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Why We Must Screen NICU Moms for PTSD

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When I learned my husband and I were expecting our third child, I imagined his birth would be similar to that of his siblings. I envisioned the moment when my healthy, chubby thighed newborn would be placed in my arms for the first time, when I would breathe in his new baby smells and feel the adrenaline and joy and disbelief of the miracle that had just occurred in the beginning moments of his life.

• What is PTSD?

I imagined the picture we would take when my older children met their new brother, the five of us squished together on a hospital bed, all smiles as we beamed toward the camera.​

What I did not anticipate was a pregnancy riddled with complications, with multiple hospitalizations and weeks of bed rest that stretched into months. My birth plan did not include a moment when my doctor, calmly but urgently, informed me she was taking my baby out, despite the fact that his due date was over two months away.

I never imagined I would be rushed to the operating room, bleeding, horror movie style, after experiencing a rare pregnancy complication known as a placental abruption.

The perfect delivery I wanted was replaced by a whirlwind of bright lights, a cold table, and the memory of seeing my child, born 10 weeks prematurely, wheeled past me on his way to the Neonatal Intensive Care Unit (NICU).

​In the days that followed, as I prepared to leave the hospital for the first time without my son, I was given a sheet of paper intended to detect whether or not I was at risk for developing postpartum depression. The questions were well meaning, but generic: Have I been able to laugh and see the funny side of things? Have I blamed myself unnecessarily when things went wrong? Rate the extent with which that is true, ranging from yes, most of the time, to no, never. ​In that moment, while my son lay alone in the NICU and the bright red incision across my middle was still fresh, the questions seemed almost laughable. Of course I was feeling anxious. Of course I blamed myself.

Six weeks later, when I was given the same test at my follow up appointment with my obstetrician, my son was still in the NICU, and I was still exposed to the tremendous stress of being physically separated from my son every moment of every day. Naturally, I was considered at risk for postpartum depression, but I was never depressed.

It was something else.

I was traumatized. ​

Postpartum Support International writes that a woman with postpartum depression might experience, “feelings of anger, sadness, irritability, guilt, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, thoughts of hopelessness and sometimes even thoughts of harming the baby or herself.” The website shares that “15-20 percent of women experience more significant symptoms of depression or anxiety.” Though the site acknowledges that women with a child in the NICU are at a heightened risk for developing postpartum depression, it neglects to mention the research that proves that as many as 53 percent of NICU moms will develop post-traumatic stress disorder (PTSD).

With one out of every 10 infants being born prematurely, the likelihood that hundreds of thousands of women worldwide experience NICU related PTSD is staggering. ​And yet, there is no tool currently in hospitals that specifically strives to detect PTSD in NICU moms.

Mothers with an infant in the NICU, who watch a potentially critically ill child waver between life and death for weeks on end and face a lifetime of related complications, have a unique set of mental health needs that I do not believe are accurately detected by the screening measures currently in place in hospitals. I believe something a simple as a questionnaire that can be given to mothers before their baby is discharged that takes into account the extreme stressors of the NICU would go a long way to help NICU mothers better understand how at risk they are for developing PTSD, which would therefore enable them to seek more targeted and effective mental health treatment. ​

The NICU is a place full of loss: loss of envisioned birth plans, loss of first holidays spent away from family and all the precious, ordinary moments in between. Often, the NICU is the place where the tiniest fighters lose their life. If it is a place where mothers lose their mental health. We must arm these mothers with the tools to seek effective and efficient mental health treatment. We must develop a way to screen NICU moms for PTSD so that they are better equipped to care for the miracles they are raising.

Getty image via Zentangle

Originally published: January 13, 2019
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