Doctoral Dissertation Research: Inequity, postpartum neglect, and social support impacts on stress and mental health in parents with infants in intensive care

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Postpartum neonatal intensive care unit (NICU) parents are a widely understudied population known to be more vulnerable to adverse physical and mental health outcomes than parents of healthy infants. This Doctoral Dissertation Research project explores the biocultural pathways through which social, economic, and structural inequities are associated with stress and depression among parents with infants in an urban children’s hospital NICU. These pathways, through which the effects of biology and culture impact each other, provide key context for understanding how intersectional inequities, social support resources, and access to adequate healthcare mediate differences in wellbeing among NICU parents in the United States, who are already at high risk of poor outcomes. The results of this work are shared directly with hospital leaders, nursing staff, and social workers at the study’s hospital research site to contribute to discussions of how to reduce parental NICU-related stress and improve postpartum mental health outcomes. This project also supports undergraduate mentorship, interdisciplinary collaboration, and science engagement activities with the public. Having an infant in intensive care is linked to higher rates of postpartum depression, post-traumatic stress disorder, and pregnancy-related morbidities due to the increased stress associated with adverse birth outcomes and stressful postpartum environments. This project uses a comparative mixed-methods approach including parental surveys, ethnographic observations and interviews, and infant medical record data to provide a more comprehensive view of the lived experiences of postpartum NICU parents. It explores how embodied NICU-related stress and mental health vulnerabilities are mediated through social and economic inequities that can affect adequate access to maternal postpartum healthcare and social support resources. To assess postpartum NICU-related stress, the project employs a self-reported NICU-specific stress scale that allows investigators to understand how key stressors associated with the physical and social NICU environment contribute to parental postpartum stress. Assessing the relationship between the sociocultural and economic environment, contextual-specific stressors, and mental implications for postpartum NICU parents is critical not only for the health of the parent but also for their infants during early development and the health of future pregnancies.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.