Laura Elkins found out she was pregnant with her second child right around the time that her home state, Virginia, went on lockdown due to COVID-19 last spring. It was certainly strange being pregnant during a pandemic, the 32-year-old told HuffPost, but her pregnancy was pretty uneventful until suddenly, at 30 weeks, she developed symptoms of severe preeclampsia. She was admitted to the hospital and gave birth to her daughter a few days later, more than two months before the child was due.
“I was a complete basket case, to put it lightly,” Elkins told HuffPost of the six-and-a-half weeks her baby spent in a neonatal intensive care unit (NICU) while the pandemic raged on.
“Emotionally, it was the most stressful time of my entire life,” she said.
Having a baby spend any length of time in the NICU is not something any parent hopes or plans for, but estimates suggest up to 15% of babies born in the U.S. each year do so — including the overwhelming majority of preterm babies. Under even the absolute best of circumstances, it can be excruciating and take a huge toll on parents’ emotional health. An estimated 70% of mothers whose babies spend time in the NICU grapple with symptoms of postpartum depression, and up to 25% experience symptoms of post-traumatic stress disorder.
Add in a global pandemic, and experts fear the emotional load has become nearly impossible for mothers and fathers to bear.
“Isolation and stress are big factors for why NICU parents have had higher rates of PPD [postpartum depression] and PPA [postpartum anxiety] prior to the pandemic,” said Sarah Levine-Miles, a licensed clinical social worker who specializes in treating perinatal mood disorders. “The impact of COVID-19 has made isolation and stress even more intense for these parents.”
“It was completely overwhelming,” said Becky, a 37-year-old who, after years of in vitro fertilization, gave birth to her first baby over the summer at 30 weeks after she developed HELLP syndrome — a life-threatening variant of preeclampsia. Her son spent 58 days in the hospital battling what seemed like one health complication after the next — all with the threat of COVID-19 lurking in the background.
“They talk to you about how even the common cold is a risk, and our baby is extra, extra, extra sensitive. You start to think, ‘My gosh, how are we going to keep him safe?’” said Becky, who asked that only her first name be used because she was discussing her own health and that of her son’s.
She recalled the nurses’ hands, which would often be chapped and bleeding from all the handwashing they were doing.
The need for other safety protocols practiced because of the pandemic also has been a source of difficulty for NICU parents. Hospitals have needed to limit the number of visitors allowed, often requiring parents to trade off who can sit with the baby — and limiting how long.
Parents like Elkins fully understand why these added protections are in place, but that does not mean they are easy to manage. She swapped out hours visiting her baby with her husband, while they also had to care for their 5-year-old at home who was not in school because of COVID-19 closures.
“It’s a logistical nightmare,” she said. “You’re trying to live in two worlds at one time,” Elkins said.
“Our baby is extra, extra, extra sensitive. You start to think, 'My gosh, how are we going to keep him safe?'”
“While these restrictions are implemented for patient and staff precaution and safety, there is a significant emotional impact on families,” said Jamie Kreiter, a licensed clinical social worker who specializes in maternal health. It can be much more difficult for those families to get support from loved ones who are not able to come to the hospital, Kreiter added, or to meet and connect with other NICU families.
With all of these added layers of emotional and logistical difficulty bearing down on parents with babies in the NICU during the pandemic, it is imperative that they get help. Unfortunately, that help may be hard to come by in hospitals buckling under the strain of the pandemic and at a time when steering clear of friends and family is one of the best things we can do for our collective health.
There are simple steps to be taken, however. Hospitals should consider providing iPads that parents can use to FaceTime when only one partner is allowed to visit, Kreiter said. They should also routinely screen parents for mental health issues like postpartum depression, now more than ever.
And friends and family can help as well, even if it is from a distance. “If you know a family who has an infant in the NICU, there are many ways to show support,” Kreiter urged. “Send a meal to the hospital; lend books, puzzles, and other activities to help occupy the time; and check in regularly.”
Having spent time in the NICU during the pandemic herself, Elkins agreed — urging other parents to accept that help, which is something she struggled with. Let people drop off meals, she said. If there is a stretch when you can get some sleep, take it, even if it means you are not necessarily by your baby’s side.
Because, as is the case for all parents but particularly those who have had a baby in the NICU, the challenges don’t stop at discharge.
As one 36-year-old mom of preterm twins born who both have chronic lung diseases (and who asked to remain anonymous given the sensitive nature of her boys’ condition) put it: “The isolation doesn’t end when you get to come home.”
Her boys were born in July and spent two months in the hospital. A few of her family members have met them, but the twins are largely isolated. She and her husband will head out for infrequent trips to the grocery store and take their boys for walks outside. She knows how important it is to be constantly vigilant against the threat of COVID-19, but it is not easy.
“I do sort of feel like the walls of our house are coming in around me,” she said. “But we’re making the best of a shitty situation.”