During my first pregnancy, it was discovered at our 20 week ultrasound that our baby had a heart condition that would require an immediate assessment by cardiology and transfer to the Neonatal ICU directly after birth.
I understood this information, and I mentally prepared for this as well as I could. My husband and I cried over it, and after a long talk we came to the conclusion that we would keep putting one foot in front of the other. After all, what more can you do when things are out of your control, than do your best? We vowed to do our absolute best, give it all we can, and accept this news. My logical mind was as prepared as it could be. Yet when my baby was born, there was nothing that could have prepared me for the raw heartbreak of not getting to see my child’s face before they were taken by a bustling team of doctors and nurses, none of which I knew. Nothing could prepare me for the agony of being at the mercy of trusting that they were safe and well, waiting hours for my first update.
The Postpartum Experience
I instantly dedicated myself to a desperate mission: to be reunited with my newborn. This mission did not involve any consideration for my own self care, healing, or immediate needs. I begged the nurse not to make me complete the bag of IV fluid I was required to have infused before I went to the NICU. I begged for a breast pump and started using it without any guidance, as it was all I could think to do while I waited. I didn’t ask for help, I didn’t know why I had to be in the postpartum unit for assessments, I didn’t care about my medication schedule. My nervous system was in full on fight mode. I only had one outcome that would comfort me and that was being in the immediate presence of my baby.
I instantly dedicated myself to a desperate mission to be reunited with my newborn, and this mission did not involve any consideration for my own self care, healing, or immediate needs.
NICU Postpartum as a Professional
This experience made for a painful, exhausting and crushing postpartum. Thankfully, my baby was treated and is healthy and well today. But the trajectory of my life had changed from this experience. The texture of my grief led me to want to understand everything about it, from the inside out. I became a postpartum doula within my baby’s first year of life. I began serving new families to try to help support this immense transition that, was so rarely mentioned during pregnancy. I went on to become a lactation specialist, then went to nursing school. I worked as a postpartum and newborn nurse for a few years before moving into the role of a NICU nurse.
Years later, after working with hundreds of new parents, I have seen my reaction to the separation from my child and their NICU stay play out again and again. Mothers at their infant’s bedside in nothing but a hospital gown and non-slip socks. They are bleeding, swollen, shivering, pale, anemic and ignoring the pain of a fresh cesarean incision or perineal tears. Their partners experiencing a wide array of reactions; wide-eyed and confused, angry, protective, or shut down.
Digesting the Experience in the Moment
We had nothing to prepare us for this moment, and no parameters of what we should or could do. So we put our own needs aside and focused on our vulnerable, brand new babies. They were alone under fluorescent lights, their precious bodies already invaded by tubes and wires. Our animal bodies want to touch, hold, bond, and feed. Yet the medical necessities of an unexpected birth outcome dictate otherwise.
According to Ayurveda, everything we ingest, be it food or drink, information through the senses, or emotional and energetic input, needs to be digested. How do we digest the NICU experience enough in the moment to afford us healing during our postpartum time? We are inevitably faced with a balancing act: both surrendering to the process and actively advocating for ourselves and our baby.
We are now living in the sacred AND the space of holding two polar opposites, letting them both exist in our experience. You can be both devastated and elated. You can be both in the most pain and the happiest you’ve been in your life. You can be open and closed. Strong and vulnerable. Afraid and brave.
Remember that these things are true:
- The best you can do is the best you can do. Give it your all and know that you did everything. Allow yourself to rest in this knowledge.
- In order for you to be at your best, it is imperative to be well nourished, well hydrated, and well rested. This will require support, you can’t do it all on your own, and you likely won’t be prioritizing self care at this time, so allow yourself to be cared for.
