Parenting in the NICU during COVID-19

• Research type

  Research Study

• Full title

  Parent Experience in the NICU: Impact of the COVID-19 Pandemic (PEN-ICP)

• IRAS ID

  296268

• Contact name

  Deanna Gibbs

• Contact email

  deanna.gibbs1@nhs.net

• Sponsor organisation

  Barts Health NHS Trust

• Duration of Study in the UK

  0 years, 6 months, 1 days

• Research summary

  Summary of Research

  The COVID-19 pandemic has resulted in changes in our daily lives in an effort to control the spread of the virus. This has included wide-scale restrictions for visiting patients in hospital, including the access of parents and families of babies receiving care in neonatal units. We do not yet have good evidence to help us understand the impact this experience has from the perspective of parents who have cared for their baby in a neonatal unit. We need to better understand the impact of these changes on parents sense of well-being and their developing relationship with their baby so we can provide the most supportive approach possible. This qualitative study will involve partnering with parents to explore how they experienced being a parent in the neonatal unit during the COVID-19 pandemic. This will include understanding how they were involved in caring for their infant, and how they believe this experience has impacted on their relationship with their baby.

  10-15 parents of babies that were admitted to the neonatal unit since April 2020 will be invited to participate in interviews lasting 60-90 minutes, which will be like a guided conversation about the topic. Interviews will be conducted via phone or video call. Interview data will be transcribed and analysed to capture meaningful experiences from the parent accounts. These meanings will then be categorised into themes which will provide an interpretive summary of the parent experience. The study findings will generate recommendations for proactively supporting parents in future.

  Summary of Results

  This study aimed to explored the lived experience of parenting a high-risk infant in the NICU during the COVID-19 pandemic. Specifically, the research study addressed the following aims:
  1. To explore how parents of high-risk infants experienced the phenomenon of parenting in the NICU during the COVID-19 pandemic.
  2. To explore the impact of these experiences on parent's perceptions of their parenting occupations and their relationship with their infant.

  Interviews were conducted with 11 parents whose infants were admitted to a level 3 neonatal unit during 2020/21. Interpretive phenomenological analysis was used and the following themes and sub-themes were identified which were linked to three time points in the parents' experiences: preparing to become a family; parenting in the NICU; and life beyond the NICU.

  Themes/Sub-themes
  Preparing for parenthood during a pandemic
  - Keeping safe
  - Vulnerability: being separated as a couple
  - Information, power and control
  - Preparing to welcome baby

  Birth and introduction to the world of the NICU
  - An emergency delivery
  - Becoming parents: togetherness, agency and advocacy
  - Give him a kiss and a cuddle and say goodbye
  - The emotional aftermath

  Being present in the NICU - navigating the pandemic rules
  - Learning the rules
  - Being part of the physical, social and emotional environment
  - Sharing parenting and juggling life
  - Bearing the emotional burden

  Parenting occupational disruption and adaptation
  - Doing normal mum things
  - Loss of anticipated activities
  - Confidence influencing engagement
  - Negotiating caregiving

  Creating a sense of parenthood
  - A tangible sense of connection
  - Beyond the baby: finding ways to feel connected
  - Routines as barriers

  Moving forward and NICU legacy
  - Preparing for home
  - Reconnection: with others and the anticipated self
  - Navigating a new (revisioned) world
  - Legacy of a 'lost' experience

  Conclusion:
  The exploration of the lived experience of parenting a high-risk infant in the NICU during the COVID-19 pandemic illustrates how the already complex and multi-faceted nature of parenting in the NICU was further influenced by the pandemic restrictions. The societal and hospital restrictions infiltrated each stage of the family's experience. The isolation of being pregnant during a pandemic and navigating high-risk or emergent antenatal care provided an already traumatic backdrop for parents whose infants required admission to a neonatal unit. Parents had to learn the organisational rules, needing to make emotionally costly decisions as to who would be able to spend time with their baby. When able to be present, parents participated in a process of occupational adaptation as they reclaimed anticipated parenting activities and worked to acquire new, alternative occupations associated with parenting a preterm infant. Imbued within these parenting activities was the importance of creating a sense of connection with their baby in both tangible and non-tangible ways. However, the legacy of these experiences continued to influence their parenting and well-being in the period beyond the NICU admission.

• REC name

  North West - Greater Manchester East Research Ethics Committee

• REC reference

  22/NW/0302

• Date of REC Opinion

  3 Oct 2022

• REC opinion

  Favourable Opinion