Postpartum Recovery in NICU

My postpartum experience

When I think back on my NICU experience with my eldest son, I often think about how tough it was to recover from giving birth whilst being by his bedside on NICU. I had been induced and due to a decline in my son’s heart rate, it was decided that I needed a forceps delivery. I was given an episiotomy to allow for the assisted delivery.

Due to the stiches, I found once simple tasks such as sitting and walking really tough and incredibly painful. I had read about how important it was to allow your body to recover from giving birth, how women would spend days in bed, sleeping when baby was sleeping and enjoying the newborn snuggles.

Being in NICU, this isn’t the way in which things happen. There are no chilled-out days in bed. Newborn snuggles are few and far between. And lying down, generally isn’t an option. I remember trapsing in each day with my pregnancy pillow as it was the only way that I could manage to sit down due to the stitches from my episiotomy.

As for walking, I don’t think what I was doing even resembled that. Waddling seems to be a far more appropriate word. I remember being in so much pain just walking to and from the expressing room – but as I had been discharged from the Post-Natal Ward, all I was able to take medication wise was Paracetamol and Ibuprofen. And really, it didn’t help me enough.

The Survey

Having had another baby since then, and having the ability to recover at home, it really made me think about how much harder I found that postpartum recovery when my eldest son was in NICU. Our local hospital was generally very good with their postpartum care, especially in comparison to some of the experiences that were shared via the survey that I circulated back in February. Thank you to every single woman who completed the survey – the information I received was really insightful and I appreciate you all taking the time out to participate.

The survey itself had a total of 221 respondents – many more than I was anticipating so thank you! There were 5 questions, plus a final question, whereby participants were able to leave comments on their own experience.

Results

For question 3, I asked everyone to rate the following options in order of priority:

Postpartum Care
NICU Baby
Other children
Self-Care of you and your partner

There was also a N/A option for anyone who did not have other children at home. I feel that I didn’t perhaps format this question in the right way. But the point I wanted to make with this question was that a Mothers priority under these circumstances will not be her postpartum care. 98% of respondents stated that their NICU baby was their priority.

I do feel like this does prove my point – I accept that a certain amount of responsibility falls to Mum in terms of ensuring she is recovering from giving birth, but as someone who has been there, nothing felt as important to me as my new baby, who was so poorly, he needed to stay on NICU. Having had the years to reflect on that time, I don’t feel I was myself at all and therefore, how could I be expected to make “the right decision?” Because in my mind, the right decision was to be with my Son. He needed me more than I needed to be away from him, even if it was for my own good. You could even argue that being with him was better for my mental health due to the extra anxiety and worry it caused when I was away from him. But I am not a professional, this is just my opinion.

Respondents comments

For the final question, I gave everyone the opportunity to leave their own comments on their own experience. A total of 110 out of the 221 respondents left a comment on their own experience. It was insightful to read about individual experiences. Some women felt that they had brilliant postpartum care during their time in NICU. Others were not so fortunate.

Side Rooms vs Postnatal Wards

One recurring comment was how some mothers were able to have a side room to recover in, that was either on the Antenatal and Postnatal Wards. This was my experience – I was given a side room on the Antenatal ward, allowing me to visit NICU at any hour of the day, without the worry of disturbing anyone. I couldn’t imagine being on the Postnatal ward, as normal, alongside Mothers with their new baby, and so I was so grateful.

I know that this is not the case for every NICU mother, and it really saddens me to hear that so many of them had to stay on the Postnatal ward, alongside the Mothers with their baby. I totally understand that not all hospitals would have the ability to provide NICU mothers with a side room on either ward, it will depend on how busy that unit is and what staff they have available, to name but a few reasons. I’m not suggesting that all NICU mothers demand side rooms either – as I am sure that if there were any available, that the maternity staff would do their utmost to ensure that it went to a Mother who truly needed it.

Seeking Treatment

This example was also linked closely to those mothers who were sent to the Postnatal ward to see a Midwife – having to wait in an area where you could see Mothers and baby together, or families heading home with their baby. This wasn’t something I experienced personally, but I can understand completely why these women found that to be a really tough experience.

