Medically Fragile: NICU Mental Health, Fetal Diagnoses & Perinatal Support
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Episode Notes
What happens when a pregnancy becomes medically complex—and a family’s hopes for birth and parenthood suddenly change? In this powerful conversation, Becky sits down with Dr. Kari Millican, LPC, Clinical Manager of Mental Health at Phoenix Children's, to explore the emotional realities of carrying and caring for a medically fragile baby.
Dr. Millican shares how Phoenix Children’s has embedded perinatal mental health support directly into fetal care and NICU services, helping families navigate devastating diagnoses, medical uncertainty, NICU trauma, grief, attachment challenges, and complex decision-making—including pregnancy after loss and medical termination. Together, Becky and Dr. Millican discuss why supporting the mental health of birthing parents is not just compassionate care—it can meaningfully improve medical outcomes for babies as well.
Topics Discussed
What “medically fragile” means in perinatal care
Understanding fetal diagnoses such as congenital heart defects, genetic conditions, and other complex medical presentations.
How fetal care teams support families after a diagnosis
What happens after an OB refers a family for advanced testing and specialty care.
Why perinatal mental health matters in medical complexity
Research showing improved infant outcomes when birthing parents receive mental health support.
The emotional toll of NICU and prolonged hospitalization
Trauma, uncertainty, sensory overload, and the challenges families face during intensive care stays.
Attachment and bonding when babies need critical care
How parents can build connection even when skin-to-skin contact or caregiving feels limited.
Supporting couples through impossible decisions
Navigating differing perspectives, communication breakdown, and conflict during medical crises.
Medical termination and compassionate decision-making
Holding space for grief, love, and values-based decisions after devastating prenatal diagnoses.
Pregnancy after loss or medical trauma
Why subsequent pregnancies often bring intense anxiety, hypervigilance, and unresolved grief.
Practical support for future NICU families
Tours, support systems, spokespersons, and preparing emotionally before birth.
The future of perinatal care
Why mental health services should be embedded into hospital systems as standard care.
Guest information
Dr. Kari Millican, PsyD, LPC-S, PMH-C, Division Manager of Mental Health Therapy at Phoenix Children's Hospital, to talk about what it means to care for the whole family when a fetus or infant is medically fragile.
Dr. Millican shares how Phoenix Children's is breaking new ground in perinatal mental health by walking alongside parents through some of the most frightening and uncertain moments of their lives, from a difficult prenatal diagnosis to the NICU and beyond. She speaks to the unique grief, fear, and love that coexist when your baby's life hangs in the balance, and why tending to a parent's mental health is not a luxury — it's a critical part of the child's care
Related Episodes
For a personal perspective on the NICU from advocate Tami Gaines, see this two-part episode, “When The Beginning Looks Different: The NICU Journey”
This podcast is a labor of love
Our goal is to support our community and reach listeners around the world, as we share perinatal and reproductive perspectives. For those who have reached out asking how to support the work, we’ve added an option through Buzzsprout: any contribution is welcome and will help cover the costs of production.