Claire’s story: I believe my second experience of PP was entirely preventable

Claire Neaves shares her story with APP

When she was 30 years’ old, Claire experienced a psychotic episode that came completely out of the blue. She believes that this was linked to what was at that point an undiagnosed under active thyroid problem. She took a year out of university but was able to return the following year.

Four years later, Claire was pregnant with her little boy, and enjoyed a fairly smooth pregnancy until she reached labour. At that point, her contractions were all over the place and she ended up being in labour for four days – initially being sent home from the birthing centre and then admitted to a local hospital for her delivery.

After six or seven hours at the hospital, Claire was given an epidural and emergency C-section because her baby became stuck. This was a traumatic and frightening experience, and because the labour lasted so long, the epidural was ineffective during the C-section, and Claire was in a lot of pain. She also hadn’t eaten or drank anything for four days, and hadn’t slept a wink either.

Claire is convinced that the psychosis started there and then on the operating table.

As she was being wheeled out of theatre, Claire recalls believing that she had died and that they were wheeling her through the gates of heaven. She was put into a recovery room but, because of the trauma and shock that was to be expected following such a difficult labour, it took a while for anyone to notice that there was something else going on.

However, after her husband left her side briefly to collect a change of clothes, he noticed a change in Claire as she was incredibly distressed and anxious – far more than he would have expected. From there on, the distress escalated significantly.

Sadly, because there wasn’t much awareness of postpartum psychosis at the time, it took a while for Claire to receive the diagnosis. In the meantime, she was inappropriately placed on a renal unit – a ward for people with kidney problems – the theory being that, because there were older people on that ward who also experienced memory loss and distress, that would be the most suitable place.

Claire was so anxious at this point she regularly tried to abscond and ended up having two security guards on the door which made things even more intimidating. As the psychosis became worse, she was given the anti-psychotic, haloperidol, which had a negative effect on Claire, making her almost zombie-like. Shortly after, she was sectioned, but even then, the psychiatrists refused to take her to the mental health unit until all other possible physical causes had been ruled out. These investigations took a long time, and it was only after seven days that Claire was admitted to the general psychiatric ward. At this point her psychosis got much worse, and, due to the separation from her newborn, she was scared about what had happened to him, believing him to have died.

Eventually, Claire was given a bed at a Mother and Baby Unit and, once reunited with her little boy, her recovery was really swift. After one month, Claire was enjoying leave and eventually moved back into the family home.

Of course, full recovery took some time, and Claire was incredibly anxious looking after her baby, feeling scared that something might happen unless she focused all her energy on him all of the time.

Three years later, Claire had her daughter and, knowing that there was a 50/50 chance of her developing postpartum psychosis again, she carefully planned every detail of the birthing experience. Because of the risks, Claire had an appointment with a psychiatrist prior to her birth and was advised that the psychiatrist would visit the maternity unit the day after the planned C-section.  However, the psychiatrist did not attend the appointment, so she ended up with no mental health support at all and no specialist treatment when the psychosis did start to creep in.

Because the feelings were familiar the second time around, Claire shared her concerns with the doctors and requested to see a psychiatrist but it became clear nobody was coming. Because she wasn’t getting the right help and was uncomfortable in the maternity ward, Claire and her husband decided that going home was going to be best. In desperation, Claire then dialled 111 and requested a walk-in appointment. The family had to wait over five hours while Claire was actively psychotic, hearing voices and feeling frightened, whilst her and her husband tried to cope with a newborn baby and a three year old. Eventually, Claire approached the nurse and explained what postpartum psychosis was and that she needed emergency help. She was then seen quite quickly but the doctor would only prescribe sleeping tablets, rather than the required antipsychotics. Even though Claire knew immediately after giving birth what was happening, it was seven days after leaving the hospital that she eventually received any support from psychiatric services.

Claire stayed in the MBU over the Christmas period and, although she wishes she had been admitted right at the beginning, she says the care within the MBU was outstanding, and she enjoyed a short but sweet Christmas dinner with her husband and family around her.

Given the insight she had following two previous episodes of psychosis, Claire believes that her second experience was entirely preventable.