Mother-newborn couplet care: Nordic country experiences of organization, models and practice

Abstract

Mother-Newborn Couplet Care is a concept and is defined as the provision of care for a sick or preterm newborn in close proximity to and coupled with the care for the mother from the birth of the infant and for as long as the mother needs hospital care. This concept of care requires system change in both obstetrics and pediatrics in terms of the planning and organization of care, equipment and design of units. Accordingly, strong leadership setting clear goals and emphasizing a culture of cohesive care, supported by targeted education and training is crucial to ensure high-quality care of all mother-newborn dyads without separation. We describe various organizational models of Mother-Newborn Couplet Care used in Sweden and Finland and implementation processes. We envision a future where newborns and mothers are always together, irrespective of medical needs, and form an inseparable center around which healthcare services and providers are organized.

Fig. 1. An extremely preterm infant in the neonatal intensive care unit, receiving mechanical respiratory support in skin-to-skin contact with the father.

Photo: The NICU at Turku University Hospital.

Fig. 2. A very preterm infant receiving non-invasive respiratory support in immediate skin-to-skin contact with his mother.

Photo: Stina Klemming.

Fig. 3. Twins born very preterm, receiving immediate skin-to-skin contact directly after birth with the mother and father respectively.

A mobile neonatal team with equipment for neonatal stabilization in the birth room provide non-invasive respiratory support and iv-treatment for hypoglycaemia. Note the mother’s iv therapy and the cup for early milk expression. Photo: Stina Klemming.

Fig. 4. A room layout example from the neonatal intensive care unit at Danderyd, Karolinska University Hospital, Sweden.

An open bay area for the intensive care of up to 4 infants, with space for a parent bed or reclining chairs by the infant ’s care space. Adjacent single-family rooms for the parents and infant once the infant ’s condition improves, or directly after birth for moderately sick or preterm infants and their parents. Some of the single-family rooms have larger shower bathrooms for mothers that need assistance. Architect: Snidare Arkitekter AB.

Fig. 5. A room layout example from the neonatal intensive care unit at Turku University Hospital, Finland, with single-family room design for Mother-Newborn Couplet Care.

On the left side, a room for twins which is used also for patients potentially needing onsite surgeries. On the right side, a room for a singleton without surgical needs. Architect group Reino Koivula.