For my first child, I was in labor for an absurd 32 hours. To say I was exhausted and overwhelmed is a huge understatement. But while labor was a marathon, delivery was a sprint. Ten minutes and four pushes later, my son was born in pretty dramatic fashion! He was laid on my chest and I was in bleary-eyed shock, incredibly emotional and almost disbelieving that it all had actually happened. In truth, I don’t have a ton of explicit memory of those first fifteen minutes after birth, just feelings of relief, awe, and exhaustion. My husband had accompanied the baby out of the room for some standard examination and treatment when, all of a sudden, he returned alone and told me our son had been rushed to the Neonatal Intensive Care Unit (NICU) for severely low blood sugar reserves and eventually dramatic levels of jaundice.
Cue massive shock and fear.
The experience of having a NICU baby is a huge mix of emotions. On the one hand, we were blessed and grateful in that our son’s health issue was relatively minor when compared to the teeny, tiny babies born twenty weeks too soon. His stay in the hospital ultimately lasted six days while the babies surrounding him had already been there for weeks and months. On the other hand, it’s still your child, and the pain of heading home from the hospital without them can feel unbearable.
Visiting our son in the NICU
Learning how to breastfeed in a crowded NICU seated in a hard wooden chair (after 32 hours of labor, I will never forgive the idiot who thought those particular chairs were a good idea), using a privacy screen that really only screened you off on one side was demoralizing and dehumanizing. Watching other parents bringing their carseats to their nurses for inspection, readying themselves to head home with the baby was a gut punch. Getting discharged from the hospital, saying goodbye to your baby, and riding that lonely, empty elevator down to your car is so terribly painful. Entering your house without your baby feels surreal and wrong and somehow embarrassing.
And then there is the agonizing decision - how frequently and for how long each day do you stay by your baby’s side despite the fact that your body feels destroyed and those wooden chairs are your only option for “rest”? Let’s not forget also, that those postpartum days include continued bleeding, uterine contractions, possibly sore nipples from both you and your baby trying to learn how to breastfeed, and most importantly, a likely case of the “baby blues.”
As it happens, my third child also ended up in the NICU but this time we had a private room and a reclining lounge! Children’s Hospital NICU ftw!
Each day, our hopes would rise that the baby could get discharged. In our case, by day three, a new issue had arisen - severe jaundice. Because of the level of jaundice, the baby had to be kept inside his incubator with three different sets of UV lights all over him at all times, meaning I could no longer take the baby out to nurse. The best I could do was pump and then insert my arms into two little holes on the side of the incubator to try to bottle-feed. Oof, that was another level of hard. I couldn’t even hold my baby anymore.
Fortunately for our family, my son was deemed well enough to head home six days after birth, but those six days were a huge whirlwind of emotion. There was a lot of self-blame - did I do something wrong during my pregnancy? Is that why he was in the NICU? There was guilt - am I a bad mother because all I want to do is lay in my bed and recover and not be sitting next to the baby’s incubator? There was embarrassment - everyone in the neighborhood knew I had given birth but it felt almost shameful that I was home without the baby, I had zero interest in being seen and then required to explain the situation. There was anger - I was out-of-proportion angry when my partner didn’t say the exactly the right thing to comfort me. Of course, there was fear - what if my son doesn’t get better or what if something new goes wrong? And finally, there was sadness - the sadness was profound in seeing my son laying in his incubator, an IV and a board hooked to his arm, another IV attached to his foot, all vulnerable and innocent.
Around 80% of people who’ve given birth experience the baby blues - feelings of sometimes intense sadness and overwhelm that typically begin 2-3 days after delivery and usually resolve on their own by two weeks postpartum. Around one in seven women may go on to develop postpartum depression (PPD), whether immediately after giving birth or anytime in the first year (or two) postpartum.
Going through some form of trauma - like having a baby in the NICU - increases the chances of developing a mood disorder postpartum. Getting through the stress and fear of having an infant admitted to the NICU is hard and painful, but the homegoing can also be incredibly stressful. While you may be terrified for your baby in the hospital, there’s also a comfort in knowing they are surrounded by multiple medical professionals, equipment monitoring their every breath and heartbeat, and interventions galore seconds away should anything go wrong. Heading home with a potentially extra-fragile baby without any of these additional supports can be overwhelming to parents and induce significant anxiety on top of all the other typical newborn baby transitions you’re trying desperately to adapt to. The extra stress of trying to keep your baby alive can also put an unhealthy level of pressure on your romantic partnership. Sometimes, there may even be moments of guilty longing for the days in the NICU where your nurse cheerfully and patiently offers to take over dripping milk into your baby’s mouth while you get a much needed emotional health break and a good night’s sleep at home.
Most parents feel an overwhelming sense of responsibility for their baby’s wellbeing the moment the baby is born. This can go into serious overdrive with a NICU baby. It can be even easier for parents to ignore their own mental, emotional, physical, and social health needs when baby’s needs feel that much more fragile and of paramount importance. This tendency is exacerbated by the fact that postpartum life is usually dominated by frequent pediatrician visits at which it’s the baby’s health that takes center stage. Typically postpartum healthcare is limited to a 6 week post delivery checkup with your OB or midwife and that’s it. Hopefully you’ll receive a PPD/PPA screening at this visit but there are limits to what a questionnaire can assess especially if you’re a parent who doesn’t feel entirely safe being completely honest on the questionnaire.
Having a NICU baby can feel very isolating and lonely. You may even feel alone in relation to your partner and your loved ones. It’s so important to be extra cautious, careful, and gentle with your emotional needs. So many postpartum parents find themselves awake in the middle of the night, in the grips of fear and sadness, googling “signs of depression” or “am I depressed,” only to get up in the morning and just plow through their days because that’s what they feel like they’re supposed to do. To all the partners who may be reading this, while you are going through your own emotional journey, you may have a few more resources than your birthing partner in these hormonal days postpartum. I urge you to take gentle care of your partner, reminding them to take care of themselves. Try to lean on one another in these moments of fear and uncertainty. While I’m obviously biased, I would encourage you and your partner to access therapy resources, perhaps both individual and couple. Additionally, look into resources for assisting you in the transition of bringing baby home, e.g. a postpartum doula, night nurse, assigning the task to a close friend or neighbor to organize the troops to support you with meals, respite care, laundry, etc. Accept help while maintaining any boundaries you need to keep with well-meaning loved ones. Do not forget to attend to your own needs. Having a baby in the NICU can be incredibly traumatic, both during and in the recovery thereafter.
If you’re interested in seeking out greater therapeutic support, I encourage you to read more about how our practice can assist you in Pregnancy and Postpartum. Click here to schedule an appointment with one of our therapists, we’re here to help.