How the Pandemic Aggravates NICU Life

Written by Awanti Sambarey, PhD, the mother of Baby Indira.

“Though she be but little, she is fierce” – William Shakespeare

Nothing prepares you to have a preterm baby. My pregnancy was wonderful, and I did everything “right” – from eating healthy to prenatal yoga, I followed everything by the book. My pregnancy was perfect – until it wasn’t. In late February, I had sudden onset of preeclampsia, where my blood pressure shot up. It progressed from mild to severe within a week, and I was rushed for an emergency C-section. Our daughter Indira was born at 28 weeks 5 days in the first week of March 2020 on a snowy afternoon. The whole process was incredibly traumatic, but thankfully all went well and our little warrior entered the world with a loud war cry!

Indira FamilyIndira was transferred to the NICU, where she was kept in an incubator in a private room. For the first 3 weeks, my husband Siddhesh and I would be at her side – coming to terms with having a preterm baby, going over her care with the medical team, understanding the functioning of different equipment and alarms – all while grieving the loss of a complete pregnancy and facing our new normal. It was overwhelming, and we wouldn’t have managed without each other’s presence. While the world was battling a pandemic, our world was growing stronger each day in the hospital. For a while, it seemed like three of us were living in an alternate universe.

Eventually, the pandemic hit Michigan. With the Governor’s stay-at-home orders, the hospital restricted visitors to only 1 parent per child. Parents could not take shifts, and one was assigned the designated parent throughout the hospital stay. This policy felt bizarre for many reasons:

  • Parents are NOT visitors. Parents are an integral part of their baby’s care team. NICU families are already under enormous stress, and such forced separation robs the family of time required to bond and heal. Mothers and babies should be considered as one unit. For the first few days after my C-section, I couldn’t even stand up without Siddhesh’s help, so it’s unfathomable to expect one parent to handle everything alone.
  • We didn’t understand why we couldn’t at the very least take shifts and have one parent be present at a time. They were not quarantining the designated parent in the NICU, and we could still go home to our families. For example, Siddhesh and I were exposed to each other anyway, so it didn’t really minimize the risk of transmission.

The next few weeks with the 1-parent policy were brutal. Part of surviving the NICU involves celebrating every milestone as our babies fight the odds. We missed being together as a family as I experienced many milestones alone – when she turned 1 month old, her transition to an open crib, her breathing without external support, and my very first Mother’s day. It was parenting like we never imagined.

NICU PandemicWe constantly appealed to the hospital administration to make policy changes, as we firmly believe that there is nothing more important for a baby’s well-being than being with her parents, and eventually, I wrote to the hospital’s COO. She was empathetic and allowed us to take weekly shifts. Indira had a happy reunion with her dad! Soon they extended the weekly shift policy for the entire children’s hospital. We kept advocating to be together, and in the last week of her stay both of us could be present for discharge training. After 73 long, grueling days, we finally brought her home together!

Despite these challenges, the hospital had several provisions to help us cope. Here’s what helped us navigate through this tough time:

  • Having primary nurses: The option to choose primary nurses for Indira was a blessing. They took excellent care of Indira, gave us hands-on training, vouched for us in discussions with the doctors, and were our main source of emotional support while we parented individually in the NICU.
  • Research: We were very involved in Indira’s medical care and did extensive research at every stage of her growth. The doctors were forthcoming and encouraged our participation and questions in their daily rounds. Being informed kept us sane!
  • Breastfeeding: Breastmilk provides immunity through antibodies, and offers the best protection against necrotizing enterocolitis (NEC). We were informed of Indira’s risk and I was encouraged to start pumping 3 hours post-delivery. Frequent in-person lactation consultations motivated me to keep pumping to help keep Indira healthy. Indira Zaky
  • Kangaroo care: We did hours of kangaroo care (skin-to-skin) with Indira. Our friend Shivona gifted us Zaky Hugs, which we used during kangaroo care and later placed in Indira’s isolette. This helped Indira to sense our presence & feel secure even when we weren’t around, giving us some relief in times of separation.
  • Parent Hosts: The NICU offered peer mentor support in the form of parent hosts – former parents of NICU babies who help current families see the light at the end of the tunnel. Their encouragement, empathy & support was invaluable.

We are incredibly grateful for the excellent medical care Indira received. However, the COVID-19 visitor policies have left deep psychological scars. We understand that these times were unprecedented and the hospital wanted to minimize risk. But, we wish that policies were made in partnership with parent advisory committees. NICU families are just as careful, if not more so, as the medical team regarding the safety of their baby.

Through it all, Indira fought bravely and gave us the strength to get through each day. She’s a proud NICU graduate in the middle of a pandemic – our very own Wonder Woman!

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