Doula Role: Neonatal Care

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How do you support a client whose baby was whisked away to the Neonatal Care Unit? Whether it’s planned or unplanned having a baby in the neonatal care unit can be overwhelming and scary for parents. As doulas, we can help our clients either prepare for their baby’s stay or help them understand what’s going on if it happens suddenly after birth.

Photo by Vidal Balielo Jr. from Pexels

Reasons for baby to go

There are many reasons why a baby would have to go to the NICU. Some need extra support after a difficult birth, induction, etc. Here are some more common reasons why a health care provider would have a baby receive care in the Neonatal care unit.

  • Premature
  • Respiratory Distress Syndrome
  • Sepsis or infection
  • Hypoglycemia
  • Perinatal depression
  • Maternal chorioamnioitis

Needs identification of family

During this time for the parents be sure to pay extra attention to the families safety needs, especially if baby going to the NICU was unplanned. They will have so many questions, be scared for their baby, and possibly the mother. In an emergency situation, your focus many need to turn from mother, who may be receiving emergency care, to partner support.

  • Physiological Needs: These are needs required to sustain life. These include such things as air, water, sleep, and nourishment.
  • Safety Needs: This means feeling free from threat of physical and emotional harm. Safety needs include the need for structure or order. It also involves feeling protected from injury or pain.
  • Social Needs: This has to do with our interactions with people. This includes the need for friends and belonging. It also involves our ability to give and receive love.
  • Esteem: This deals with our need to feel important. This includes our desire for self-respect and the feelings of achievement.
  • Self-Actualization: This deals with finally reaching our full potential. This is how we find meaning in our lives.

What questions to ask:

Here are some questions for parents to gather information about baby from hospital staff. In the rush of baby moving to the Neonatal unit parents may need your help to remember what questions they need to ask.

  • What is the anticipated length of stay for my baby?
  • What is my baby’s prognosis?
  • What can I expect in the short and long term?
  • What medications is my baby receiving? And Why?
  • Do the medicines have side effects?
  • When can I hold or touch my baby?
  • What types of tests will be done?
  • If this treatment does not work what are our other options?
  • Do you anticipate any long-term complications from this illness?
  • Will I be able to breastfeed or bottle-feed my baby. If so, when and how?
  • Can I stay with my baby? Can I sleep there?

What happens next

The uncertainty and worry that comes with having a child in the NICU is very stressful for parents. Most hospitals with a Neonatal unit have recommendations on how to cope such as books or support groups for families.

“The general rule is if a baby has been stable – not needing oxygen, eating all feeds orally and otherwise stable – for 48 hours, they are discharged home with close follow-up.”

 Pankaj Nagaraj, MD, UnityPoint Health

Resources:

  • https://www.unitypoint.org/livewell/article.aspx?id=0f9e4fe7-eb43-4235-a30a-f5853feb23f1
  • https://drterrimd.com/top-5-questions-nicu-parents-should-ask-their-medical-team/
  • https://kidshealth.org/en/parents/nicu-questions.html
  • https://blog.chocchildrens.org/the-top-10-questions-every-parent-should-ask-their-nicu-care-team/
  • New Beginnings Training www.trainingdoulas.com
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