Nurse Ruth’s face was set in tense lines of seriousness as she probed my cervix with a metal instrument. I knew this procedure by heart, having been through it five times in the past 17 years: dilate the cervix, measure the uterine cavity, insert the intrauterine device.
But Ruth was frowning. The last time, another nurse said the depth of my uterine cavity was too short. Twelve years ago, after the birth of my third child, I learned that my retroverted uterus had yet to properly settle itself nicely inside my pelvis and that my cervix had partially descended into my vagina.
Now as Ruth brought out the instrument and gazed at the blood smear on the tip, I trained my eyes on the crumple of her brow and tried to decipher what she wasn’t saying. In another life, I would not set my foot within a 10-mile radius of this place. But here I was, 36 and frightened, and I willing her to say something positive; I willed her to say that childbirth hadn’t ruined me that much.
But she didn’t say those words. Instead, she worked until I could no longer endure the discomfort of metal scraping against the soft of my womb. Because my cavity was still so short, Ruth suggested an alternative contraceptive — a progestin implant. She feared my uterus would expel an IUD if she went ahead and inserted it.
True, the last IUD had snapped and poked at my insides all night until the following morning when I found a doctor, who pried open my cervix and got it out. The one before that, my body began to act strangely and I experienced unexplainable vaginal bleeding whenever sex was vigorous.
“I have heard terrible things about the implant,” I told Ruth. “I hear it can reduce me to the biblical woman with the issue of bleeding who was healed by Jesus.” She laughed, despite the seriousness of the moment, but then she had positive and convincing things to say. She invited me to the clinic’s family planning seminar scheduled for that week. She gave me an emergency oral contraceptive for the time being, and we agreed to have the contraceptive inserted into my arm at my next visit.
I smiled and thanked her. Then I cried all the way home, ignoring the curious looks of concerned passersby, some of whom paused, as Nigerians are wont to do, to ask what made me cry.
My husband G was waiting at home when I got back. He looked pensive but tried to act cool until I had kicked off my shoes and changed into a house dress.
“How did the procedure go?” G asked. He wanted to know if I was fine. By “fine” he meant if my uterus had behaved and accepted another IUD.
“I am fine,” I said.
He tried to have a conversation but I just couldn’t. I went through the motions of my day; tried to keep my mind off things. I wrote pages of a story and deleted them. I picked up a book but the words kept bleeding into each other. I watched our son watch cartoons. In the middle of the night, when the world had fallen asleep and only the chirps of crickets and rustlings of night animals sifted in from our open window, G woke up and found me loitering by the shelves.
“Something is bothering you,” he said.
“Do I look like something is bothering me?” I said, as I rearranged the books which I had arranged the week before.
He begged me to come to bed. He held me. I coiled into his embrace, and then I wanted to fuck. But as he slid inside me, I held my breath and tightened my vagina muscles, willing my cervix to behave and not leak drops of blood as it had done sometimes in the past. After he rolled off my body, I hurried into the bathroom, slipped a finger into my vagina, and inspected the wetness for blood stain. I saw none. I crouched over on the floor and wept into the cup of my palms.
This was not my first panic attack, and it was not the worst.
I can easily recall when I found out the possible name for this ailment that ate at the seams of my mind, but I can’t put a finger on when my Postpartum Depression actually began.
Perhaps it all started that the day after I gave birth to my first child, my daughter Chi, in September 2002, when I got home and found the small wooden stool my mother-in-law had brought for me. A new mother is required to sit on this stool, to press her legs together and make herself small. The belief was that this posture would keep the pelvis region clenched, to help restore vaginal muscle tone. There was also the wild belief that women who suffer postpartum complications, like uterine prolapse and pelvis floor problems, were those who did not strictly perform this old ritual and the many others.
