Caroline Flowers Tomekowou
“I love the word ‘survivor.’ I think there's so much more strength in the word survivor than there is indicated of weakness. Being a mom is tough, survivor or no survivor. But when you’ve gone through this, having those tough days can bring you ALL the way back. It’s almost like being in recovery. We never forget.”
Caroline is a Providence, RI native living in Worcester, MA with her husband and 3 children. She identifies as a West African Woman, and works as a Reproductive Mental Health Psychotherapist and as Program Director for Postpartum Support International - MA.
This blog is made possible by a sponsorship from Sage Therapeutics. All content on this page has been curated by the Mass. PPD Fund without input from Sage Therapeutics, Inc.
February 2022 | Interviewed and edited by Jessie Colbert, Executive Director, Mass PPD Fund
Did you have expectations about bringing home a new baby? What did you think it would be like? What were your hopes and fears?
I definitely had more hopes and more good feelings about being a mother. We did go through fertility. We were feeling lucky that we were pregnant in our first round. I think the only fear that was coming up every so often was financial. My [now husband] was looking for the right job. I was already stable; I had already been working at CHL [Community Healthlink] in crisis. And [financial concerns] would only come up when, you know, I went in Babies R Us and found this ridiculously expensive bedroom set for a person not even born yet, when I couldn't fund some outlandish thought of mine! Other than that, I kind of thought this was going to be simple. We were waiting for the rainbows and sunshine that everybody promised.
Oftentimes when a baby is born, parents have plenty of support for the baby, but not a lot of support for themselves. Did you feel like you had people looking out for you?
We didn't think about that. We were both raised by one parent and we were their only child. We'd come down from that line of parenting, so we figured it'd be just us. Which was already more than we had. And I come from a line of my cousins and half-siblings that had gotten pregnant early, were single moms, were struggling. So, for me, I had already done all the things that the people around me didn't do. I went ahead and finished high school. I got a bachelor’s, I got a master's before getting pregnant. I had a partner and we already had half our wedding planned. So, for me, the person you plan your life with is who takes care of you. We didn't know enough that we needed more.
I do think that I expected more visits – people wanting to come and see the baby, come and visit with us and chat. And if they brought food, great. I think that would be the extent of where I saw support.
Tell me about your journey with mental health challenges around your new baby. When did you realize something was “not right”? What turned things around for you?
So, it was probably the day I went in to be induced because they thought the baby was going to be too big. I'm just kind of walking around the room and I really don't know what to expect. I'm hearing somebody yelling, and it turns into a different kind of yell. All I could picture was, like, she was seeing the devil or something! And then I started panicking. As the nurse is explaining, “Oh, they're pushing,” I started crying. I was like, Oh my goodness, is that what I'm waiting for, to do THAT? Because I had spent most of the [pregnancy] in rainbow and sunshine land. All of a sudden it looked like the rainbow was starting to fade a little bit.
[Later when] I got the epidural, all of a sudden I was bedridden. Then being told, okay, you're having some decels [decelerations in the baby’s heartrate], so we might want to start talking about a C-section. And I was like Oh, okay, that I wasn't expecting. And then when it started being like, yeah, we're doing this – we’re going into the next day now – and I'm being told that I can't eat. The rainbow was just gone now, being wheeled in to go have surgery. Afterwards, I got to my room and the baby is fine, and my aunt and my dad are there with my husband. So, things kind of stayed level emotionally then.
But then my days in the hospital [were extended]. The baby was actually a little small – not meaning NICU but definitely not what they expected. And there was some jaundice, so that added a day. And she wasn’t taking the breast, so I think that added a day, too. I started to feel that downward spiral again. I remember a nurse being very aggressive with trying to help me breastfeed and pulling on me and yelling. I felt very, very judged. And I only had, like, two visitors. I was not feeling successful at becoming a mom. The sun was gone before I even left the hospital. I knew that I didn't feel right, and I didn't have a name for it.
I came home to a house where my husband was working two jobs, and I was home by myself with a screaming baby. I never felt like I needed people before I had this baby. To be a pioneer, to [succeed] for my community, I had to do it alone – which isolated me. I didn’t create the village to help me with this baby. And I was like, Oh my goodness, I made a mistake.
