Neonatologist Université de Montréal Montréal, Quebec, United States
Background: Parents with high-risk pregnancies or who know their child will be sick at birth may experience adverse psychological outcomes. Prenatal classes adapted to these situations do not exist. Objective: To describe the development and evaluation of a prenatal education and support group for parents whose baby will be admitted to the NICU because of prematurity or congenital anomalies. Design/Methods: The format of the workshop and themes to discuss were developed in a needs assessment phase by questioning 45 parents. They identified several important themes: their future parental role, normalizing their experience/emotions, coping with their “broken dreams” (mourning their objectives: pregnancy, delivery, breastfeeding, parenting, etc), adapting to their new reality, control and trust. They also described educational themes: information about the NICU, what the baby would look like, technology around the baby and common neonatal interventions, who was part of the neonatal clinical team and the role of parents in this team. These findings were used by our parent-partner group to design a checklist and a presentation with pictures to moderate the workshop. A pilot phase with 20 parents optimized workshop time and delivery.
During eight months, prospective parents were invited to participate in the workshop when a diagnosis made admission to the NICU highly likely. Parental perspectives were investigated using mixed methods at two different times: after the workshop and after one week in NICU, where recall was also evaluated. Results: 136 parents participated. The average gestational age at the time of the workshop was 32 weeks. 48% were primiparous. During the evaluation phase, the average score given by parents was 9.6/10. Almost all agreed/strongly agreed that the workshop was useful (98%); that the workshop help to prepare the birth of the child (95%); that the workshop made them feel less lonely and isolated (90%); and that exchanges with other parents were beneficial (92%). All answers to open-ended questions were positive, for example: “I think it's an essential workshop for any parent expecting this type of birth. Thank you so much!” or parents say they appreciate “the presentation and all they do to care for babies”. After the birth, all parents remembered the workshop and could recall and identify topics that were discussed. 95% of parents would recommend it to other parents. Open-ended questions helped us improve the workshop content.
Conclusion(s): Prenatal educational workshops provide a unique and useful means to support future NICU-parents and to prepare for a neonatal hospitalization.
