Supporting single parents in NICU

Premature baby and mother hands

Throughout my pregnancy, I hung onto the hope that things would be easier once I had my baby. It wouldn’t be so odd to be single with a baby – there’s loads of single parents, right?! Since L arrived, I’ve felt much more comfortable about my single parent status. People are too busy fussing over how cute he is (or usually how small he is…) to care about my significant other. I surround myself with mums on maternity leave, not a partner in sight as the paternity leave ebbs away. Sure, I can’t join in the mother-in-law outrage but we spend far more time moaning about our lack of sleep anyway.

But I hadn’t expected the in-between world of NICU. No longer pregnant, but not able to take my newborn baby home. The NICU bubble isn’t designed to be compatible with single parenthood. The basis of family-centred care in the NICU is 24/7 access for parents. Parents. Plural.

I had no idea how NICU worked as I’d been too traumatised the evening before L’s arrival to listen to the nurses scrambled to my bedside to brief me on their secret world. I broke down in tears and they were quickly whisked away. Several hours after my c-section, my mum wheeled me down to L’s incubator. A few minutes after I had seen my son for the first time, a nurse told me they’d make an exception for my mum on this first occasion. My head was spinning – I couldn’t do this on my own!

Once I had some time to gather my thoughts, I realised that the NICU norm was 24/7 access for the mother and the father. There was a separate hour visiting slot on weekends for grandparents and siblings. I liaised with the nurses and my mum was granted parental rights to visit L at any time, but I had to be present. I felt grateful for this and didn’t test the boundaries of her pseudo-parental role until we were moved to SCBU. I was too overwhelmed to argue my case for the support I needed. I hope I will never encounter NICU again and certainly not as a single parent. But if I did my time again, I would’ve ensured that I had the same support as every other mother on the unit. If you are a single mother on NICU, here are my suggested things that you expect as support from the unit [based on the policies at my NICU – other NICUs have less/more strict terms]:

a named person with equivalent parental responsibilities: after negotiation, my mum was allowed to visit L whenever I was present. It wasn’t too difficult to achieve this and my mum was named on our contact forms as the ‘other’ parent. It was made very clear to me that my mum was allowed in as my support and not in her own capacity. Although I didn’t realise this at the time, it placed a huge pressure on me. Like all NICU parents, I was paranoid about becoming ill and being unable to visit. If I fell sick, L wouldn’t have any visitors. An agreement that my mum could visit independently would have eased the pressure on me and perhaps would have allowed me to have a break. I can’t imagine not spending every day at the hospital, but it would have been nice to have spent some evenings resting knowing that L was in the company of his grandmother.

I had never envisaged a situation where I wouldn’t be able to care for my baby after his birth and luckily I wasn’t in that situation. But I know many other preemie mums who were in ICU themselves after their early delivery. I wish I had put a disclaimer in my maternity notes that my mum should be granted all parental rights in the event I was incapacitated. I couldn’t bear the thought of L being in NICU all alone if I had also been unwell following the c-section.

physical contact for the other person: I was given an almighty telling off when I asked my mum to help me change my 2lb baby’s nappy in the incubator. I was scared, not quite sure how to lift his wires without hurting him, but wanting to show the nurses I could do it myself with a little family help. Only parents can touch the preemie. But I knew once we were discharged, my mum would be the other person cradling L. As L became stronger, I was increasingly frustrated that he wouldn’t recognise my mum’s touch.  I asked several nurses if she could touch L but the answer was always only parents could touch the baby. It was a ridiculous application of protocol – why would L’s biological father, who hadn’t spoke to me during my entire pregnancy, be allowed to waltz in and pick up the baby in the place of my mum who was by my side throughout? I plucked up the courage to raise the question during the consultant round, much to the indignation of the nurse on duty. The consultant agreed immediately that my mum could touch L, as she was my partner in NICU for all other purposes.

The first time my mum held L was a beautiful moment. She couldn’t believe quite how tiny he was, despite seeing him nearly every day for the last 4 weeks. But the moment was ruined somewhat by one of the large bulky privacy screens surrounding us, incase other parents saw and wondered why I had special treatment. This made me feel as if we were doing something wrong. Single parents should not be made to feel guilty for wanting another pair of (non-parental) hands to help out.

no questions: I haven’t seen L’s medical notes, but I assume there would’ve been clear instructions that his father was not involved in his care. Despite this, I got asked several times by different nurses if he had been in contact or if he was planning to meet L. How long we had been together. Did he live in the same city as me? Yes, I know we all like to have a gossip and as far as I could tell, I was the only single parent in our NICU. But there is a time and a place.

respect: This may have been me with a chip on my shoulder, but I often felt like I was treated differently to some of the couples on the NICU. When dads turned up at the end of the day, chairs were pulled up and updates were given to the other parent. My mum would often have to hunt down a seat and would not really be acknowledged in the same way. I was talked down to when I disagreed with a care plan or course of action. I made to feel like I was a silly teenage single mum rather than a professional woman. I once overheard the nurses talking about a surprise for the dads on Father’s Day – a card or something with the baby’s prints. I spoke aloud and asked if L could have something addressed to his grandad. They seemed shocked that I had overheard (it was in the middle of the quiet ward, I was the only other parent) and said it was supposed to be a surprise, rather than reassuring me that L wouldn’t be left out.  If situations arise that shine a light on a parent’s single status, nurses could consider the best way to address it with the parent.

The loneliness that a single parent will feel in NICU is inevitable, despite the best intentions and support from staff. There were many nurses who did provide me with support and kind words when I had to answer questions about L’s father. But the NICU environment could be made more sympathetic to single parents, with some minor tweaks and a little thought.

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