The Hidden Trauma of NICU Fathers – and Why It Matters: Why NICU Dads Are at Risk for Depression, PTSD, and Anxiety

With Father's Day approaching, I thought this would be a good time to share an article I had the honor of writing for the Trauma-Informed Maternal Health Network. This is a follow-up to my previous post about a new dad's experience of NICU trauma and how to cope with it.

"Normal" birth

Like so many other first-time dads, I had expected my wife to go into labor spontaneously, labor for a day or two, and then give birth to our son via a relatively straightforward vaginal delivery with little to no medical intervention while I held her legs and encouraged her to breathe.  He’d emerge, get dried off and swaddled, and then be placed directly on her chest.  

"Abnormal" birth

That’s not how things played out.  Instead of this “normal” birthing experience, what we got was a 3 am induction, Pitocin, intrauterine pressure catheters, fetal heart monitors, an epidural, and, ultimately, an unplanned C-section because the baby’s head was out of position and his heart rate kept dropping.  My wife gave birth with her arms strapped to a T-shaped operating table and shivered the whole time.  Our boy was immediately whisked away into an adjacent room for emergency stabilization.   

A few minutes later, when I laid eyes on my first child for the very first time, he was lying in a warming tray in a diaper with supplemental oxygen and various doodads and gizmos attached to him.  He spent twelve hours in the NICU and was then mercifully released to our room on the maternity floor with no further complications.

So, we got a bunch of unexpected medical interventions before and during the birth, and a little bit afterward.  As the non-birthing partner, I wouldn’t consider myself traumatized by our birthing experience.  Not everyone is so lucky.          

Traumatic birth

For example, my best friend’s second baby was born at thirty-two weeks, a full two months premature, after his wife had undergone ten rounds of IVF over eight years.  Their son spent the first three months of his life in the NICU, unable to suck, swallow, or breathe on his own. Instead of happily cuddling and bonding with their baby, my friend and his wife spent many sleepless nights in the NICU watching helplessly as he lay in an incubator with tubes down his throat and up his nose and various doctors and nurses standing by on high alert.      

What NICU fathers experience but rarely discuss

Even when everything “turns out fine,” as it did for my friend and his family, the fear, doubt, anxiety, numbness, and hyper-vigilance can follow parents home from the NICU.  Many of my dad and non-birthing-partner therapy clients often report various signs of lingering traumatization following lengthy NICU stays, including:

• Constant worry about their baby’s breathing, feeding, or overall health

• Disrupted sleep or nightmares, even when their baby sleeps

• Sudden anger, irritability, or emotionally shutting down

• Avoiding hospitals or situations reminiscent of the NICU

• Feeling disconnected from their baby or partner

• Feeling constantly on alert because “something bad’s about to happen" 

What’s especially challenging is that many of these NICU fathers struggle to recognize their experience as traumatic, instead claiming that “Other parents had it worse,” or “The baby’s okay now, so I should be okay,” or “I just need to move on.”  It often takes a bit of psychotherapeutic heavy lifting for them to grasp that trauma doesn’t work that way.

Moms and birthing-partners deserve the lion’s share of support following any birthing experience, especially when a traumatic NICU stay is involved.  My purpose here isn’t to downplay or negate the moms, but rather to highlight that dads and non-birthing partners need support, too.  Generally speaking (and I know there are plenty of exceptions), men are more likely to suppress their feelings and “push through” emotional stress. In fact, 1 in 10 fathers will experience depression up to the first year postpartum, with the peak onset of depression 3-6 months following the birth of a baby. While suppressing feelings might’ve helped during a NICU stay, it usually doesn’t at home.  The entire family benefits when dad gets the support he needs.  Without it, he’s less likely to be present and responsive when his new family needs him the most.

How to cope

So that’s the “why.”  What’s the “how”?  How can new dads get support?  I have two main suggestions.

1. Socialization.  Modern American parenthood has become very isolating.  We tend to silo ourselves into our new families.  That’s a problem.  Depression and anxiety thrive when we’re isolated.  I believe it’s vitally important for new dads to spend as much time as possible with other new dads.  The old adage that “it takes a village” is still accurate. Postpartum Support International is a great starting place to connect with other dads in a supportive group setting.

2. Normalization.  By which I mean therapy.  Parenthood makes us feel every emotion on the Feelings Wheel, especially the ones we don’t expect to feel.  But because men aren’t traditionally socialized to understand or express feelings the way women are, many new dads respond to those unexpected, challenging emotions by acting out or entering Dorsal-Vagal shutdown, both of which prevent dads from supporting their partners and babies appropriately.  New dads need a safe, non-judgmental space to process, explore, normalize and express feelings.  

Find a Therapist

• If you’re a new or expectant father in Illinois and this resonates with you, give me a call.        

• You can also find a therapist by searching the Trauma-Informed Maternal Health Directory or Postpartum Support International Provider Directory.