That was the year when I learned that our society also manufactures ready-made excuses for terrible men, that new mothers must work hard to make their bodies sexy again or they will be blamed if their husbands philander or become terrible partners. Add that to the fact that many new mothers struggle to comprehend the harm wreaked on their bodies by childbirth. But they do not speak about it for fear that they will be dismissed as weak. They do not have support groups. The pregnancy literature accessible to them is always about how to “snap back” and become sexy again. At church, they are endlessly taught how to please their men and make them comfortable. No one really cares about how the women feel, if they are still haunted by the memories of childbirth, how they are coping with the immense bodily changes, if they are emotionally ready to have sex, if they even want to go through pregnancy ever again. They are expected to perform their roles as virtuous wives and good mothers, or they’ll fall short of societal expectations, of which the consequences are grave.
As such, the women relive their traumatic experiences. They walk around with shoulders hunched by these burdens. They put on a smile and perform these roles, ignorant of the symptoms of their hormonally-triggered mental illnesses, until they buckle under the weight of it all.
It would take many years before I learned that there is such a thing as Postpartum Post-Traumatic Stress Disorder or even Postpartum Depression.
While my body went to pieces after the birth of my first child, I still submitted myself to the process again and again. That is what I was taught marriage is all about — giving birth to children who will carry forward the man’s torch after you all are dead and gone, no matter the emotional and physical cost.
On our wedding day, families showered me with prayers: I would give birth to seven sons and two daughters, they would all gather again in exactly nine months to celebrate the arrival of our first child. I hefted those sacks of expectation on my frail shoulders like my mother had done and the mothers before us all.
My first labor stretched for three days. I was just 19. Because I had become too weak by the third day, the doctor took a scalpel to my perineum, fused a suction to my daughter’s head, and pulled her out. The suction cap left a huge red swelling on her scalp. After I was wheeled back to my hospital ward, my first inclination was to feel the floor with my toes to be sure I had truly survived this. Then I wanted to sleep for a whole week, the very idea of standing or walking turning my knees to mush.
My daughter was asleep in her cot when a sister-in-law scooped her up and began to inspect her body. She saw the swelling and gasped. “You must never let anyone see this or they will call you weak,” she told me, and drew a hat over my daughter’s head.
She was a middle-aged woman who herself had had three children, a girl and two sons, the second of which had put her through a traumatic birthing experience that left her immobile for nearly two months.
I shrank but nodded in agreement, believing she knew better and was speaking from experience. It sounded so right; relatives roamed around us, hugging and thumping my husband’s hand, praising him for marrying a woman who in the end conquered childbirth and brought him a daughter. I sat on my bed and smiled and laughed, even though my stomach felt gorged out and I became dizzy whenever I tried to sit up straight. I pretended to be strong. A strong woman was a husband’s pride, was what I was expected to be, what I would be.
I kept my daughter’s hat on and performed my role of a strong wife. My episiotomy was stitched so tightly that I cried when I bent to pee or defecate. My inverted nipples had blistered and bled each time my daughter latched on to suckle. Pregnancy had messed with my lower intestine and I would sit on the toilet bowl for hours, crying as I passed constipated shit because my bowel had forgotten how to regulate the usual flow of feces. I moved through each day in pants, dizzy with fatigue, and my husband counted down the days until we could start having sex again. My stitches would take weeks until they really stopped itching, leaving a jagged dark scar that travelled from my vagina, past my perineum, and into my anus.
On the first day we resumed sex, I clamped my mouth shut and moaned sensually, but not too much, to aid my husband as he galloped toward orgasm. Then I spent maybe 20 or so minutes sitting my butt in a bowl of salted warm water to soothe the ache that had begun to throb where my stitches had supposedly healed.
I was happy that I had given birth to a child, but I do not mean “happy” in the mindless joyful way of one who had achieved what she had always yearned for. My happiness was the kind of relief that washes over your body when you have passed a difficult test and proved to your family that your education wasn’t really a waste of money. I would often stay up at night, gazing down at my daughter as she slept in her cot, fascinated by the fact that this chubby, beautiful human being who’d weighed 3.7 kilograms, or 8.15 pounds, had popped out of my body. I remember obsessing over her breathing pattern, rearranging her blanket and pillows, afraid they would smother her in her sleep. I was tenaciously protective of her. But while having my sitz bath later, I would lock myself inside the bathroom for a long time, listening to the chatter of the children in the neighborhood, the passing cars, and laughter of passersby on the street below. I would breathe in the spicy deliciousness cooking in the restaurant beside our house. Until my daughter woke with her usual cry. I knew I should go to her, but when you are 19 and your body has undergone an unbelievable trauma and you are sore all over, you will wish to shape-shift into a fly and wing your way out of the window. I had none of such extraterrestrial powers, so I simply cried and cried until someone heard and banged on the door and asked if everything was alright.
