World Prematurity Month 2024: Intrusive thoughts after NICU
All smiles: Catriona and Samuel (born at 29 weeks) after neonatal intensive care
I glanced over the summary of the Preterm Birth Inquiry Report and a quote jumped out at me as sipped my coffee. “At exactly 30 weeks my twins were delivered by emergency caesarean. One night I was at Pilates and the next I was in hospital and supposedly a mother of two.”
“Supposedly” That word hits hard. So hard that when I read it, it almost took my breath away.
Catriona’s first hold of Samuel in NICU, six days after his birth
I visited my first baby Samuel, born prematurely at 29 weeks, every day, for 54 days. For much of that time I was a bystander, waiting and watching by the cot side. Sometimes I was a ‘carer’, supported by nursing staff to help with ‘cares’ – changing a nappy through incubator portholes, holding a syringe as my hard-fought expressed breast milk trickled through a feeding tube, or changing his babygrow (one that was specially modified for all his wires and tubes). A bystander, a carer, ‘supposedly’ a mum.
Role reversal
Perhaps it was easier to adopt the carer role, to disassociate myself from the reality of what had happened, or to protect myself from what might happen if things went wrong. Or maybe that’s just an excuse I tell myself, better than the simple truth – I just didn’t feel like his mum.
I loved this tiny human with all my heart. I craved feeling him against my skin and grieved for the time I felt had been stolen from us. And during our rollercoaster journey through neonatal intensive care, I counted down the days until I could bring him home. That was when he would finally be mine. That’s when I would be properly be his mum.
Unwelcome emotions
It’s hard to describe the jumbled-up emotions I experienced when we finally got to be at home together. Joy and relief etched with an overwhelming feeling of worry and still that sense of loss. But there was one overriding emotion in the months afterwards that stood out – shell shocked. I was exhausted, recovering myself from what we had been through and wrangling with a host of unwelcome emotions. I felt numb and disengaged, as if I was ‘going through the motions’, but nothing more.
It was hard to shake that NICU Mum role. And while difficulties with bonding and attachment aren’t unique to neonatal parents, it’s plain to see why bonding with a baby born prematurely, after weeks or months in the most extreme environment of neonatal intensive care, would be much extra challenging.
“ I was exhausted, recovering myself from what we had been through and wrangling with a host of unwelcome emotions. I felt numb and disengaged, as if I was ‘going through the motions’, but nothing more. ”
Fear from nowhere
And then they hit me. The intrusive thoughts appeared from nowhere. They gave no warning and caught me completely off guard. Walking down the stairs I would have a sudden thought to throw my baby ahead of me, or walking through a doorway I would feel sick to the pit of my stomach, scared I was going to smash his tiny head against the woodwork. I felt moments of overwhelming certainty that my baby wouldn’t live beyond his first birthday, and crossing the road an invasive image of being hit by a car would flash in front of my eyes.
The ideas were fleeting, and while I always knew I never had any intention to harm my baby or that there was no rational reason why harm would come to him, they were frightening and added another layer to the anxiety I felt. I had no way of controlling the intrusive thoughts and I found by ignoring, rather than dwelling on the awful nature of some of them, that they gradually went away.
Cationa with husband Mike and baby Samuel at home after 54 days in NICU
I never told anyone about my intrusive thoughts, but looking back I feel it’s so important that we speak about them to normalise them and to let others know they’re not alone. Many new parents will experience some degree of intrusive thoughts, and for parents following the trauma of neonatal intensive care the incidence of these experiences are understandably higher.
Wisdom of Winnie
The impact of neonatal intensive care is long lasting, and it’s vital that parents receive appropriate psychological support at the right time. My own journey lasted years, but my first step to recovery was when Samuel was five months’ old. We held a naming ceremony for him and, having had the planning and preparation of my last trimester taken away from me, I took comfort from planning this special day for us. I searched high and low for a quote that could sum up my feelings and would express my love for a baby born too small and too soon. And it was Winnie the Pooh that came to my rescue: “Sometimes the smallest things take up the most room in our hearts”. I allowed myself finally to feel like his mum.