Building Strong Foundations in the NICU: Reducing Risk Factors of Postpartum Depression Through Occupational Therapy

Abstract

Purpose: Giving birth to a premature infant is a major risk factor for maternal postpartum depression (PPD), which may negatively impact parent-child bonding and result in long lasting behavioral and neurodevelopmental risks for the infant. Strong Foundations: An Occupational Therapist-Led, Activity-Based Support Group was developed to address the increased risk of PPD for mothers in the Neonatal Intensive Care Unit (NICU). The objectives of this formative pilot program evaluation were to assess the feasibility and potential effectiveness of this unique program.

Methods: Participants were selected from mothers with infants in the Level II NICU of a community hospital in the Greater Boston area. Group sessions, led by a certified neonatal occupational therapist, included Infant-Care Techniques, Meditation and Gentle Movement, and Creative Discussion Activity Classes provided over 4 weeks. Participants completed pre- and post-surveys on self-efficacy, stress, social support, and program feedback.

Results: This program was found to be moderately feasible. Comparison of pre- and post-Likert scale scores demonstrated neutral or positive change. Two areas, "perception of maternal role" and "desire to remain in contact with other participants" revealed a directional, however not statistically significant, increase. Participant responses to open-ended questions demonstrated that the program was well received.

Conclusion: Using an activity-based support group, such as the Strong Foundations program, is an avenue to support mothers in the NICU as it addresses the three main contributing factors of maternal confidence, stress level, and support network. PPD is a critical health care problem. The opportunity to reach the NICU mothers while they visit their infants is one that should not be overlooked.

Keywords: Maternal confidence; Maternal mental health; Neonatal intensive care unit (NICU); Occupational therapy; Postpartum depression; Support group.