Researchers uncover hidden toll mothers face in NICU
December 6, 2023
A study led by Gillings School researchers unveiled the often-overlooked challenges faced by mothers with hospitalized infants in a neonatal intensive care unit (NICU). The article, originally published in the Journal of Midwifery and Women’s Health in January 2022, has now been recognized as one of the top-cited articles of 2021-2022 by the Wiley Online Library. Yet, the impact extends far beyond these accolades.
Dr. Alison Stuebe
In the article, researchers show the unique hurdles these mothers face, including increased health issues and depression risk.
“Mothers with hospitalized infants face a host of challenges. They enter pregnancy sicker and have more pregnancy and postpartum complications than other moms,” said Alison Stuebe, MD, professor and Distinguished Scholar in Infant and Young Child Feeding in the Department of Maternal and Child Health and the study’s co-principal investigator.
The research, based on interviews with 50 women whose infants were admitted to the NICU, sheds light on the postpartum experiences of these mothers. In addition to health issues and depression risk, women faced logistical issues with parking, food access and places to rest, all of which led to forgoing their own health to be in the NICU by their newborn’s bedside. Notably, Spanish-speaking women reported additional hardships, including a lack of social support, immigration-related concerns and linguistic isolation.
Dr. Renée Ferrari
Further findings revealed a significant trend: Women in these circumstances often neglect their health, while providers fall short in actively monitoring their well-being. However, a crucial insight emerges — these women not only desire care for themselves but are also willing to accept it.
“They want it provided in a way that acknowledges their overwhelming desire to be with their critically ill newborn. To provide this, we need to rethink how health systems are designed,” said Renée Ferrari, PhD, adjunct assistant professor in the Department of Maternal and Child Health and the study’s lead author and co-principal investigator.
Dr. Sarah Verbiest
Finding ways to rethink health systems was an imperative course of action for the team. Co-principal investigator Sarah Verbiest, DrPH, who not only serves as an adjunct assistant professor in the Department of Maternal and Child Health but also as executive director at UNC’s Department of Pediatrics and Collaborative for Maternal and Infant Health, was part of the latter group’s interdisciplinary team who found the support to build on that next step.
“We have been looking for resources to continue the work and are pleased that we were just awarded a cooperative agreement award from the CDC,” she said.
In October 2023, UNC’s Department of Pediatrics and Collaborative for Maternal and Infant Health, along with Reaching Our Sisters Everywhere, the University of California San Francisco’s School of Nursing and subject matter collaborative partners, received a $4 million cooperative agreement from the Centers for Disease Control and Prevention (CDC) to advance best practices to improve postpartum care in and beyond the NICU. This program, Care for NICU Families, works with communities across the country to create a system of postpartum support for families who experience NICU care. Dr. Verbiest will serve as the program’s co-principal investigator.
As to the future impact of their research, Dr. Ferrari emphasizes the continued work to raise awareness of the mother-and-child bond.
“We would like to see health care systems and hospitals recognize that mothers and newborns are an interconnected dyad,” she said. “They both matter and deserve attention. Their healing, recovery and well-being are linked. More support is needed.”
Other researchers on the study included Erin McClain, MPH, assistant director and research associate at UNC Collaborative for Maternal and Infant Health; Christine Tucker, PhD, MPH, assistant professor in the Department of Maternal and Child Health; Nkechi Charles, MA, doctoral student in the Department of Maternal and Child Health; Virginia (Ginny) Lewis, MSW, research and program evaluation consultant; and Katherine Bryant, MSPH, program manager at UNC Collaborative for Maternal and Infant Health.
Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.