Finding Our Way with the Help of Ayurveda
Even when a birth doesn’t require acute intervention or intensive care afterward, the birthing parent experiences a swift increase in vata, or air and ether energy after delivery. Vata rushes in as the space that was filled with baby and placenta is now vacated. This influx of air and ether energy can manifest in the body as gas, bloating, indigestion, severe cramping, and inability to
sleep. It can manifest in the mind as anxiety, restlessness, hypervigilance, fear, and feeling scattered. Ayurvedic postpartum care focuses on gently decreasing vata and rekindling the digestive fire, or agni in sanskrit. We focus on creating a calm, cocoon-like environment around the new family, decreasing stimulus, feeding mama easy to digest, nutrient dense foods, and massaging mom and baby with warm, herbal oils to build up the depleted tissues and coax them back to vitality and health.
How to Heal and Fortify Post NICU Experience
Begin with digestion. Digestion of this experience, now. Digestion within your mind, heart and body. Even though it is tempting to stuff the feelings and be strong, we can avoid accumulation and increase clarity by prioritizing our digestion. You will be able to show up as the advocate you need to be if your mind has clarity and your intuition has a clear path.
Express and lean into your difficult and painful emotions within a container. Journal, if you are feeling like processing on your own first. Let your grief release as it comes in waves. Know that it is medicine to you every time you talk with a friend, family member, nurse, or chaplain. Tell the story of your birth. Name what you feel you have lost. Accept the uncomfortable emotions that have a hold on you. See them, feel them, name them. When you feel safe to, cry, scream, vent, and experience your emotions. Let it be messy. This is the first step of digesting this experience and finding clarity.
Plan all your activities around these four priorities: Self care, baby care and updates, meals and rest.
Your Digestive System and Eating
Meanwhile, focus on gentle eating. Easy to digest, warm foods will be your allies during this time. When it is time to eat, opt for broths, herbal teas, soup or liquidy stew, porridge, and oatmeal, with healthy fats such as ghee and olive oil. Sip on warm water throughout the day and night. Your body and mind will thank you as warm, wet foods decrease bloating and gas, encourage easier bowel movements, ease the mind, and increase the ability to sleep.
Let each meal and snack be a comfort to you during this time. It is best to avoid raw, cold, dry, light and airy foods. Such as salad, crackers, chips, popcorn, and carbonated beverages. There will likely be a rule against having food or drink with the exception of water in the NICU. Say no thanks to the giant cups of ice water and keep a non-spill thermos of warm water with you. This is both comforting to your nervous system and supportive to your digestive system.
How to Priortize Self Care
Plan all your activities around these four priorities: Self care, baby care and updates, meals and rest. The best way to do this is to ask your NICU nurse about your baby’s schedule. Most NICU babies are on schedules for feedings, care, and meds and they sleep in between care times. This way you can plan when to rest, pump, or be available for feeding. Knowing their schedules gives you a window for self care, even if it is the most basic of self care. Try to coordinate your nursing care in the postpartum unit to occur opposite of your baby’s care times. This makes it so when your baby is sleeping, you are present for your assessments, medication times, meals, and naps. When you do this, you receive the care you need and you don’t have to worry about your health on top of your baby’s health.
Your postpartum nurse’s job is to make sure your uterus is decreasing in size as it should, that you are able to void and stool and that you are not bleeding too heavily. They will also be checking your vital signs at least every 4 hours, which gives them important information on your health such as the beginning of infection, or increasing blood pressure which can lead to pre-eclampsia or seizures. I know it can be devastating to leave your baby’s bedside, but it is crucial that you receive proper care in the first few days to avoid postpartum complications.
Aside from your four main priorities: self care, baby care/updates, meals, and rest, decrease your input to the bare minimum. This means emotionally, socially, and information-wise. Don’t worry about social media updates, thank you cards, hosting visitors, and explaining the baby’s medical condition to everyone. In fact, if you have someone close to you who you trust, it’s worthwhile to write ONE birth announcement post & delegate the updates (as you wish them to be stated) to your friend or family member, so it’s off your plate.
Be gentle with yourself as you learn to cope. This is soul work. Feed yourself with love and empathy. Express and digest your emotions. Let them become the fertilizer for the strong and resilient Self that emerges through this journey.
