Dads are more stressed than moms after bringing preemies home

Jan. 31--Baby Ava weighed 2 pounds, 15 ounces when she was born 10 weeks early after her mother had preeclampsia.

When she was born in 2014, she didn't move or cry initially. Ava's skin was too sensitive for clothing, her parents couldn't hold her, and she was connected to all kinds of wires and monitors. After a five-week stay in the neonatal intensive care unit, where each day was a struggle, the Illinois couple got to bring their baby home -- but after getting accustomed to having help from monitors, they knew the transition wouldn't be easy.

"She wouldn't be connected to monitors to tell us if she's still breathing; we won't have nurses constantly monitoring her," said Ava's dad, Irwin Obispo, a pharmacist manager at a local retail pharmacy. "The stress of having to take care of a preemie with all the extra monitoring and attention to care is highly overwhelming."

There also was sleep loss paired with a day job and worries about his wife, plus the knowledge that the family had narrowly slipped through some very dangerous territory at the hospital.

"I may have physically endured pain, but the emotional and mental pain of possibly losing his family is equally as hard," said Michelle Obispo about her husband.

Contrary to popular belief, it's the fathers whose stress levels rise when bringing premature NICU babies home from the hospital -- while the mothers' stress levels stay constant, according to a new study by researchers at Northwestern Medicine.

They found that before being discharged from the NICU, both parents had high levels of cortisol, the stress hormone. But during the two weeks after being discharged, the mothers' stress levels returned to normal, while the fathers' continued to rise.

When the babies are in the hospital, they're cared for by a team of nurses and physicians, said Craig Garfield, lead author of the study, and associate professor of pediatrics and medical social sciences at Northwestern University.

"When the baby comes home, suddenly baby needs care and support, mom needs care and support, and dad may still be trying to juggle work and his growing home responsibilities," said Garfield, who also is an attending physician at Lurie Children's Hospital.

Mothers also tend to process the situation long before fathers do, which may account for their being able to adjust faster, said AnnaMarie Rodney, owner of Chicago Family Doulas.

As soon as a woman gets pregnant, she begins to plan for her baby, while many men might not do as much until the baby is born.

"I talk to five to 10 moms a day, and the things I hear from them are that when they're pregnant, their husbands don't think their lives are going to change," Rodney said. "When dads realize, 'I'm a dad,' -- this changes everything -- but now, if anything isn't perfect, it's an additional stress, and they really don't know what to do with it."

If the baby goes directly to the NICU, many fathers continue to feel powerless, said Jennifer Howard, a licensed professional counselor in Virginia who specializes in the treatment of perinatal mental health and is the mother of a preemie. In there, the machines, nurses and doctors take over, as the parents watch.

"When your baby is discharged from the NICU, it can feel quite overwhelming to transition to a position where you are now in charge," Howard said. "This transition likely heightens dad's feelings of insecurity about their ability to care for their baby."

The partners also are faced with a unique role, as they're supposed to be the strong ones in this situation since they didn't give birth, so they have to care for the mother and the baby. And while postpartum depression is a much-publicized medical problem facing mothers, men's stress and postpartum issues haven't been studied much until now.

"It's largely misunderstood, but fathers also experience perinatal mood and anxiety disorders," Howard said.

About 1 in 7 women will experience postpartum depression, and 1 in 10 men will also experience it. An NICU stay is one of the factors related to postpartum depression, and it could affect men and women, Howard said.

Fathers often are the first to see their preemies or sick children in the NICU because the mother is still in the recovery room. Fathers also watch emergency C-sections, and they are there during the crisis, while the mother may be under anesthesia or may not be as aware of what's happening.

"If the birth was traumatic -- for instance, if the baby was resuscitated -- then dads may be exposed and more aware of the baby's health concerns," Howard said. "This can lead dads to experience symptoms of PTSD, as well."

But postpartum depression and stress symptoms after childbirth typically manifest differently in dads than in moms.

Men will often be angry, irritable, will be more likely to abuse alcohol or other substances, and will withdraw and be alone, said Crystal Clancy, executive director of community engagement at Pregnancy & Postpartum Support Minnesota.

They should seek professional help immediately, as they need to be healthy to properly care for their infant.

Danielle Braff is a freelancer.

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