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Discussion Starter #1
Hey there,<br><br>
I am a first time mom-to-be and am thinking of switching my OB practice to an MD who delivers at Somerset Medical Center in NJ, which does not have an NICU. Does anyone have any feedback on the necessity of having an NICU? My pregnancy is not considered high risk, but what if something goes wrong during birth? Also, has anyone delivered at Somerset?<br><br>
Thanks in advance for any feedback.
 

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It isn't necessary, particularly if you are not high risk.<br><br>
I had a high risk pregnancy and they really thought I was just a walking timebomb for much of my pregnancy. (I had an abundance of amniotic fluid ) The Drs did have a plan for me for what hospital I was to go to if I went into labor early.<br><br>
I ended up making to term and I had my child at a hospital without a NICU. My son did end up getting transferred to the Children's Hospital but that was a better NICU than the one at the hospital I would have delivered at if I had my child early.<br><br>
IMO it is fine, if there are issues they can transfer safely. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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Discussion Starter #3
Thanks Abimommy - I was wondering if there are issues in the time it might take to get to the hospital with a NICU (in my case, about 20 minutes).
 

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If it was essential for a low risk birth to have a NICU immediately available, they wouldn't allow births in hospitals without NICUs.<br><br>
I gave birth once at a hospital without a NICU, and twice at home (the NICU was about 15 minutes away, a hospital w/no NICU 10 minutes away), and no issues <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shrug.gif" style="border:0px solid;" title="shrug"><br><br>
Is there anything that makes you think you might need one?
 

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Discussion Starter #5
Hi Jenna -<br><br>
Thanks for your reply. To answer you question, I have no reason at this point to think I would need one, I am just concerned what would happen if G-d forbid something went wrong at delivery. Does a non-NICU hospital have the capability of handling problems, and could something happen en route to the NICU?<br><br>
Since this is my first, I have no idea what to expect.<br><br>
Thanks much.
 

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Yep. In fact that's why one would hire a homebirth midwife, too, if one was having a home birth. The nurses and doctors at a hospital (and the midwives, too) are trained in neonatal resuscitation, they'll have oxygen on hand, be able to administer medications, etc. I'd recommend asking your potential new doctor what would happen in that case. He or she would be able to give you much more information on what should happen in the case of something scary happening.<br><br>
But basically, yes, you're going to have lots and lots of support from doctors/nurses if something goes wrong. AND, you can minimize your risk of something going on by avoiding interventions, actually...
 

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If it's any consolation, I was reading somewhere that the presence of a NICU at a hospital actually increases the chance that your baby end up "needing" it. (I can't remember where, so don't quote me on it yet. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol">) In this case, it's a little like cesareans--done far too often, but a godsend when genuinely necessary.<br><br>
I think the PPs summed it up well, though. Just visit all of the "what-if" scenarios with your doc.
 

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<div>Originally Posted by <strong>Turquesa</strong> <a href="/community/forum/post/15391961"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">If it's any consolation, I was reading somewhere that the presence of a NICU at a hospital actually increases the chance that your baby end up "needing" it. (I can't remember where, so don't quote me on it yet. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol">) In this case, it's a little like cesareans--done far too often, but a godsend when genuinely necessary.<br><br>
I think the PPs summed it up well, though. Just visit all of the "what-if" scenarios with your doc.</div>
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Yep! I would actually feel safer in a hospital without a NICU than a hospital that does have a NICU.<br><br>
Similarly and I think importantly--<br>
I was looking into the hospital birth options for a new Amish community in my region--and discovered a small hospital near them at which births were covered only by a group of family practice docs. They did have an OB group available for consult and surgery, but none of the OBs worked normally at that hospital--had to be specifically called out to help. No NICU either.<br><br>
That fam practice group/hospital had a very low csection rate compared to the rest of the region--and a very low NICU rate as well. Go figure! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up">
 

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<span>I don't think they are a necessity in a straight forward pregnancy, all my births have been home birth's though so that probably is what makes me think this.</span>
 

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If your baby should need NICU and there is not one in your hospital, they have special NICU ambulances that will transport the child, usually to a Children's Hospital. If it is too far, then they will careflight in a special helicopter set up or with the equipment needed in case of an emergency.
 

