Excerpt from Navigating the NICU (BLOG PART 2)
Section 4: Self Care in the NICU
I could have written this entire book on self care and the emotional components of navigating the NICU, but I feel that the foundation of comfort and confidence in the NICU setting begins with orienting yourself to the environment, who is taking care of your baby and why, what to expect, and how to find support.
Our nervous system really cannot do the work of regulating itself, integrating our experiences, and beginning the healing process until it has a sense of the physical and emotional landscape in which we are now existing. We need our feet on the ground, so to speak. The shock of birthing or adopting a baby and having them need intensive care immediately can keep us stuck in the mental or ethereal realms and we will often just barrel ahead, putting our own care on the back burner because… what else can you do?
It is my sincere hope that the resources above have helped you find a tether to the ground in this experience so that you can feel oriented and resourced enough to begin to implement a bit of self care.
EMOTIONAL SELF CARE
I know, self care is a very loaded term. It carries an air of privilege, invoking images of bubble baths and face masks. I am using it for lack of a better term, because it is critical that you find ways to care for yourself as a NICU parent. It is a heartbreaking reality that once your baby is in the NICU, your postpartum care is minimized as the fear and focus is shifted to your baby’s health.
All the regular postpartum advice of getting lots of rest, sleeping when the baby sleeps, staying in the house for the first month… it doesn’t apply to us NICU parents. Our postpartum environment consists of a hospital recliner, lots of car rides, and too much standing.
I’d like to take this moment to remind you again (it’s so important!) to prioritize the idea of expressing your pain, grief, and sadness instead of just pushing it down and powering through. When we observe and accept this new reality of NICU life, and articulate and express our emotional response, we free up space to allow nourishment, softness, and support into this experience. We don’t have to just throw away all hope of a postpartum experience. Your vulnerability is your power, and it will open you up to immense growth.
With vulnerability and growth comes hard feelings. So, let’s begin by dropping our self judgment. I know it’s hard. It’s going to come up over and over again and not once is it going to help you heal or grow. We can so often question or blame ourselves for the outcome that our babies are in the NICU, or judgment for how we are feeling. Newly birthed parents have a wide spectrum of responses to having a baby in the NICU. You may feel unbearable pain at the separation and are willing to spend every second you can in the NICU, no matter how much pain you are in or how tired you are. You may be having a hard time feeling a bond to your baby due to all the medical interventions or the massive helplessness you feel. These are all valid responses. Allow them. As much as you can manage, don’t judge yourself. You are allowed to feel this way today and feel a different way tomorrow.
Your mind is going to be swirling with a million things. Let’s break it down into the things you NEED to be doing in these first few days, and I will help you organize and delegate the rest. First things first: your health. Your baby is being observed and cared for 24/7 by a dedicated nurse and a huge medical support team. Even though it can be unbearable to be away from them, we can know that this is true enough to allow ourselves to be cared for as well.
PHYSICAL SELF CARE
In your first few days postpartum, it is critical that you are observed via your vital signs and assessments to monitor your temperature, heart rate, bleeding/lochia, the size and tone of your uterus, blood pressure, ability to pee and poop, and to check incisions and tears. We want to catch signs of preeclampsia, hemorrhage, retained placenta, or infection as soon as possible, so these assessments are important. If you birthed at home, stay in touch with your midwife and make sure you can go to your follow up appointments. In these first few days, implementing self care is going to look like knowing your assessment times in the postpartum unit and being there for those assessments.
In addition, if you feel like something is wrong, SAY SOMETHING. Advocate for yourself. Tell your partner, tell your nurse, tell your doctor that you feel like something is off. You know your body better than anyone. Pay attention when you feel like something isn’t right.
If you are having pain, and this is critical if you birthed by cesarean section, STAY ON SCHEDULE WITH YOUR PAIN MEDS! I can’t emphasize this enough. Especially if you are going to spend a lot of time in the NICU, sitting in a recliner, standing more than you should, or holding your baby for hours, you want to stay ahead of the pain, not be chasing the pain.
If you are in the NICU and begin feeling faint, feel a gush of blood, or are having excessive pain, don’t hesitate to tell your baby’s nurse. They can easily call your postpartum nurse and get you the help you need.
While you are in your postpartum room, try to take advantage of the ability to take a nap if you can. You can coordinate with your nurse and your baby’s nurse so that you can be in the NICU for care & feeding times and rest in your room while your baby is sleeping. I know from experience that this is easier said than done. Use your judgment to discern if you feel comfortable leaving your baby. Just know you do have a safe opportunity to sleep during this time.
Now that we have covered the very basics of self care in this situation, let’s move on to some special considerations for the NICU environment.
Because your baby is in an elevated warmer, isolette, or crib, you will likely be standing quite a bit. This puts pressure on your pelvic floor and your pelvic organs as well as increasing the swelling in your legs and feet. Therefore, you need to prioritize elevating your feet as often as you can to counteract the amount of standing you have to do in the NICU.
Another way to support your body since you will be standing a lot is to utilize belly binding. Belly binding supports your abdomen and lower back, your abdominal and pelvic organs, and gives you a sense of support and comfort. If you had a surgical birth, you may have been offered a medical binder from the hospital. I highly recommend using this if it is ordered for you. You can also use a pregnancy or postpartum belly wrap, which are easily found online. (Do not use a waist trainer.) If you are able, look for a doula or birth worker trained in traditional methods of belly binding. With this option, you will gain a sense of ritual and reverence in supporting your postpartum body.
Here at the Center for Sacred Window Studies, we share voices from many perspectives and backgrounds. We believe that the sacred weeks post birth, and the experience of humanity is experienced in countless ways. We learn by listening to one another and honoring our stories. The views and opinions of our writers do not necessarily reflect the mission, viewpoints or opinions of the Center for Sacred Window Studies.