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Once you know that your baby will be spending time in the NICU, start preparing
for his or her delivery and NICU stay.
Find out what level of care your hospital's NICU offers. In the United States,
Level II NICUs can care for babies who weigh more than 1000g (2.2 pounds). Level
III, Level III+ , and Level IV NICUs care for smaller or more critically ill
babies. If your health care practitioner or neonatologist anticipates that
your baby may need more advanced NICU care than your hospital can provide, arrange
to be transferred to a hospital with a higher level of care prior to delivery,
if possible.
If possible, tour the NICU at your hospital before you deliver
so that you will know what to expect and see how small some of the babies are.
If you are not able to tour the NICU, try to find photos of babies taken while
they were in the NICU. Some PROM list members have photo albums of their babies'
NICU experiences and would be happy to share if you post a request to the PROM
list.
Meet with a neonatologist as soon as your baby reaches the point of viability
(depending on where you live, this is anywhere from 22 to 24 weeks) or when
you are admitted to the hospital, whichever is later. Jot down a list of questions
for the neonatologist in your written log. Depending on your baby's gestational
age at this initial meeting, your neonatologist and your health care practitioner
may recommend an immediate course of steroid injections (usually given
on two consecutive days) to boost your baby's lung development and reduce the
incidence of respiratory distress syndrome.
If your baby is less than 28 weeks gestation at the time of this first
meeting, expect that the neonatologist will give you the worst-case scenario
for your baby's survival and may discuss whether or under what circumstances
you would like a "do not resuscitate" (DNR) order applied to your baby. The
PROM list members who have experienced this initial "doom and gloom" talk encourage
you to keep in mind that while it is true that many of the tiniest babies do
die, the odds that your baby will be one of the many PROM preemies who survive
increase significantly each week.
Plan to meet with the neonatologist again at or around 28 weeks to reassess
your baby's condition and learn more about your baby's care after delivery.
If you have not yet received steroid injections, you may be given them around
this time. Some practitioners give a second round of steroids to women who received
them previously, but others will not because of the risk of infection and divided
opinions about effectiveness.
If your baby has been diagnosed with any specific conditions or disorders, arrange
for a consultation with a specialist in that field to learn more about what
you will need to do after your baby is born. Also, arrange for any prenatal
testing associated with your baby's condition before your deliver.
Obtain lactation information before delivery, if possible. The first breast
milk you pump will contain the colostrum, which provides important antibodies
for your baby, and you will need to know how to pump and store it. Also, initiating
pumping as early as possible (preferably within the first few hours after delivery)
may help with long-term milk production. The lactation consultant can also help
you arrange to rent a breast pump or advise you on which pump to purchase.
Use the Resources section of this article as a starting point to learn
as much as you can about the issues preemies and their families face. If
you are on hospital bedrest, your hospital may have books that they can lend
you, or you can order books online and have them delivered to the hospital.
Many of the books may also be available at your local library.
Sometimes after delivery your child might need blood transfusions. There might
be a possibility to bank blood from a family member in advance. If blood from
an anonymous donor is a concern for you, consult your health care team to find
out if it is possible for a family member to bank blood specifically for your
baby. The local Red Cross might also be able to provide more information.
If you have time, consider creating a plan that tells your health care team
how you would prefer your baby's delivery to be handled. The birth plan
doesn't have to be formal or even written, although jotting something down on
paper may help you organize your thoughts. Recognize that the fact that your
baby will be premature will mean that you will need to be flexible about your
birth plan. See Appendix A of this article for some ideas of what to
consider as you create your birth plan.
Prepare a contact list of any friends, family, and/or representatives from your
faith whom you would like to be present at the hospital or in the room with
you during the birth. Give your nurses a copy of the list in case you need to
delivery emergently or unexpectedly. Remember, it is okay to uninvite
people if you change your mind and decide you would like more privacy during
the birth.
If there is a religious or cultural ceremony that you would like to
have performed, arrange for someone to perform the ceremony. You should also
find out who is "qualified" to perform the ceremony if someone from your faith
or cultural background is not available.
Next page
>> Article by Jodi Donnelly, Mommy to Anthony PROM @ 16
weeks, born in 2004 @ 31.5 weeks, 41 days in NICU and now thriving
and Kay Squires, september 2005
Special thanks to Inkan, Jen, Jody, Lise, Sonya, Valerie, Beth and the members
of the PROM list
© 1998-2024 Inkan, The PROM Page
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