Life in TIN in time of Coronavirus

by Claudia Ravaldi

A reflection on pregnancy, prematurity and neonatal intensive care in the time of the coronavirus.

We know that pregnancy represents a time of great physical and emotional changes during which fears and uncertainties can emerge that make this experience composite and complex. The quantity of more or less pleasant, more or less joyful, more or less anxious sensations, emotions, thoughts that normally “overwhelm” women during pregnancy are undoubtedly a great experiential baggage, which requires adequate spaces and times for processing and a good welcome inside and outside to be integrated into one’s own experience in the most harmonious way possible.

All this “work” is normally done by every expectant woman and is favored by a proactive, facilitating and caring external environment. This last environmental condition does not depend directly on the will of the woman, but on a series of circumstances and variables that often escape the control of the individual.

The pandemic that has been raging all over the world since January is a clear example of an adverse environmental condition, which escapes the will and control of the individual. In this particular context, the psychophysical changes of pregnancy and the puerperium can be completely amplified and conditioned by the general climate of uncertainty and fear that we are experiencing and for expectant women it can be much more difficult to find that healthy balance between emotions, thoughts, sensations. , wishes and reality.

If we think of the normal internal changes that occur during pregnancy and we think of them during the pandemic, we therefore realize that it is appropriate to rethink the strategies of support and intervention with expectant mothers, also in light of all the social restrictions related to the contemplation of spread of the virus. Finally, in this complicated framework it is necessary to insert a specific reflection for all those situations in which the course of pregnancy differs from physiology.

The arrival of a premature baby during a pandemic is a situation that must therefore take all these aspects into account.

We asked Sara Lanzini , a perinatal psychologist from Milan, to reflect with us on this issue which in the confusion of recent weeks risks remaining in the shadows.

“It is very important to reflect to better understand the emotions and experiences of those parents who, with the arrival of their baby, face the reality of NICU (Neonatal Intensive Care).

Knowing the environment of the NICU, for a long or short time, is for parents a reason for uncertainty, anguish and stress at a time when instead there should be only the joy for the arrival of their baby: many parents describe it as a reality suspended where every day obstacles and sometimes small but incredibly powerful progress are faced. So now, in this moment in which everything is more tiring and limiting, an important space must be dedicated to those parents, to those who find themselves facing a difficult start to life in a moment that is already difficult in itself.

The situation at this moment in Neonatal Pathology and in the NICU is surreal: unlike other wards, empty or semi-deserted due to the ongoing emergency, here life continues as always. The children are born, some ahead of time, some with difficulty, some with pathologies not yet defined or some with problems already highlighted in pregnancy and everything continues incessantly. However, it is in this reality that a big difference can be seen: the parents’ entrances, which were previously almost totally free and not bound by particular times, are now unfortunately much more limited in terms of times and methods for reasons of course of safety but which unfortunately often do yes. that the sense of helplessness and inadequacy that parents experience during their stay in Neonatal Pathology increases.

It often seems very difficult to understand how to help new mothers and new fathers, in these circumstances: what they often report is not feeling capable in their role towards that little one, of feeling helpless, of not being able to hold him, feed him, console him and it is then that it becomes essential to explain that instead a lot can be done and that their presence alone is really important for that child who can hear their voice, the delicate touch and the closeness. How can these parents be helped now? How can they be enabled to know that even if time is less they are still a fundamental and inexhaustible resource for their child? It is complicated and demanding, but it is essential that this happens. What we are going through is scary, it generates many thoughts and many questions but these parents live the first moments of their child’s life, more or less difficult, NOW and they deserve NOW, all the support and help possible from us health professionals. . Hence, an important role is played by communication and the ability to approach parents in an empathic and welcoming way: the possibility of constant dialogue, of contact with the operators who take care of their child and the possibility for them to maintain the possibility of a space for listening and venting at this moment appear necessary and as operators we must always understand that the person in front of us is a person who is experiencing a moment of normal fear and difficulty in a moment that is not normal nothing and as such has the right to receive our support and our welcome. “

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