Podcast Episode 13
Introduction
Welcome to our 13th Podcast episode! It is a continuation of my amazing conversation with Anese Barnett, a perinatal mental health therapist. If you have not listened to part one, I strongly encourage you to go back and listen to Maternal Mental Health in the NICU – Are We Doing Enough? Part I.
You will absolutely want to listen to this episode if you are a NICU mother who has experienced or is currently experiencing the stress and associated trauma of having a baby in the NICU. Or if you a NICU dad, grandparent, friend, or part of the NICU care team, get some tips on how to encourage that amazing NICU Mom to pause and care for herself.
Anese and I continued our discussion of maternal ritualistic behaviors and she explained how to spot atypical responses from mothers if their ritual is disrupted. But, more importantly she offered concrete suggestions on how their significant other, parents, friends, or nurses can address their concerns to them in an empathetic and understanding way so they are willing to open up and accept further help. Anese and I discuss an amazing idea for NICUs that will seemingly help you get your NICU Moms the help they need and deserve. Afterall, it is the NICU care team, especially the bedside nurses who interact with and see the mothers struggling to cope day in and day out.
We chatted about some of the mental and physical ailments associated with trauma if it is not addressed in a healthy and timely manner. Did you know that we as mothers can actually pass our trauma and negativity down to our children if we do not deal with the birth trauma and/or NICU trauma that we endured?
Anese offered some great resources for NICU parents or anyone who wants to understand more about NICU trauma and how our body as a whole can be affected for years. She provides great insight on questions to ask and how to find the therapist that is right for you or your loved one.
Maternal Mental Health is incredibly important and we as Moms often neglect it and do not make it a priority. After listening, I guarantee that you will have been enlightened by the information we share. Most importantly, I hope if you are neglecting your mental health, I encourage you to start taking care of yourself as a whole person – mind, body, and spirit!
Afterall, we not only want healthy babies after they are discharged from the NICU, but we need healthy parents, specifically healthy Mamas who are at their best to care for them at home!
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Meet Anese Barnett
Anese Barnett is a veteran NICU mama to a now rambunctious toddler who inspires her work and education daily. She is a perinatal mental health therapist and clinical psychology doctoral student who is passionate about improving mommy’s mental health, especially for those experiencing high-risk pregnancy and the NICU.
She lives in northern Virginia with her husband and little boy. She specializes in supporting a mother’s mental health during pregnancy and beyond, specifically for high-risk pregnancies and those enduring NICU trauma. She is passionate about the community she was once a part of and strives to learn more beneficial ways to support the mothers who are now going through the experience.
Previously, she worked with small children and their mothers. But, after unexpectantly delivering her son prematurely at 33 weeks, she felt driven after her personal high-risk pregnancy complicated by IUGR and NICU trauma, to focus on maternal trauma. She is very knowledgeable on maternal mental well-being from a personal and professional point of view. I know you will gain a significant amount of new knowledge after listening to our conversation.
Maternal Ritualistic Behavior
We left off on Part I of Supporting Maternal Mental Health in the NICU – Are We Doing Enough? podcast episode discussing maternal NICU rituals. Anese clarified that some rituals are normal and not considered problematic. Rituals become concerning if the mother becomes emotional or her reaction is elevated if the ritual is disrupted.
How can professionals or loved ones address concerning behaviors?
Anese recommends addressing mothers first with empathy followed by honesty. First, let the mother know that you understand how difficult it is for her to be away from her infant in the NICU. Second, ask how she is doing and mention that you’ve noticed her accelerated reaction if the ritual is disturbed.
Consider speaking to the mother with one of her loved ones by her side. By asking the question in a loved one’s presence, it brings more awareness to her friends and family. Once she is openly communicating, it will be an opportune time to ask if she has thought about speaking to someone.
How can the healthcare team support NICU families?
Neonatal Intensive Care Units ensure that parents have all of the adequate resources and pieces of information parents will need during their baby’s NICU stay and for their upcoming discharge. But, could they consider doing more regarding maternal mental health? After all, it is the NICU staff who interacts with the parents day after day while they are visiting their baby in the NICU.
Anese mentioned the idea of NICUs developing and having a ready-made list of counselors or therapists who specialize in NICU trauma and maternal mental health in their local area to give to mothers. If possible, the list could specify what health coverage the therapist accepts as well as their areas of expertise. So, if after a discussion, the mother is agreeable to speaking to someone, the member of the care team can easily hand the list over.
Even if the mother does not utilize the offered help right then, she will have the list to refer to at a different time. When it comes to maternal mental health, women are less likely to ask for help or to take the time to research names on their own.
In general there should be improved collaboration between the NICU care team and social worker in labor and delivery. Maternal mental health should be a top priority and not forgotten beyond labor and delivery. According to studies, women who have an infant in the NICU for greater than 2 weeks are at an increased risk for postpartum depression.
Why mothers open up and trust NICU nurses
It’s powerful for mothers to hear from the bedside NICU nurses or NNP because the mother sees them daily. Mothers of NICU babies begin to trust and build a trusting relationship with their baby’s nurses. Due to the trusted relationship, the nurse can empathetically acknowledge how difficult the NICU journey can be, then ask open-ended questions. The mother is more likely to open up to the NICU staff because they expect them to know and truly understand how difficult the NICU journey can be. Mothers often feel as though the NICU staff are truly the only people who understand her grief.
How can friends and family help?
If a friend of family member of the mother notices some concerning behaviors or overwhelm, they should take the same approach of starting with empathy, acknowledgement, followed by open-ended questions.
