Fighters Of The NICU: Babies And Mothers

           Babies are born every single day, when all goes as planned they come into this world happy, healthy, and screaming. But the March of Dimes estimates that for 380,000 births in the United States per year, things don’t necessarily go as planned. As young adults we are taught in our health and biology classes that the human gestational period lasts approximately nine months, or 40 weeks to be more precise. According to the American College of Obstetricians and Gynecologist (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) “Babies born full term have the best chance of being healthy” (March of Dimes, 2016). Full term is now considered to be between 39 weeks, and one day shy of 41 weeks.

            In general having a baby when everything goes according to plan can be hectic and stressful, but what happens when that plan deviates to something that a mother may have never considered? Babies born premature are at risk for multiple complications, there little bodies have not developed to the level of a full term baby, and the basic needs for survival can prove difficult. The medical community does not always have a clear cut answer for why babies are born prematurely, but sometimes aside from the simple fact of being born early, the baby may have other health complications, adding on even more medical factors that come into play, and can greatly alter an infant’s Neonatal Intensive Care Unit (NICU) stay.
            No doubt these babies are fighters, but how do these scenarios affect mothers? According Friedman et al. (2013) in their article appearing in Acta Paediatrica in a NICU setting “150 mothers were referred for psychiatric evaluations and psychotherapeutic interventions” of those they were “referred because of depression (43%), anxiety (44%), and/or difficulty coping with their infant’s medical problems (60%)”. It is not uncommon in a NICU setting to not be able to hold your baby, and a post-partum time that is typically filled with caring for your newborn, family and friends visiting, and perhaps even becoming accustomed to breastfeeding; is instead spent attending care times, meeting with medical specialists, and trying to grasp all the information being thrown at parents. Mother’s to preterm babies are faced with the reality that they must return home, while their little one stays at the hospital. Additional stressors can be if the mother has additional children in the home, according to Friedman et al. (2013) “mothers who saw the psychiatrist had few living children”. This shows that family size alone can determine a woman’s ability to seek post-partum psychological care. That’s just one factor, some women have limited resources to address their own psychological needs, these barriers to treatment can come in the form of limited insurance, low income, and sometimes even just not enough hours in the day.

In Friedman et al. (2013) study the most common diagnoses amongst the mothers in their group were “depression (40%), anxiety disorders (31%), and post-traumatic stress disorder (5%)”. Women in this type of situation can only benefit from having access to post-partum mental health care. Our authors further explain “The rate of Post-Partum Depression in the NICU has an elevated range from 28 to 70%” (Friedman et al., 2013). This information further indicates the need for counseling services to be made available to NICU families.

            In conclusion one can clearly see the need for mental health services to be made available to NICU families. For future research I would like to spend time finding what sources are made available to NICU families and how easily they can be accessed by families who have a little one in the NICU here in Milwaukee and Waukesha County. According to the March of Dimes in 2013 in Milwaukee County 1,786 babies were born preterm that accounts for 12% of live births in the county. That is 1,786 families who were affect by a little one coming earlier than planned. Once again in my research many of the articles and studies I came across concerning this topic were conducted in other countries. The study referenced in this post was conducted in New Zealand. This further emphasizing that in the United States we need to have a more of a focus on post-partum mental health and the issues facing women and families during this very critical time in their life.
If you would like to learn more the purpose that March of Dimes serves, I would encourage you to watch the following video. 

Reference List

Friedman S, Kessler A, Yang S, Parsons S, Friedman H, Martin R. Delivering perinatal psychiatric services in the neonatal intensive care unit. Acta Paediatrica [serial online]. September 2013;102(9):e392-e397. Available from: PsycINFO, Ipswich, MA. Accessed March 16, 2016.

March of Dimes. (2016). March of Dimes PeriStats. Retrived from March of Dimes website http://www.marchofdimes.org/peristats/Peristats.aspx.

Cuplrits Of Post-Partum Depression

           Changes in one’s life can lead to stress and anxiety. Reflect back to a time in your life when you were going through a major change, perhaps it was a new job, moving to a new home, getting married, did you feel stressed, worried, or exhausted at any point? If you answered “no”, then congratulations, because you my friend are one cool cucumber! It’s commonly accepted in our culture that bringing a baby into this world can be the most joyous, yet sometimes most difficult times in a mother’s life. This post will address a few of the culprits that can lead to Post-Partum Depression (PPD) and what current research suggests.

            Recent research suggest that there are common factors that may influence a mother’s likelihood to experience PPD. While there are a variety of issues that can affect a mother’s post-partum mental health, the specific qualities that Vligen and Luyten focused on were dependency, self-criticism, anxiety and level of education. In layman terms they found that women who were more critical of themselves had a higher rate to develop PPD, “post-partum depressed mothers were found to have significantly higher levels of self-criticism compared with non-depressed mothers” (Vliegen & Luyten 2009). They point out that their research correlates with other studies that have found “PPD is particularly associated with having high standards and excessive self-criticism” (Vliegen & Luyten 2009). This I found very interesting, because in an era when we tell young women you can have it all, be a wife, be a mother, and have a successful career, the same qualities that will help you achieve all those things could play a part in causing you to experience PPD during a time that is marked as a happy.

            Further research by our authors also led them to believe that mothers who have a lower level of completed education are more likely to experience depressed symptoms after baby arrives, it was hypothesized that less education could result in more anxiety in new mothers. From a Community Psychology stand point it made me wonder if having more psychoeducation for new moms who have not completed as much schooling could lessen the anxiety that comes with bringing a baby into the world. Vligen and Luyten believe that a mother who has more of a dependent personality might work in her favor to avoid PPD. They did not offer up a lengthy explanation on this, but it made me wonder if perhaps someone who is more dependent on others may be more willing to ask for help if they are becoming overwhelmed, thus cutting off PPD before it can fully begin.

            After completing this research I was led to draw several conclusions. First while conducting research the studies that I was coming across were mostly conducted in foreign countries, very seldom things seem to be done in the United States. I couldn’t help but draw a parallel to the fact that the United States is one of a very few countries who offer no paid maternity leave, whereas some countries offer up a year of paid maternity leave. The fact that minimal research was conducted here and our lack of benefits for working mothers, made me question if we need to have more dialogue here about issues women face as they transition into motherhood. Secondly I believe the dialogue surrounding the expectations that we as women set for ourselves, could be tweaked. Take to any social media forum and you will find story after story of mothers, who may work, or stay home, or fall somewhere in between talking about how they feel they cannot measure up to some standard that we have set in our mind as to what it means to be a woman and a mother. Finally that further research needs to be conducted on this subject, there are so many factors that contribute to PPD, and to best serve this population we need to have a better understanding of the issues that women are facing. 

Works Cited

Vliegen, N., & Luyten, P. (2009). Dependency and self-criticism in post-partum depression and anxiety: A case control study. Clinical Psychology & Psychotherapy, 16(1), 22-32. doi:10.1002/cpp.597