This became a routine. Sitting in warm baths. Weeping when no one was looking. Performing my role as the strong wife. To family members, I was a capable mother, but my hands shook all the time. I drifted through hazy days inside this altered body, unsure of how to wear it, what to do with it. I no longer knew myself.
Those days, the memories of my first labor often came, without warning, in debilitating flashes. Sometimes I wished I could reach into my head and twist something so I wouldn’t be haunted by such unfair vividness. This continued as my baby grew, as I got pregnant again just a year later, as I neared my due date. Many months had passed but I still could not shake that sense of horror that filled my very bones when I thought of childbirth. I began to wonder if I was trapped in some kind of capsule — had the sense that everything else had seized and this fear was the only thing real. I would often wake up in the middle of the night, sweating.
My husband found me staring at the wall one night, a few weeks before our second daughter Som was born. Outside our window, the world was dark and still, the air filled with the symphony of generator noises in the neighborhood. He asked why I was awake and staring. I looked at him. Our lamp sat by the door, casting orange shadows on the wall. I remember how worried he looked, how he shifted closer and held my shoulders.
“What if all of this is just a dream?” I asked him.
“What do you mean,” he said.
“What if I didn’t really wake up that day in 2002 when I went to give birth to Chi? What if I am in a sort of purgatory or a dream and none of this is real?”
He shook my shoulders and said I must stop talking rubbish. Then he said we must pray. We knelt by the side of the bed, him clasping my hands tightly in his. He shut his eyes in piety, his face squeezed in intense sorrow. He told God to keep me safe. He was so downcast.
I muttered, “Amen,” and smiled and said I was finally fine. He hugged me. He believed me.
Where I come from, if a woman so much as reveals she is depressed — an affliction that is still associated with evil spirits and demonic attacks — she is taken to the church for exorcism. She is considered tainted, bad luck to her husband, a threat to her children. And so knowing the repercussions for speaking one’s truth, knowing it can bring your harm, what is the point of speaking it?
In June, 2007, three months after our son Chu, our third child, was born, I visited the clinic to have an IUD inserted and learned that my uterus had yet to nicely anchor itself within my pelvis. I had leaked drops of blood the week before, after I had sex with my husband, and had thought it was the remnant of my postnatal shedding. We were going through a period of financial crisis. In all my imaginations about my future, I had not anticipated becoming a permanently mutilated thing. I was a mess.
In the following weeks, I still could not shake that feeling of bereavement. I began to mourn what I had lost, the sense that I would never again regain who I used to be, that I would have to make do with what childbirth had left me with. I took to walking, from Faulks Road to Okigwe Road to Brass, on sunny days. And when I got home, I would not remember what I saw during those walks, or who I had talked to.
My detachment from reality soon began to worsen. I trailed off in the middle of conversations. I struggled to suppress the truth about my body. The legacy of patriarchy had taught me that I must appear perfect for my husband, for the community, or I would be considered weak. This struggle ate at the seams of my mind. When I finally accepted that I was depressed, I did not know what to do with that information.
What do you do when your egusi soup shows signs of turning? My mother taught me to add a bit of potash, to boil the spoilage away and scoop the froth out, to add some pepper and crayfish and salt, and the soup would return almost as new. But when the soup fully sours, you throw it away; there was no remedy for that kind of rot.
I was frothing over and there were no therapists in my area of Nigeria whom I could talk to. My husband could not understand my mood swings, why I kept fading out of simple conversations. I kept the truth of my depression and mutilation from him because I feared he would consider me weak, that he would be repulsed and no longer find me sexually appealing. It would take a very long time before I stopped believing in those patriarchal myths, began to put myself and my health first, and charted a path to true relief. But before this, before I began my journey to redemption, I tortured myself with my silence. I could smell the rot of my corrosion, the unravelling of my mind’s seams. How quickly I was disappearing inside my altered body. My clothes became sizes larger. My hairline began to recede, my hair grew ashy and fell off in clumps.
