I saw a post last year; it simply said “PTSD – The hidden cost of having a premature baby?”
Nothing can prepare you for parenthood, but you allow yourself to imagine the arrival of your baby; those first precious holds, taking them home to meet loved ones, the time together to grow and bond – and then suddenly everything you imagined is dramatically replaced with the alien and uncertain world of neonatal intensive care.
It is widely reported that parents who’ve spent time with their babies in neonatal care are a greater risk of developing anxiety or post traumatic stress disorder (PTSD). Some studies suggest that it affect as many as 70% mothers following NICU and given the nature of NICU this shouldn’t come as a surprise. Yet this is a topic that remains relatively unspoken about and more importantly there are limited, and in some areas no resources dedicated to it.
PTSD can have a significant to severe impact upon every day life; from re-experiencing or re-living events with often negative thoughts, by avoiding or becoming nub, to the feeling of being constantly on edge with anxiety and physical symptoms such as headaches, feeling nauseous or becoming light headed. I remember the first time I felt panicked and sick with PTSD, I was returning to the neonatal unit for the routine 4 week follow up review. Walking into the hospital I could hear and feel the sound of my heart pounding in my head; I could hear the beeps of machines and if I closed my eyes all I could see were wires. I felt sick to the bottom of my stomach and there was nothing I could do to stop it.
PSTD often presents itself after the acute phase of neonatal care; once you have left the claustrophobic confines of the unit and when the beeping of machines should be far behind you. The support network of the hospital can disappear over night and you are left to wonder how on earth you made it through. Family and friends may assume that the difficult times are behind you and accessing the usual mum and baby groups for support can be a struggle in itself. I’ve written before about answering the dreaded “how old is your baby” question . You try to explain prematurity, corrected ages and what being in NICU was like, but find you are greeted with perhaps good-willed, but often insensitive remarks such as “I could never have left my baby in the hospital” or “At least you didn’t have to go through proper labour”.
By the way, if you’d like to know what not to say to the mother of a premature baby, then check out our Top Ten here.
Rather than being a supportive environment, mothers of premature babies can find the usual routes of seeking support closed to them. These exchanges can exacerbate negative feelings and bring back painful memories – I personally struggled to listen to others speaking about how they couldn’t put their new baby down, when all I would see was many tiny baby so far removed from me in his incubator. In addition many mums will not have the option to go out and seek help, finding themselves literally isolated during the winter months when their baby is still too fragile to be exposed to the cough and cold season.
The Smallest Thing campaign is seeking to raise awareness, not just within the general public, but also to the team of health visitors who will often make that first contact. Tommy’s have developed a brilliant Wellbeing Plan endorsed by NICE which helps women and health care professions to discuss mental health. With the knowledge that mothers have a significantly grater risk of developing mental health difficulties if they have had baby in neonatal intensive care we are calling on all health visitors to use the Wellbeing Plan or similar tools to discuss mental and emotional well being early on in the posy NICU journey.
Finally, mental health and the well being of others should be everyone’s business. NICU remains a mysterious and unknown place to those who have not lived it and for that reason perhaps it isn’t immediately obvious to see a link between time in NICU and PTSD. Raising awareness and speaking honestly about our experience and the true realities of neonatal care is therefore crucial:
Of the uncertainly and unknown. The panic that sets in when your baby is not in their incubator space when you arrive, have they been moved – is the news good of bad?
Of the physical pain at having to leave your new born everyday. The feelings of emptiness and loss.
Of the ups and downs; the lines, wires, monitors and alarms.
Of the hot, close, claustrophobic environment.
The security buzzers at the entrance and of the constant rigorous hand washing.
Feeling watched as you attend to the simplest of cares such as changing a nappy – of struggling with the simplest of cares such as changing a nappy!
And the feelings of guilt, jealousy, grief and loss that go hand-in-hand and in stark contrast to the feelings of joy, anticipation and hope.
I will always be a NICU mum; and PTSD will always be lurking around the corner.