Try to have an awareness of your sensory input. You are in a depleted and vulnerable state. Background noise, too much screen time, and violent or intense TV shows can be overwhelming or triggering. Allow yourself to use your senses as healing tools; gaze at your newborn, feel the warmth of a mug between your hands, listen to music or sounds that are comforting to you, savor the taste of the food you are eating, bond with your baby by smelling their head and feeling their hair or skin. You can even keep one of their shirts or blankets with you to find sensory relief and bond with your baby. We use “scent cloths” in the NICU, which is a piece of flannel that one of the parents keeps in their shirt for a while and then it is placed near the baby’s head so they can smell their parents. Sensory healing is effective and very comforting!
Accept Help and Ask for Help
Finally, know that all of these suggestions will be more effective with the support of family members and friends. They can process with you, bring you warm meals, and buffer you from the world outside of your experience at this time. Know that support is available to you through your medical care team, doulas, social workers, chaplains, case managers and NICU parent support groups, if you need to go outside your circle of family and friends. This is the time to allow yourself to be embraced by your village and accept help and kindness that comes your way.
Despite the chaos, confusion, heartache, and uncertainty, this will be one of the greatest learning experiences and transformations of your adult life. Be gentle with yourself as you learn to cope. This is soul work. Feed yourself with love and empathy. Express and digest your emotions. Let them become the fertilizer for the strong and resilient Self that emerges through this journey.
For caregivers, family and friends of NICU parents…
It can be intense to care for newly birthed parents who are traversing a NICU stay. You are witnessing someone in a massive transformation; becoming a parent while bearing the weight of their baby’s unknown outcomes. It is imperative that if you are offering your help that you come to the situation intentionally, and are prepared to be a safe place to hold space for your client, friend, or family member.
Here are some helpful tips for supporting newly postpartum NICU parents:
- Ask the birthing parent about their experience of the birth. Then be prepared to use active listening & hold space as they begin to process their experience.
- Ask open ended questions. Instead of “Are you ok?” ask, “How/what are you feeling right now?” If you are a caregiver, instead of “Do you understand?”, ask “What questions can I answer?”
- Try to help to ease decision fatigue. Instead of asking parents “Do you want some water?”, just bring them water. If you have offerings that you know will benefit them, just offer it so the only effort they have to make is accepting.
- Help parents take notes during rounds or when something is being explained. It’s a lot of information to take in.
- If you are a close friend or family member, you can be a person that the parents can delegate tasks to, such as creating a meal train, giving updates to family through a text thread, bringing them warm, easy to digest meals in the hospital so they don’t have to eat hospital or takeout food, updating social media per their requests, or gathering supplies for the parents or baby as needed.
- If you are with the parents at the bedside, make it a point to mention the beautiful, normal, expected attributes about their baby. It can be overwhelming to see your newborn with an IV, or intubated, or with a feeding tube. Talk about their perfect toes, their beautiful hair, their long eyelashes.
- Give parents every opportunity to do baby care on their own. This is empowering and helps break down fears of their baby’s fragility and intimidating medical equipment and devices.
- If it is within your scope, explain the equipment they see and the alarms they might hear. For a parent unfamiliar with the NICU, every alarm can feel like an emergency. Helping them know normal parameters, when an alarm will go off, what that means, and what we’ll do about it is very important.
- Encourage the newly birthed parent to focus on warmth, oleation, rest and hydration. Provide as much of this as you can through offering warm, easy to digest foods with plenty of protein and healthy oils and fats.
- Make sure mama has a thermos of warm water or tea at all times.
- Give them a head, hand or foot massage with warm oils. (The oil can even be warmed up by rubbing it between your palms!)
- Help the new parents keep track of when the down time is between baby’s care & feeding times and encourage rest and sleep during this time.
- Break things down into digestible moments. Information and sensory overload can create panic for new parents.
Sometimes in the NICU, instead of taking things one day at a time, it’s one hour at a time. In fact, it may become one minute at a time or one breath at a time. Let the new parents know it’s perfectly ok to need to take things one breath at a time, and be present with them as it passes. As much as you can, be a grounding presence so that the parents feel safe expressing their grief so they can begin healing.
Writing compliments of
Mother, RN, Ayurvedic Health Counselor