What do you do when you turn like soup and there are no remedies for what ails you? Do you throw yourself away?
Being a Christian means casting your burdens upon Jesus. Whether religion solves the problem or not, it doesn’t really matter because that act of spiritual supplication slaps a temporary Band-Aid on your affliction, so you can breathe, even for a minute, before your wound erupts again. And you return to Jesus again.
It was difficult to convince my aunt, a bible-thumping Christian, that I was depressed. It was difficult to find the right language for my affliction, and so I went along with her conclusion that I was being haunted by evil spirits. She made appointments with a spiritual healer to intervene in my case. We went for the exorcism with the items the healer demanded: two bars of soap, two bottles of olive oil, a packet of salt, a white kerchief.
The healer was a small light-skinned woman who wore a white scarf tightly over her head. She received us with curiosity. She asked if I was married to my husband, and I showed her my wedding ring. She washed her hands with the soap we had brought, and wiped them dry with the kerchief. Then she called me to the middle of the room, muttered incantations, sang Christian songs, and danced and clapped her hands.
For a long time she prayed and sang and danced. I sang along, clapping. My aunt, too. The room was dimly lit, lazy rays casting hazy shadows on the carpeted floor. From the open window, I heard the thumps of pestles into mortars and the clang of spoons into pots. I heard the cries of children playing in the field nearby. The neighborhood was awake and bustling, and I wondered what it would feel like to join the kids and yell at the top of my voice, to play with such reckless abandon. To be somebody else again.
“She was attacked by an evil spirit during her first pregnancy,” the healer paused amid singing to tell my aunt. She swayed. She muttered more incantations. She yelled at the supposed spirit to flee from my body.
“Her husband is facing financial difficulties, is it not true?” she asked my aunt again. My aunt bobbed her head furiously. “The spirit is ruining everything she touches.”
I was dizzy with confusion and irritation. My stomach gurgled. My last meal had been the scoops of spicy jollof rice I had the afternoon before, and I had stayed awake most of the night, gazing at the ceiling. Now I was dizzy, fatigued. Darkness hovered before my eyes and I slipped into it. When I opened my eyes briefly, I was crouched over on the floor.
The healer sang victorious songs. My aunt thumped her hands heartily. They danced.
“The spirit is gone,” said the healer. “She is free in Jesus’ name!”
My aunt yelled, “Amen!”
I had an explanation for that fainting spell, for our financial situation, but I held my tongue because I knew it would be dismissed as rubbish, or that they could subject me to more prayers. On our way home, my aunt held my hand in hers, her eyes bright with happiness.
“You are free in Jesus’ name,” she said.
I nodded and said something in the affirmative, and she was pleased that I had accepted my healing. It was a hot afternoon and sweat pooled under my arms. My scalped itched. She talked all through the ride home. She reminded me of the prayers and fasting I must perform daily for two weeks, and the bible passages I must read; it would be a serious time of piety — that’s what the healer called it — and this fasting stretched from six in the morning until six in the evening, every day, to keep the evil spirit permanently away.
My husband was in the sitting room when I walked in. He took one look at my face and asked if everything was alright.
“I have a headache,” I said. “I want you to do something for me.”
I got a pair of scissors, sat by his feet and told him to cut my hair, all of it, down to the scalp. My hair had suddenly become an itchy, heavy burden, an unwanted thing I must remove from my body or I feared I would never be able to breathe again.
“Why?” he asked, giving me an incredulous look.
“Please,” I said. “Or I will cut it myself.”
He began to say something but stopped. Maybe it was the look in my eyes. Maybe he understood that I wouldn’t be fine until the hair was gone. So he took the scissors.
