Support while in the NICU
This is a continuation of the previous blog post summarizing two podcast episodes that stood out to me over the past month leading up to World Prematurity Day (November 17th): Navigating the NICU with Sue Hall (The Birthful Podcast, episode 85 and 72 Days in the NICU with Ingrid (Motherbirth, episode 33. In this post I discuss what you can do as a parent of a baby in the NICU and what others can do to support you.
When the family is at the hospital, what can they do?
Sue Hall mentions that it is extremely important to tend to the birthing individual’s own recovery of the birth first. “Moms whose health is fragile push themselves too much to stay with baby and end up getting readmitted to the hospital.” It’s important that you, your partner and others involved get enough rest to be able to deal with the situation as best you can. It is also important to recognize the emotional stress that being in the NICU can put on you. Sue also says in the Birthful episode that in addition to seeking help from friends and family, you can ask to speak to a social worker, see if there’s a parent support program pairing you with former premature or NICU parents, or check out Facebook groups and other online support groups. As a parent of a baby in the NICU, Ingrid talks about how much it helped her family to have a community of other parents who had been through or were going through similar situations.
Aside from healing and seeking support, Sue suggests that you should try to trust and work with your medical team. Feel free to ask if you can be present when the medical staff does their rounds during the day. This is the best time to ask questions, voice concerns, make suggestions, and get an understanding of the plan for the care of your baby. You can also ask for a conference with your medical care team to try to gain confidence in them or ask to speak to a charge nurse if you’re hearing different things from different medical staff.
The more hands on experience you can do with your baby the better. Babies can often do different things depending on how premature they are or why they are in the NICU. For example, parents of a 24 week old baby will most likely not be able to breastfeed, do skin-to-skin, hold their babies, speak loudly to them, expose the baby to bright lights or maybe even touch the baby. Over time as their baby grows these things will be slowly added to the list of things that your baby can do so it is important to ask the medical staff what is possible for you to do and what might not be.
Eventually Sue suggests that parents might be able to take the baby’s temperature, give a bath, change a diaper (or maybe even take the baby on a walk). The more you get to know your baby’s signs of pleasure and distress the easier it will be when you need to take your baby home. Sue also mentions that some hospitals have classes you can take about your baby including learning CPR. The more you get involved at the hospital the better. Hospitals often have chaplain services for you to utilize, or you can invite your own pastoral care team in. NICU social workers can also provide money for transportation and meal tickets.
What can nurses do to help families?
In the Motherbirth episode, Ingrid discusses the many things the nurses did to help her while her baby was in the NICU. From the beginning, the nurses did their best to explain the situation as thoroughly as possible for Ingrid. Whenever she had a question the nurses did a great job of answering thoroughly so Ingrid knew what might happen next. Since she spent time in the hospital before the birth, she developed a relationship with her nurses and was thankful when one nurse dropped the work she was doing to go in to the operating room (OR) with Ingrid when she gave birth.
While her baby was in the NICU, Ingrid felt like the nurses allowed her to have some say in the care of her baby and made an effort to help her feel like a parent. Initially the nurses taught her stress responses to watch out for. If her baby yawned, got hiccups or put up a hand like a stop sign then her baby was getting too much stimulation. Later the nurses taught her how to pick up her baby from the isolette, which felt more natural to Ingrid than having her baby handed to her by the nurses. The first time she got to hold her baby the nurses put on some music for her. The nurses also had encouraging words for her throughout and taught her how to pay attention to her baby for cues rather than the monitors. Both Ingrid (briefly) and Sue Hall mention that this is characteristic of an ideal NICU: one that welcomes (Sue’s words) “parental involvement and bonding.”
What can doulas do to help?
There have been several well-known studies that show that having a doula can reduce rates of cesarean births and help limit the number of medical interventions. One relatively recent study by associate professor Kathy Kozhimannil at the University of Minnesota compares hospital births to Medicaid-funded births (supported by a community-based doula program). The study found that the doula supported births also had lower rates of preterm birth and cesarean births.
This NPR article summarizes Kozhimmannil’s work and discusses what we know about doulas and cesarean births in general.
In my opinion, the more doulas know about preterm births, what to expect and what we can do to help, the more effective we will be in our roles as advocates and supporters for our families.
Sue Hall has a wonderful website that she mentions in the Birthful podcast. Motherbirth has done several other episodes about NICUs including this one. Lamaze’s blog Science and Sensibility has also done some great posts about the issue.