Peace amid chaos: How spirituality, religion may help families cope in NICU

Clinical study suggests spiritual care can help some families through unexpected challenges during and following childbirth
A family of four smiles for a photo.

The Brelsford family today. From left are Camille, Matt, Gina and Elise.

Credit: Penn State

HERSHEY, Pa. — In 2007, Gina Brelsford was like any other new professor – she hoped she wouldn’t embarrass herself in front of her students. As a new instructor in clinical psychology at Penn State Harrisburg and a soon-to-be mother, she was nervous for many reasons.  

“I used to joke with my class that the worst thing that could happen was that I would go into labor during lecture,” Brelsford said.  

Her worst-case scenario became reality after just 30 weeks of pregnancy. Without warning, while teaching, Brelsford began to experience some bleeding and a drop in blood pressure that resulted in an ambulance trip to Penn State Health Milton S. Hershey Medical Center.

After being sent home that first day, she returned two weeks later and gave birth to a baby girl, Elise, who was taken to the neonatal intensive care unit (NICU) just moments after delivery.

A photo of a newborn baby.

Elise Brelsford during her stay in the NICU at Hershey Medical Center in 2007. 

Credit: Penn State

“That was an impactful moment for me,” Brelsford said. “I had just given birth to my first child and didn't see her until the following day.”  

Although Elise had no major medical issues during this time, the challenge of being a family during her five-week stay in the hospital was stressful for Brelsford and her husband, Matt. They visited once or twice a day in shifts, while trying to carry on with the routines of daily life. 

A change of course

Brelsford recalled that the NICU nurses and physicians they encountered were supportive, yet she experienced a need for greater psychological and spiritual care and saw it as an opportunity. Previously, she had studied how religion and spirituality related to family functioning and emotional well-being. She decided to change course in her research to investigate how this kind of support for NICU families could be improved. 

Brelsford partnered with Kim Doheny, director of clinical research for the Milton S. Hershey Medical Center’s Neonatal Intensive Care Unit, to understand how religion and spirituality can play a role in caring for NICU families.  

“A stay in the neonatal intensive care unit is a highly stressful experience, even for families with the healthiest babies,” Doheny said. “It’s typically unexpected and traumatic because they’re dealing with the reality of a delivery that was different than what they planned for.”

Doheny and Brelsford recently published data from their pilot study in the Journal of Psychology and Theology, which examined how religion and spirituality might contribute to a parent’s ability to experience personal growth following their baby’s stay in the NICU – called post-traumatic growth.  

According to the researchers, this personal growth may include such broad, positive outcomes as: relationships are made stronger or more meaningful; individuals begin to see themselves in a new way; and a new appreciation for life may develop.

While none of the 25 participants experienced clinically significant levels of anxiety or depression, the data collected four to six weeks after discharge indicated that increased religious coping, spiritual disclosure and infusing the parent-child relationship with spiritual significance were associated with increased personal growth after the child was discharged from the hospital.  

Prayer is an example of religious coping that parents in the study may have used – something Brelsford could relate to, as she herself prayed a lot while Elise was hospitalized. 

According to the researchers, spiritual disclosure ― sharing views on religious beliefs and faith journeys with a partner ― is another potential NICU coping strategy. On a personal level, Brelsford said she and her husband talked often and openly about their faith while Elise was hospitalized. 

Although parents face many stressors in the NICU environment, the study findings suggest that increased infusing of the parent-child relationship with spiritual significance, or sanctification, related to growth, despite the stress. Brelsford explained that parents who feel that their faith plays a role in their relationship with their child, or parents who feel that their role as parent has spiritual significance, may experience this growth.

Brelsford added that parents without religious beliefs also may sanctify their parent-child and parent-parent relationships, imbuing their family connections with their own sense and concept of sacred purpose.  

For example, many new parents, religious and nonreligious, may sanctify their parent-child relationship through choosing the name of a relative, or a name with personal meaning, for their child, said Rose Baer, a chaplain resident in Hershey Medical Center’s NICU.

Baer feels that her role as a chaplain is about being present for families experiencing the ups and downs of a journey through the NICU.  

“In my opinion, spirituality is all about connection,” Baer said. “I believe that when there’s connection, there is the possibility of healing and growth.”  

Family-centered care

Doheny said that since Brelsford’s stay in the NICU more than a decade ago, Hershey Medical Center began offering new resources to help families cope while their baby is being treated. Social workers and child life specialists work together with chaplains to create an environment where parents and siblings receive optimal psychological, social and spiritual support during their stay, according to each family’s wishes.

A young girl stands in a field and smiles for a photo.

Elise Brelsford, 12 years later. 

Credit: Penn State

Ultimately, Doheny said it takes a team effort to provide families with the best possible experience in the NICU – and it starts by educating families and checking in with their needs, not just their baby’s needs.  

Based on her research and personal experience, Brelsford added, “There is a need to attend to the whole person within the family unit, offering each individual the option of receiving psychological and spiritual support.”  

This research was funded by an internal Research Council Grant from Penn State Harrisburg. The authors disclose no conflict of interest. Lisa Nestler, Penn State Harrisburg, also contributed to this research.