When I first moved to Aba, I had recently turned 19 and the air was mildly hazy with the harmattan dust that coated everything with a film of brown. People walked around swaddled in thick sweaters and wool stockings and complained about how cold every day was, which I thought was hilarious because the temperatures were consistently in the 60s, nowhere near the dire situation in the city of my birth, Kano, in northern Nigeria, where the harmattan was so severe that it sucked all the liquid from your body, cracked your lips, broke your heels, flaked your skin, caked your hair and eyebrows and eyelids with dust, and the cold winds howled outside your windows like an old Volvo with a really bad engine. I was enthusiastic about my marriage and was excited when neighbors addressed me as Nwunye Olisakwe — Olisakwe’s wife, never my name, because, as programmed by my socialization and all the years of the Sunday School classes and church sermons, bearing my husband’s name was an honor every girl must aspire to, the prerequisite to attaining that prestigious status of the Virtuous Woman. I was desperate to get pregnant.
On Mother’s Day that year, we sang the famous old song that went, “Sweet mother, I no go forget you, for the suffer wey you suffer for me,” and I was pregnant with Chi. I danced and sang along with the other women, happy to be performing this rite of passage, this celebration of suffering that would guarantee my continuous membership in this pantheon of Virtuous Women.
But then childbirth happened, and my postpartum complications followed. Everything soon became bleak.
My husband is beautiful in a laid back, unassuming kind of way. He’s average height, sturdy and white-goateed — 16 years older than me. He remains bright-eyed, despite all the financial turmoils he’s endured, and speaks about his future business plans as though he’ll pluck the start-up funding from the guava trees in our yard. He’s refused to be subdued even in the face of intense hardship. He’s the most optimistic man I’ve ever met.
But one morning in August 2017, he looked defeated as he watched me dress up to go grocery shopping.
“The wig looks nice,” he said after I had donned the lush afro that swallowed half my face, swallowed even the desolation that had dulled my skin, and shrank my cheeks. When I looked into the mirror, I thought, I look elegant.
I was going through another phase of depression and was no longer optimistic about anything. I could not bear socializing with family friends and had shaved my hair, for the second time since my marriage, down to the scalp, with a pair of scissors and then a blunt razor that left red markings on the edges and the back of my neck.
“Have you had anything to eat this morning,” he asked me, and I said no. “You should eat something,” he said. “You are getting thinner.”
For an instant I saw myself through his eyes, how tired I possibly looked, how quickly I had begun to disappear again inside my dress. How unappealing. Something shrank inside my stomach. I muttered excuses about not being hungry, and quickly grabbed my bag and left.
Down the street, I met a neighbor who had known my family throughout my marriage. She stopped to say greetings. She called me “Nwunye Olisakwe” and asked if my family was all well. I began to respond as I usually would, but instead asked if she knew my first name. She frowned, then laughed incredulously and asked, quite simply, if everything was alright with me.
“What is the matter with you,” she asked, her eyes bearing concern. I said something incoherent and ended the conversation.
I walked to the junction to board a bus and tried to brush the encounter away from mind. I felt as if I had not only sacrificed my body and mind to marriage and childbirth, but had also lost my name. I had thought, I should ignore this; it was the way things are, how it always had been. But I was still upset, and made even more so because of the expression on the woman’s face; she had looked at me with concern, as if I had lost my mind, as if she could not believe that an Igbo woman like me would reject the prestige that came with bearing a man’s name.
I stopped at the junction but did not board the buses that rolled to a stop before me. It was getting hard to keep denying how thoroughly unhappy I was. I felt as if I had reached the end point in my situation. I could feel the anxiety clawing at my insides, the desolation nibbling at the seams of my mind, the sweat pooling under my arms. I knew that I was hurting my family with my moodiness, my husband especially, because I had walled myself away from him. I no longer felt any sense of joy in our city, in our life. I was anxious, triggered by even the simplest things, but unable to explain my anxiety to others. I knew I needed to heal, to find myself. I knew it was time to leave home.
That evening, I told my husband that I wanted to apply for an MFA; it had been three years since a friend suggested I apply to schools in the United States. We both sat in the room after our children had gone to bed, and I stared at a spot on his forehead because I could not look into his eyes. I did not want to see if they carried the mix of emotions I felt, the confusion and desperation and fear rumbling inside me, all at once.
