- At six months, intervention participants had lower mean EPDS (4.82 vs 5.82) and PCL-5 (18.7 vs 22.2) scores, differences not statistically significant.
- Doulas identified two acute suicidal crises after neonatal deaths and facilitated emergency psychiatric care, underscoring doula-led support's clinical value.
- Small sample size limited power: 37 enrolled, 34 completed mental health screening, restricting ability to detect statistically significant effects.
Matern Health Neonatol Perinatol. 2026 Sep 24;12(1):54. doi: 10.1186/s40748-026-00303-5.
ABSTRACT
INTRODUCTION: Parents of infants admitted to the neonatal intensive care unit (NICU) face barriers to postpartum care and are at risk for adverse mental health outcomes. The Postpartum Care in the Neonatal Intensive Care Unit (PeliCaN) study evaluated a novel doula-coordinated, midwife-delivered care model for NICU parents. This secondary analysis compared mental health outcomes between participants randomized to the PeliCaN intervention versus usual postpartum care.
METHODS: Postpartum parents of preterm infants < 34 weeks admitted to the NICU with an anticipated stay > 1 week were included. Doulas provided individualized emotional and informational support and coordinated a postpartum midwifery visit within the NICU. Mental health outcomes were compared between groups, including Edinburgh Postnatal Depression Scale (EPDS) scores at enrollment and 6 months postpartum and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) scores at 6 months postpartum.
RESULTS: Of 37 participants enrolled in the parent trial, 34 completed mental health screening and were included. At 6 months postpartum, intervention participants had lower mean EPDS scores (4.82 vs. 5.82; P = 0.56) and PCL-5 scores (18.7 vs. 22.2; P = 0.40) compared with usual care, though not statistically significant. No participants endorsed thoughts of self-harm on EPDS screening at baseline or 6 months postpartum. However, two intervention participants experienced neonatal deaths and disclosed acute suicidality to their doulas outside of screening. Both were connected to emergency psychiatric care.
CONCLUSION: Although screening scores did not differ significantly between groups, doulas identified and facilitated intervention for acute suicidal crises in two high-risk NICU parents, an important exploratory clinical finding that highlights the value of doula-led postpartum support models.
TRIAL REGISTRATION: ClinicalTrials.gov registration information (for the original PeliCaN Trial) Date of registration: August 22, 2022. Date of initial participant enrollment: November 29, 2022. Clinical trial identification number: NCT05510284. URL: https://clinicaltrials.gov/study/NCT05510284 .
PMID:42786527 | DOI:10.1186/s40748-026-00303-5
Share Evidence Blueprint
Save to Google Notes
Search Google Scholar
Save as PDF
⭐ My Revision List