Covid-19 Pandemic

Having had two children myself, I have seen just how busy maternity staff are. I am under no illusion here – they all work incredibly hard. With the added pressures of the Covid-19 pandemic as well, they are under more pressure, just like many areas of the NHS. One thing that mothers struggled with was the fact that with their partners not able to visit as normal, they had no way of being taken to NICU to visit their baby, as maternity staff were rushed off their feet. Some mothers stated that they then pushed themselves too much by walking to NICU because they were so desperate to see their baby, and not wanting to burden the staff. Mothers appear to be being driven to desperate measures just to be able to see their baby on NICU.

For families who have had a baby in NICU during the Covid-19 pandemic, the other issue that has affected seeking Postpartum support is the limited visiting times for NICU parents. I am aware that visiting times for parents has varied from trust to trust. But some women stipulated that they were limited to certain hours of the day to be with their littles ones and having to wait to be seen by maternity staff, who are already rushed of their feet, which results in mothers further limiting the time that they had with their baby. Is it any wonder why NICU mothers were perhaps forgoing postpartum care during the pandemic?

Health Visitors

It was evident from these responses that experiences with Health Visitors were varied. Some were able to go above and beyond for families, whereas others weren’t able to support families in the way that was required, with some being totally unaware that the family were in NICU. For me personally, I found that my Health Visitor was unaware we were in NICU and I think I only saw her once, maybe twice at home.

One thing that was fantastic though was that I was invited to attend a “Nurture Group” which was run by Health Visitors, and designed for parents of premature babies, who missed out on antenatal classes due to the early arrival of their little one. Whilst I did attend Antenatal classes, the thought was that I could benefit from meeting other NICU parents. It was one of the best things I did – this group allowed me to connect with a NICU family that were on the unit with us. And we have been friends ever since! I am unsure of whether the “Nurture Group” is something that is offered nationwide – but if it is available where you are, I can’t recommend it enough!

Expressing Colostrum

Expressing is something that can become part of a NICU mothers daily routine. For those women who choose to do it – it is not for everyone and you do have a choice – it can be really daunting, which is how I felt about it as I had no idea what I was doing. Several women mentioned that they lacked support with expressing, which I was really saddened to hear.

For a lot of NICU mothers, expressing breastmilk is very precious as it’s sometimes the only way in which you can feel like you’re doing something for your baby. It’s something that was totally alien to me, I had no idea what I was doing, and without the support I received, I would never have been able to establish my supply, and later, fully establish breastfeeding with my son. Having discussed expressing with NICU mothers before, I know that it’s something that the NICU teams actively encourage mothers to do, but how can they if they aren’t sufficiently supported?

Mental Health Support

Mental Health support was an area that was mentioned many times within this comment section. Mental Health support is a broad area, and respondents didn’t specify the exact support that they were looking or hoping for. During my family’s time on NICU, we didn’t have mental health staff on hand in the way that some hospitals are now able to offer it. So, it is fantastic that some trusts are able to provide parents with the support they require, but on the flip side, there are still so many parents who aren’t offered the support.

Lots of women commented on how there was no mental health support beyond their baby’s discharge. There seems to be a misconception whereby parents miraculously forget all that they have been through in NICU once their baby is allowed to go home and therefore don’t need mental health support beyond discharge. I am here to say, that this is not the case, and I know plenty of parents who can back me up on this!

Conclusion

I have been a NICU mother myself. I know that it is an incredibly difficult environment to be in. You endure a roller coaster of emotions, and it can have long term effects on a parent’s mental health. The reason I chose to create this survey was to demonstrate that postpartum mothers, who’s baby has been admitted to the Neonatal Intensive Care Unit aren’t receiving the care that they need. The NICU nurses are there to care for the poorly babies. Maternity staff are overstretched already and can’t be expected to chase after a mother, who is on NICU visiting their baby, to ensure that they take any medication that they need and rest up. A certain level of responsibility does fall to mothers to ensure they’re looking after themselves, but having been this mother, I can tell you that all reason goes out of the window when your baby is on NICU. And so, I ask you this, who is looking after NICU Mummy’s?