all of them and still nothing. So, Pam asked me to share my birth story anyway and she’d see what she could do. The way I tell the anecdotal version of my first son’s birth is pretty funny, and so Pam and I laughed our way through it, together.
She then asked if there was something in my childbearing year that I did struggle with. And, out of nowhere, a lump formed in my throat: Yes. When I was six months pregnant, I was diagnosed with bipolar affective disorder. Years of challenges in my life led to seeking the assistance of a psychiatrist, my subsequent acceptance of the diagnosis, and compliant adherence to the treatment that came with it. It was hard, really, really hard. Because of the pregnancy and subsequent breastfeeding relationship, the options for pharmacological treatment were limited to certain classes of medications. As it would happen, the medication that worked best for me, the one that helped pull me out of the darkest depression I’d ever experienced, the one that helped me to feel my good fortune, rather than to simply know it was something I possessed, also took something from me.
My whole life I’ve dreamt of being an author. A really good one. During my pregnancy, I was actively pursuing my dream. I was half-way through a master’s degree of fine arts in creative writing through the University of British Columbia. Although living with bipolar affective disorder made it difficult for me to make it through the everyday tasks of living, I was always able to escape into my writing. With the responsibility of caring for someone else looming before (and within) me, it became clear that I would need to get a handle on the day-to-day part of living in a reliable and consistent fashion. My unborn child deserved a mother who could undertake the work of motherhood.
The medication I was prescribed did just that; no longer threatened with depression, mania or psychosis, I could simply be myself all the time. It was wonderful! I could carry out a meal plan, keep a relatively clean house, stay on top of my finances, eat and sleep on a regular basis. What I could no longer seem to do, though, was write. Or read, for that matter. I could read research papers, science-based writing about birth, and parenting, but literary fiction or non-fiction was completely inaccessible to me. It took me a while, and a fair amount of struggle with my course work, to realize that this had happened. Finally, one day I had to write to my professors and the program director requesting that my degree be put on hold.
That happened shortly before my phone call with Pam, a year-and-a-half into my eldest son’s life, while I was pregnant with our second. I talked with Pam about the gratitude I had for my medication alongside the deep, deep sorrow I felt having to accept the loss of my life-long dream. I talked about the resentment I held toward having bipolar affective disorder. There wasn’t much Pam could say or do in that call. But, she validated my sense of the unfairness that bipolar affective disorder even exists. She validated how hard it was to live without being able pursue the goal of becoming an author, and she affirmed the steps I’d taken to seek help when I needed it. Pam did those things very well.
The course went on from there. It was rigorous and demanding. Every week I found myself in tears, thinking I wouldn’t be able to do the work, thinking I would never ‘get it’, thinking I would never be able to honour women’s lives and stories the way they need to be for deep healing to happen. Every week I got angry over trivial matters, and blamed others. Every week, I was tempted to drop out of the seminar. Clearly, the material was too advanced; it was moving along too quickly. But, my husband, Pam, and Virginia encouraged me and I stuck with it. Although it took a few extra weeks, I completed the course, and through it I came face-to-face with the deep pain and shame I’d associated with having bipolar affective disorder.
I had to accept bipolar and its treatment as an ongoing and dynamic part of my life, not something I could simply erase, or take a pill for and then run away from, or magically resolve somehow. Just as a woman who has experienced trauma in birth cannot simply ‘suck it up’, although so many hurt themselves in the attempt. And, in so doing, that acceptance brought me back to myself. The self I thought I’d lost or no longer needed. It gave me back the sense that I am capable.
It is so easy to get caught up and defined by a diagnosis, be it bipolar affective disorder, postpartum depression or something else. It is so easy to get stuck in a moment, to be held captive by our narratives of loss. It is so easy to forget that somewhere in the midst of it all is ourselves learning, growing and evolving still. If you are stuck on something, I would encourage you to seek the assistance you need, not to ‘move on’ as in move-away-from, but to get local, personal, to reconnect with who you are: whole and unique and beautiful. Reclaim your power, your dreams and your community. No matter where or who or how you are, you are not alone. It is possible. And there are people who can and want to help.
As for me? Well, I don’t know if I will ever become the next great Canadian author, but I thought I would start with a magazine article or two.
Nan Nassef is a Birthing From Within mentor and doula, a Birth Story Listener, and a mother of two incredible children. She maintains a personal blog about motherhood and life with bipolar affective disorder at: nanyambo.com