Navigating the Challenge of Trauma in Relationships: Partnerships in the NICU

"He's avoiding visiting the hospital", "he's shut down emotionally", "she seems so fragile, I don't want to burden her with any more stress", "she's hyper-paranoid about the baby, and won't let me take him/her around my family or friends even though I feel it's safe now", "it feels like he/she ignores me now that the baby is finally home", "we don't talk about the things we used to care about any more", "our relationship is uncomfortably different". 

All of these are quotes from parents with whom I've spoken about their babies' stays in the NICU. In fact, in conducting my initial research in creating NICU Healing and leading support groups, what I found most parents felt they needed was guidance in how to salvage their relationship from a circumstance that had brought enormous stress upon it. Marriage is a challenging and dynamic relationship-- ever-changing-- and the NICU, along with the stress that it brings, can throw what might be an already fragile partnership into a tailspin. 

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Studies have shown that the evidence of both depression and PTSD amongst NICU parents are almost equal between mothers and fathers, and occur at staggering rates of over 20%. However, the way that these challenges present themselves between the opposite sexes can be vastly different. Women tend to exhibit symptoms of traumatic stress during the initial weeks in the hospital, whilst men oftentimes don't show symptoms until well after the baby has been discharged home. While there are various theories regarding why this is so, research is showing that different ways of coping can have a profound effect on partnerships. Common knowledge has it that the divorce rate amongst NICU parents and especially of parents of children with special needs is very high. The challenge of facing this incredible trauma can prove to be overwhelming for relationships, and can result in further tragedy to an already difficult circumstance. 

What can you do? 

It's important to be aware that partnership issues while going through a highly stressful life event are common. Even though you may not know any other families personally who are going through the same things as you and your partner, try to remember that relationship challenges during and after the NICU are incredibly common, even long after discharge. You are not alone.

As such, reaching out for support from other parents can be really useful. Online support groups for both moms and dads can open up a world of understanding, particular to each of your own individual experiences. It's important to know that others in the same circumstance struggle with similar things, and that you're not an island. Others who have been through similar things can give suggestions about how to reconnect with each other, and be a shoulder to cry on when it seems your partner, in that moment, just can't.

Additionally, making a space for each partner to speak to their experience is crucial in facilitating healing for both members of the parent structure. Hence, if you feel that your partner hasn't had a chance to express his/her struggles with their experience, try to actively make a space for that. Ask questions, be curious. Although it's challenging with a baby in the hospital or, in the months thereafter, raising a medically-fragile infant, try to be mindful of making time to speak with each other, one on one, at least once a week. Sometimes that can look like chatting with each other before going to sleep at night, going on a walk with the baby where cell phone use is minimized, even working out a time when you can have a date night or a lunch alone (once you have trusted caregivers that can provide childcare). The trauma of going through the NICU oftentimes has the effect of changing an individual's perspective on life drastically, so in a sense, making this space for conversation is essentially making a space to get to know your partner in this new context, and developing understandings that will help you to be better able to support them when they are struggling. 

Another tip that can be useful for partners is to try and identify the parenting strengths of each other, rather than allowing alienation to set in when one partner has a hard time doing something specific. Although it's not always the case, it's sometimes challenging for fathers to witness their child on life support in the NICU. Some case studies have shown that fathers can feel as though they are "out of control" or "no help" while their baby is hospitalized (keep in mind this gender role can easily be reversed as well). They can feel like their efforts would best be spent going to work and/or supporting the mother, as opposed to participating in the daily rituals in the hospital like diaper changing, skin-to-skin, etc. Many dads (and oftentimes moms too!) report feeling scared of hurting their fragile charges, and need to be comforted/guided through the experience of providing cares for their child (especially first-time parents). Even though this circumstance can sometimes be baffling for a partner, should you find yourself within it, try not to let what might seem like avoidance cause damage to your relationship, and try to foster empathy. Encourage them. Stand beside them. All things considered, it is an incredible strength to be able to do what you can do when you're in the NICU and beyond, and giving your partner the understanding and empathy that you can see they are trying is a great way of establishing trust and acknowledging each other's strengths.

Finally, when things seem like they've gotten to a point at which it's difficult to imagine how to re-calibrate with your partner, don't be afraid to reach out for help. Our culture is often saturated with the expectation that couples should be able to thrive within even the most challenging of circumstances. Reaching out to a trusted professional can be a valuable way of making a space for healing together, and being able to witness each other get through this struggle. Grief is a common emotion associated with the NICU, and it doesn't only affect one member of a parenting partnership, it affects both. Finding support to guide you through this process, particularly together, can be invaluable in building a structure of teamwork that you may be able to revisit throughout your relationship.