A smiling mother breastfeeding her newborn

Couplet Care Bassinet™ Research

A team of maternal health experts and clinicians at the University of North Carolina at Chapel Hill – medical anthropologist Dr. Kristin Tully, maternal-fetal medicine physician Dr. Alison Stuebe, pediatrician Dr. Carl Seashore, and lactation specialist Catherine Sullivan of the Carolina Global Breastfeeding Institute – developed the Couplet Care Bassinet to address barriers to safe skin-to-skin contact, breastfeeding, and infant sleep. The interdisciplinary team co-developed the Couplet Care Bassinet with mothers, partners, maternity health care professionals, and industrial designers through prototypes and randomized controlled trials. This patented medical device is being offered throughout the United States through UNC-spin out company Couplet Care, Inc. to support quality inpatient postpartum care.

Advancing the Standard of Maternity Care

As part of the World Health Organization/UNICEF Ten Steps for Successful Breastfeeding, the standard of care is for healthy mother-infant pairs is to “room-in” together after childbirth. However, this evidence-based practice can be challenging for families and for hospitals. Limited maternal mobility and postpartum pain combined with the high walls of outdated bassinets means that the environment creates unnecessary risks and frustrations. Dr. Tully led research that identified infant safety hazards and maternal distress with stand-alone bassinets (Tully & Ball, 2012), with challenges for breastfeeding particularly after cesarean section (Tully & Ball, 2013). Enabling continuous maternal access to their infants is critical for responsive parenting, early breastfeeding, and practicing safe sleep. The World Health Organization also recommends supporting “positive postpartum experiences” as part of this special phase of people’s lives (WHO, 2022). The ability to reach and comfort a new baby is a vital aspect of both patient safety and emotional connection. The Couplet Care Bassinet is part of respectful and supportive care for all, as part of critical reforms to improve postpartum care through the “4^th Trimester” (Tully et al., 2017; Tully & Stuebe, 2022).

Addressing Unmet Needs

Couplet Care, Inc. was founded by UNC Chapel Hill Associate Professor Dr. Kristin Tully to address the unmet needs she observed through research and her own experience as a mother. Outdated bassinets contribute to risk of infant drops/falls and maternal frustration, and the difficulty of accessing infants has led birthing parents to experience significant pain and rely on nurses or others for assistance with non-medical needs such as infant positioning and safe sleep arrangements(Tully & Ball, 2012). Further, bassinet tubs that are not secured into the frame can tip under the weight of mothers’ arms and the height of the tub walls introduce risks with infant handling. These barriers are especially problematic to the one-third of U.S. women who give birth by cesarean section, as well as those who have disabilities or pregnancy-related health complications.

National Institutes of Health Supported Research

To address these gaps in postpartum patient safety, Couplet Care received funding by the National Institutes of Health for independent evaluation of the Couplet Care Bassinet with new mother-infant pairs. First, Dr. Amanda Thompson led a randomized controlled trial in 2021 with 50 mother-infant pairs (NIH R34HD097017). Participants were randomly assigned to the Couplet Care Bassinet or a standard bassinet for use throughout their postpartum stay. Participant characteristics were evenly distributed between the groups. The results were that those randomly allocated to the Couplet Care Bassinet had:

Less infant time out of the postpartum room for non-medical reasons
Less maternal requests for postpartum nursing assistance (e.g., for infant handling)
Less infant wakings of the mothers prior to hospital discharge

Additionally, participants rated the Couplet Care Bassinet highly. Maternal experiences include:

“What I liked best about this bassinet is that you can change its position to the side which makes it easier to grab and put down my baby, as well as change her diapers.”

“I like the lowering functional aspect of bringing it down to the bed; also like the lower corners to access the baby.”

“I liked pretty much everything about the bassinet. Very easy to move around and easy to reach into. Loved the night lights.”

The American Academy of Pediatrics has recognized Dr. Tully’s innovative work on infant safety and cited bassinet technology as a means of improving the built environment (Feldman-Winter et al., 2016). The use of outdated bassinets is inefficient and frustrating for nurses and other clinicians too, who need to be supporting the highest acuity patients and not helping access infants for diaper changes or other handling and care needs (Taylor, Tully, & Ball, 2016).

Currently, the National Institutes of Health is funding a large randomized controlled trial of the Couplet Care Bassinet at Johns Hopkins University.