Whether it is the NICU nurse or a friend or family member approaching the mother, repetition is key. Even if you ask if she is doing okay and she responds with yes, ask again in 1-2 days. Let her know that when she is ready, you will be there. The more that she sees that you care and are a constant support to her, the more she will open up in time. With the consistent check-ins, the mother will realize that she has support and you are giving her permission to acknowledge that she is not okay.
Once the mother says she is ready to talk to someone, ask her permission to notify a couple of people on the list of therapists so you can make a decision together who may be the best fit. Better yet, offer to escort her to her first appointment. Offering to make the calls and get the ball rolling will be incredibly helpful as mothers tend to not prioritize their own mental health.
The associated long-term affects if maternal mental health is not addressed after NICU trauma?
How it affects the baby
If the mother is not mentally well, she will not be able to connect with or respond well to her baby. The lack of bonding and attachment can ultimately affect the baby’s neurodevelopmental outcomes. If mothers do not care for themselves physically and mentally, they are more likely to be a victim to the symptoms of post-traumatic stress disorder in the future.
Chronic pain is often linked to unresolved trauma
If a mother does not properly address their mental health issues, they will live their life with flashbacks and/or physical pain. Many women do not realize until they’ve received the proper help with their mental health that their physical ailments are connected to the trauma. By digging deep with a therapist and starting the healing process, the chronic pain or ailments will be alleviated.
Trauma and the associated memory loss
Most mothers do not typically begin to work with a therapist until 2-3 years after they’ve experienced the NICU trauma. It is then that they realize the disconnection from their body and the memory loss they’ve experienced is in fact due to the unresolved trauma.
Projecting our trauma onto our NICU survivors
If our trauma is not addressed, we as mothers are at risk of projecting our birth trauma onto our children. We need to be cognizant of the stories we tell and how it may affect our children. Birth trauma may illicit negative thoughts as we think of our children being brought into this world. Some mothers retell the story on or near their child’s birthday in a negative way. To use your birth trauma as if it were a weapon to use against your child will only end up hurting them. We cannot place unrealistic expectations on our children just because of the trauma we endured to have them.
We need to shift the narrative with our children and share their birth story in a different light. If we focus on our child’s strength and resilience it will help to nurture them, not tear them down. By keeping our story positive for our children, we can inspire them and provide them with hope for whatever their future holds. As we create a healthy narrative, it will strengthen our bond with our children and ultimately improve their outcomes.
Why do NICU mothers retell their traumatic stories repeatedly?
If you’ve been through a traumatic experience, the process of telling our story repeatedly is reflective of our brain attempting to process our trauma. Retelling your traumatic story is normal, but mothers need to be cautious that they are sharing it in the right space. If you become vulnerable and share your story in a space that is not helpful or even harmful, and you do not get an appropriate response, it can cause further trauma. It is recommended that you only open up and share it in spaces that will help you heal like with a therapist or an appropriate support group.
How to find the right therapist
Most therapists offer a free consultation initially. Utilize this opportunity to ask questions to ensure they are the right therapist for you. It is important to ask your potential therapist if they have experience in trauma and more specifically, do they consider what you went through to be traumatic. Remember that you as the patient are able to choose your therapist, they are not choosing you.
Where can mothers get additional resources?
Anese Barnett, our guest is a maternal mental health therapist that specializes in supporting mother’s mental health during pregnancy and beyond, specifically for high-risk pregnancies and those enduring NICU trauma. You can follow her on Instagram @i.am_anese.b
Parijat Deshpande is a high risk pregnancy expert who focuses on mind-body health. She is an author and public speaker who guides women and helps to improve their pregnancy complications and reduce their risk of preterm birth. Follow her on Instagram @healthy.highriskpregnancy.
Postpartum Support International has a directory of therapists. If the therapists are newly trained within the last 2-3 years, they will have had an additional component of NICU specific training.
Madison Henry offers lactation support groups specifically for NICU mothers. Follow her on Instagram @mamabirdhendry.
Dr. Joann Cole, PhD, PMH-C is a clinical psychologist who specializes in Perinatal mental health, Adolescent pregnancy and parenting, Dialectical behavioral therapy, Grief and bereavement, Motivational interviewing, Pain and stress management, Pediatric psychology, Substance abuse disorders, Trauma and mood disorders, Trauma focused cognitive behavioral therapy.
Top Tips for NICU Parents is a free collaboration of tips to help NICU parents during their baby’s NICU journey. Grab your copy now!
Closing
We must make maternal mental health a priority. I genuinely hope that your eyes have been opened up whether you are a NICU mom, support person, family member, friend, or if you are part of the NICU care team. Maternal mental health cannot be neglected! If we do not address the trauma early on, I am here to personally tell you that not only does it follow you, but it will even escalate.
For me personally, once Anese mentioned the associated memory loss from trauma, I would have buckled at the knees if I wasn’t already sitting down. Please take it from me, it happens. And I would give almost anything to get back some of the memories from my son’s early days and even years. So many of them are a blur and I now understand a big part of why that happened. I was one of those moms who didn’t have time to go see a therapist. I had a new baby to take care of and I was TOTALLY FINE – until I wasn’t! I finally realized that my temperament had changed and my ability to handle difficult situations had completely deteriorated.
It’s okay to not be okay – especially if you’ve been through something traumatic. And having a baby in the NICU is completely traumatic! Please know that you are not alone and what you are feeling is normal! And although those feelings are normal for what you are enduring now or what you have previously experienced – it will follow you and you will not feel normal years down the road unless you deal with your trauma. Do it for your child so they have a healthy Mama, but most importantly, do it for yourself!
Please consider talking to someone so you can begin the healing process and work through those feelings early before they affect your temperament, your physical health or your relationship with your baby and family. Follow the links above or ask your primary care provider or nurse to help you find someone to talk to.
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Click below for a great free resource of top tips to help new NICU parents navigate through the difficult NICU journey!
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