“So, you will be gone for two years,” he said quietly. “But you will come home every holiday to be with us, right?”
Inside my head, I told him how unhappy I was and that I blamed him for the trauma my body and mind had been put through. I blamed him for marrying me when I was merely a teenager and changing the course of my life. But I could never have said those words to him.
“I will come home every holiday,” I said instead, fervently. I told him about the advantages to getting an MFA, why I must get better at writing, this thing I loved to do. I promised to always come home.
For a moment, he watched me, saying nothing, and I felt uncomfortable under his stare and also felt the need to reassure him that I was not running away forever. Then he said, “You will do well in America. I trust you.”
I wrapped my arms around his waist, pressed my lips against his, fumbled with his shirt buttons. He held me tightly, then pushed his arms under my blouse, under my bra cups. His fingers were warm and callused. “The children might walk in,” he said, and quickly stood up.
In the bedroom, we undressed silently, pressing against each other in the dimly lit room. I mounted him, my movements slow. His face was oily, his features firm, but there was a sheen in his eyes and I could not tell if it was from excitement, or if it was something else, before he turned his face away from the faint light sifting in from the window. Later, I waited until he had fallen asleep, before I returned to the sitting room to switch on my laptop and look up schools in the United States.
In 2018, I went ahead with my plan, and moved to Montpelier, Vermont to attend the Vermont College of Fine Arts.
I am now living the first chapter of the new part of my life. Before attending the first day of classes, I gazed at my family photos, thinking. I could almost read the expression in my husband’s eyes. His face is stretched in a smile, his eyes are mild. He’s become the primary caregiver to our three children — Chi, Som, and Chu. He has eight siblings and one living parent; he’s burdened with other responsibilities, too, and there I was, so far away from him, so far away from home. I felt crushed with guilt. I cried as I prepared for class. I cried when class was over. I cried when I spoke with them later over the phone. I cried because I was again putting everyone’s feelings first before my mental health. I cried myself to sleep in my room, the first place I could call my own in my 36 years. I thought moving away from home would give me the opportunity to heal, to find myself, but I isolated myself in my room, pummeled myself with guilt, could hardly handle hanging out with the new friends I’d made, and would stare at my computer, paralyzed, until my friend Rebecca knocked on the door and asked, gently, if I’d like to join her at the Three Penny Taproom Bar, or on a trip to Burlington.
Then one morning, during a class with the poet Bianca Stone, she asked us to make a list of the things we’d rather write about, the things we were afraid to write about, no matter the forms we primarily write in. I made notes about my postpartum complications and the cultural myths surrounding childbirth and motherhood in my community. After that class, I broke into tears. I cried all night. I coiled in my bed and wept, and all of the following morning. During subsequent classes, the conversations burrowed holes into my carefully stacked traumas, and I wrote a poem about childbirth.
I wrote that poem four months ago, and I returned home to spend the summer with my family in Nigeria, during which my agent sold my novel to a publisher in the United Kingdom. Many of our relatives think my decision to attend school abroad is a shocking anomaly, and always tell me this. They believe it is an abomination for an Igbo woman to leave her children in her husband’s care, for a wife to live so far away from home. I initially tried to explain the importance of my education, but then I learned to assuage their concerns with typical responses: I tell them that our children are almost all teenagers. I tell them that Chi is already 16 and has graduated from secondary school. I tell them that my husband is doing just fine. And sometimes my husband throws in the clincher, perhaps to taunt them: “They will soon join their mum at school in America,” he’d say. And this always ends the conversation.
I have since found a new rhythm and I am no longer as anxious as I used to be.
Speaking out is like lancing a boil; the body will not return to its prior state, but you are filled with relief once the poison had seeped out.
It is now 17 years since the birth of my first child, and my altered body has finally begun to feel right. I have learned to wear it. I have slipped easily into a new life, one occasionally wracked with the memories of my experiences, but I am no longer afraid because I now know my affliction.
Previously published in Longreads
Ukamaka Olisakwe is the author of Ogadinma