I started having these thoughts about, I should just hop on a plane to California. And I’ll go running on the beach. I’ll work in a bar. I don’t know where that picture came from, but it was very clear. And that was sounding really, really good. There would also be moments where it seemed okay. Like, she's cute, I could sort of do this. . . I just kept floating between those thoughts. And I was doing a lot of crying. It was so strange being a clinician and just being very out of the loop about what was happening.
Caroline had only heard of postpartum depression once from a former colleague. She didn’t want to be treated locally because of her professional relationships, so the colleague recommended the day program at Women & Infants Hospital in Providence, RI. But they didn’t have space.
I was going to do something which brought me some relief but was, you know, in hindsight, pretty reckless: baby shopping. I'd go and Babies R Us and I’d fill up three shopping carts of crap, and my husband had to go back and return it. I would make up my own little stories and picture myself somewhere else. During one trip the [Women & Infants intake coordinator] was on the phone. By the time I got to the register she said, “Why don’t you come tomorrow?” And it probably saved me from being a runaway mom.
How did the program help you?
Weirdly enough, it helped just being around other new moms with their babies, and sitting in a circle of complete strangers who talked about anything from “cradle cap,” down to cutting their fingernails that grow so fast. Being in the company of other people that wouldn’t think I was a monster for wanting to run away. I also really enjoyed being close to the baby without her having to be on top of me. And, eating. There was something about eating with other people that felt good in a different kind of way. Yeah, it was really just about being around other people that got it.
I was getting some criticism because I was breaking cultural rules of being out so much with my baby in the beginning. So, [after the program] some of the work was being undone, but not enough to where it sank me. I also did two family sessions with my husband. Technically, [mental health issues] are not something that exists in his culture, but he witnessed who I was compared to what he was seeing now. He allowed himself to be more open-minded and it strengthened our relationship. He also let go of one of the jobs so he was home a little bit more and that was nice.
Caroline briefly attended an aftercare support group at Women & Infants. She also was put on medication but had an adverse reaction. She went back to work at about three months and stayed okay.
Caroline got pregnant again two years later and experienced depression beginning early in the pregnancy, which was treated by medication and a brief hospital stay. Her OB pressured her into getting a tubal ligation after the birth because of her mental health challenges. Caroline also has a stepson who lives with the family full time.
Looking back, what do you wish you had known? What do you wish had gone differently? How can we do better in general to prevent experiences like yours?
I definitely believe in setting up a birth plan. It's not so much about the plan [working out exactly]. But going through the planning will open up your mind to things you didn't consider. And don’t leave everything up to the doctors or the hospital. Like, when you’re being presented with a next step, ask how this will affect the rest of the process. I accepted [the doctor’s decisions] and then was told, I can’t eat anymore, I can’t get out of bed anymore. Also, your support person might not know they can speak up for you. I feel like that is important, especially when you might be facing a situation that could turn out to be traumatic.
Probably the worst thing that came out of all of this for me was being judged by my OB. I had the same OB twice. The second time around, because I was depressed by month two of the pregnancy, he started talking about tying my tubes. He put it in a sense of, if this is what happens when you get pregnant, we really don't want to go through this again. And my husband will still say that now – I think that conversation really stuck with him. At the time, I felt like [the OB] is my friend and he gets it. So, I signed the papers and I got a tubal ligation. And I was 29. So now I’m 33 and I will never have another child again. It wasn't until last year that I started to think, Would he have made the same recommendation for my future if I was white?
The other thing that is my long-term mission is getting a partial hospital [a program providing daily outpatient psychiatric treatment] in Massachusetts. There's no way there isn't enough evidence or support for why this works.
Do you identify as a “survivor”?
I love the word survivor. I think there's so much more strength in the word survivor than there is indicated of weakness. Honestly, to lose the sun and the rainbow, and then to find it again is probably the hardest work I've ever done. And there’s something empowering about having to stare in the face my worst moments every day, but also see the other side of how much love is there. Being a mom is tough, survivor or no survivor. But when you’ve gone through this, having those tough days can bring you ALL the way back. It’s almost like being in recovery. We never forget.