UB-led research examines how tech can help mothers separated from newborns

A UB–led study has found that parents whose newborns are transferred to another hospital for intensive care experience both positive and negative emotions when relying on technology to stay connected.

The study, “Technology to Support Bonding When Separated at Birth,” was published in the Journal of Neonatal and Perinatal Medicine last fall ahead of print publication.

The researchers examined four databases for peer-reviewed evidence on the use of technology to support the bonding and emotional experiences of mothers separated from their newborns when their infants needed care not available at the hospital where the mother was recovering.

The technologies included camera-based and video-based platforms, some with observation but no sound; some with sound and ability to communicate with neonatal intensive care unit (NICU) staff; and some that used smartphones, iPads or other means of communication.

These technologies showed both positive and negative effects. The positive emotions included a decrease in stress and anxiety, as well as an improvement in family relationships. The negative emotions were guilt and psychological distress. Researchers also suggest that, to ensure success, NICU staff should be consulted before implementing these technologies.

The research team includes Sabrina Schwartz, RN to BS program coordinator and clinical assistant professor in the School of Nursing; Kafuli Agbemenu, associate professor in the School of Nursing; and Mickey Sperlich, associate professor and interim PhD program director in the School of Social Work, as well as Rebecca Lorenz, senior associate dean for academic affairs and educational innovation at The Ohio State University.

Prior to returning to school to pursue research, Schwartz worked on an LDPR (labor, delivery, postpartum and recovery) unit. In this role, she cared for pregnant women throughout labor and delivery, supporting them through the early postpartum period as they transitioned into motherhood.

“Many people assume this is a ‘dream job,’” says Schwartz. “But the reality is that it is not always easy or joyful.

“Because our hospital did not have a NICU, newborns who required a higher level of care needed to be transferred to another facility. Due to EMTALA (the Emergency Medical Treatment and Labor Act), we were not permitted to transfer the mother along with the newborn if she was stable, since her condition was not considered an emergency.”

Schwartz says she witnessed mothers make the difficult decision to leave the hospital against medical advice so they could be with their babies.

“I remember wheeling them out and watching them slowly walk to their cars, holding their abdomen and moving with obvious discomfort. Each time, I worried about the risks they were taking — postpartum hemorrhage, infection or other complications that could place them in serious danger,” Schwartz says.

That experience sparked Schwartz’s research interest and a central question guiding her work: How can we keep mothers and newborns together when transfers are necessary?

Sperlich, who previously worked as a certified midwife, now focuses her research on promoting trauma- and equity-informed approaches, as well as infant mental health and healthy development.

“Anything we can do to promote connection between parents and newborns, as early as possible, is important to me,” says Sperlich, noting that meeting the challenge of having a premature and vulnerable infant in intensive neonatal care is difficult in the best of circumstances.

“For parents who are also recovering from a difficult birth or complicated immediate postpartum, or who have other children at home and may lack family or social support, lack financial means or live far away in the ‘maternity care desert’ from their infant’s NICU, being able to connect remotely to at least see and hear their infant provides a vital temporary connection,” she says.

The research demonstrates how assistive technologies in the NICU can help to decrease the stress and anxiety parents feel when separated for various reasons from their fragile newborns, Sperlich says.

“Through the years I have known several families who have had infants in the NICU; only recently have such technologies become available,” she says. “Despite the United States’ status as an economic leader in the world, we are failing miserably when it comes to maternal and infant health indicators, including preterm birth rates, and infant and maternal mortality, especially for families of color.”

Many community hospitals have closed recently, according to Schwartz, including the one where she worked.

“These closures have contributed to the growth of maternity care deserts, forcing some families to travel one to two hours to reach the nearest hospital for delivery,” she says. “One important strategy is improving collaboration between primary care and obstetrics/gynecology providers to identify high-risk pregnancies early and refer patients to facilities with Level III or Level IV NICUs, where both mother and newborn can remain together and receive appropriate care.”

Schwartz says another potential solution is developing birthing centers in maternity care deserts to support patients with low-risk, uncomplicated pregnancies closer to home.

“For those who can’t access these, webcams and other assistive technologies can be stop-gaps.”