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The nearest hospital to me is 10 minutes away, nearest NICU is 60 minutes. I actually did need the NICU with my first when my water broke at 31 weeks but the local hospital made sure I was stable before shipping me via ambulance to the NICU hospital (actually, they didn't even ship me to the NICU hospital, Mayo has 2 hospitals, one has the high-risk maternity unit and the other has the NICU, so even after he was born he had to be shipped to a different hospital across town). If he had been born at the local hospital I know they would have been able to stabilize him before flying him to Mayo. And yes, I've read stories where a baby has been admitted to the NICU and I've caught myself thinking "There's no way my hospital would have flown that kid to Mayo for that..." so I do think being at a NICU hospital increases your chance of having your baby admitted to the NICU, whereas a level 2 hospital would have just put them in the regular nursery with extra nursing care.
 

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Well, it's a necessity for me, because I had a "normal, low-risk" pregnancy and then had a baby born severely brain damaged that couldn't breath without seizing and spent 2 weeks in the NICU. Yeah, you can get transferred, but every moment counts in some cases. The majority of people won't need a NICU though, so it's up to you and what your comfort level is.
 

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The nearest NICU to the town we lived in when my daughter was born was about an hour away by car.<br><br>
The nearest NICU for this pregnancy is 2.5 hours by car. The hospital I'll be delivering at is a critical access hospital and doesn't actually even have a pediatrician on call 24-7 (family practice docs cover some days) and the L&D nurses are just regular nurses who have been cross-trained to cover OB when there's a birth. My current doctor (family practice) tries his best to "risk out" any pregnancy where there is any question of post-birth complications but sometimes they have to fly babies out on the helicopter.<br><br>
All doctors and nurses who work in L&D units have frequently updated training in neonatal resuscitation. Even in a hospital without an NICU the pediatricians on call will have experience with newborn emergencies and know how to stabilize the baby for transport. You'd be amazed at the level of scary stuff pediatricians working at a hospital with just a level 1 nursery are able to deal with.
 

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If you are full term, not having any issues or underlying conditions, I would not worry about it. I *personally* wouldn't deliver at a hospital w/o a NICU, but I had a very complicated birth with my last son due to him being early and an infection causing my membranes to rupture. He was born with meningitis and need resucitation at birth. With my first, he also needed the NICU for severe Jaundice, but that was only a level 1 NICU and probably something that could be handled in the nursery if your hospital has one (for the bili lights). I would have had no concerns about delivering my first at a hospital without a NICU.
 

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I would say not necessary, BUT:<br><br>
My full-term, low risk pregnancy baby turned emergen-c-section didn't void her bladder for 24 hours after her birth, and ended up on a helicopter to the nearest NICU the next day (4.5 hours away by car). The hospital also did not have a childrens' ward, which may have encouraged the NICU transfer. I was not allowed to fly with her because I was less than 48 hours post-op, and there would have been no way for me to drive myself the 4.5 hours to see her (no other family around). So DD flew alone (in an isolette) and Huz drove us up. Painful, any way you look at it.<br><br>
So yes, I might birth a low-risk baby again at the same hospital, with the NICU far away, but I will be better prepared to handle the "what-ifs".
 

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I would want one because on the off chance that we need it, I wouldn't want my baby to be at a different hospital.<br><br>
DD #1 was supposed to be a med-free natural birth. Instead, due to undiagnosed pre-e (atypical presentation) that caused severe fetal distress while I was in labor, we ended up with a c-sec and she spent 6 days in the NICU. It was hard enough to not have her rooming in; I can't imagine how hard it would have been if I were recovery from surgery and she was not even in the building! I realize this is highly unlikely, but it was also completely unexpected on our end. We arrived at the hospital expecting to be on the monitors for 30 minutes and instead discovered her heart was almost stopping with each contraction and were headed to the OR within minutes.
 
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