Importance of Maternal Support

Inpatient postpartum care that supports mothers’ physical health and emotional well-being is positively associated with breastfeeding outcomes (Tully et al., 2022; Pearsall et al., 2022). Supportive health care team practices on the postnatal unit equip mothers for hospital discharge, but patients describe numerous areas for improvement (Scroggins et al., 2025). Improving maternal support is important for many reasons, including to reduce risk for infant drops (Seashore & Tully, 2018).

Recently, Drs. Tully, Stuebe, and their colleagues identified that new mothers had very little sleep (median of 2.8 hours, range 50-minutes to 5.6 hours) in the 24-hours prior to postpartum hospital discharge (Hepler et al., 2025). Maternal fatigue was stressful and filmed cases included infant-directed yelling by a father because of frustration with the baby’s limited sleep in the stand-alone bassinet. The parents requested the infant be removed from the postpartum room, which is a common occurrence. If the family would have had more anticipatory guidance for sleep expectations, coping strategies, and access to their infant for soothing within arms’ reach, their story may have very different. Unfortunately, patient and family reactions to clinical services during inpatient postpartum care are often negative – with accounts of confusion and frustration (Mangas et al., 2024).

Although the Ten Steps to Successful Breastfeeding are important, rooming-in as it is currently set up presents obstacles to safe, enjoyable, and supportive care (Tully & Sullivan, 2018; Wasser et al., 2017). The Couplet Care Bassinet has been intentionally designed to fit the needs of all users (mothers, infants, family members, clinicians) to enhance respectful and supportive care. For more information, see CoupletCare.com

References

Feldman-Winter L, Goldsmith JP, Committee on Fetus and Newborn, Task Force on Sudden Infant Death Syndrome. Safe sleep and skin-to-skin care in the neonatal period for healthy term newborns. Pediatrics. 2016; e20161889. Open access link.

Hepler B, Brandon D, Docherty S, Stuebe AM, Tully KP. Observational video study of maternal sleep during the 24 hours before hospital discharge after childbirth. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2025; 54(4): 438-449. Link.

MangasM, Simran Saggi N, Peralta Macias M, Stuebe AM, TullyKP. Birthing parent and companion verbal reactions following interactions with inpatient postpartum health care team members: An observational study using naturalistic filming. BMC Pregnancy and Childbirth. 2024; 24: 841. Open access link.

Pearsall MS, Stuebe AM, Seashore C, Sullivan C, Tully KP. Welcoming, supportive care in US birthing facilities and realization of breastfeeding goals. Midwifery. 2022; 111: 103359. Open access link.

Seashore C, Tully KP. Preventing newborn falls and improving care for postpartum women and their newborns. Hospital Pediatrics. 2018; 8(9): 593-594. Open access link.

Scroggins JK, Gibson AN, Stuebe AM, Sheffield-Abdullah KM, Tully KP. Postpartum hospital discharge: Birthing parent perspectives on supportive practices and areas for improvement. Journal of Perinatal and Neonatal Nursing. 2025; 39(1):32-44. Link.

Taylor CE, Tully KP, Ball HL. 2016. Night-time on a postnatal ward: experiences of mothers, infants, and staff. In F Dykes, R Flacking (Eds). Ethnographic Research in Maternal and Child Health. Routledge Press: New York, NY (pp. 117-140). Link.

Tully KP, Ball HL. Maternal accounts of their breast-feeding intent and early challenges after cesarean childbirth. Midwifery. 2014; 30(6):712-19. Open access link.

Tully KP, Ball HL. Postnatal unit bassinet types when rooming-in after cesarean birth: Implications for breastfeeding and infant safety. Journal of Human Lactation. 2012; 28(4): 495-505. Open access link.

Tully KP, Smith J, Pearsall M, Seashore C, Sullivan C, Stuebe AM. Postnatal unit experiences associated with exclusive breastfeeding during the inpatient stay: A cross-sectional online survey. Journal of Human Lactation. 2022; 38(2): 287-297. Open access link.

Tully KP, Stuebe AM. Foreword: Respectful, equitable, and supportive postpartum care. Clinical Obstetrics and Gynecology. 2022; 65(3): 538-549. Open access link.

Tully KP, Stuebe AM, Verbiest SB. The 4th Trimester: A critical transition period with unmet maternal health needs. American Journal of Obstetrics and Gynecology. 2017; 217(1): 37-41. Link.

Tully KP, Sullivan CS. Parent-infant room-sharing is complex and important for breastfeeding. Evidence-Based Nursing. 2018; 21: 18. Open access link.

Wasser HM, Heinig MJ, Tully KP. The importance of the Baby-Friendly Hospital Initiative. JAMA Pediatrics. 2017; 171(3): 304-305. Open access link.

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