Guest Author - Julixa Newman
One of the biggest differences between a multiple pregnancy and a singleton pregnancy is the high risk of early term labor. That being said, it is always a smart decision to check out your hospital's NICU unit before giving birth. There are three different levels of NICU (Neonatal Intensive Care Unit) care, and you want to make sure that if your babies need special care they will not have to go to a different hospital; or even worse, have to go to different hospitals!
Level I NICU units provide basic care for newborns that are born at or around full term. They will be able to stabilize your babies and get them ready for another NICU unit if your child is born with any complications.
Level II NICU units (specialty care): These NICU units are designed to provide care for infants that are usually 32 weeks gestational age and weigh 3.3 lbs or more, including infants that have serious complications related to immaturity and/or illness. Level II units are also used for infants recovering from special illnesses and those who have been transferred from a Level III unit. Within the Level II NICU there are two different levels.
Level IIA does not have assisted ventilation-which means they do not have ventilators for babies who need help breathing on their own, except on an interim basis until the infant can be transferred to a higher level facility.
Level IIB NICU's can provide mechanical ventilation for less than 24 hours, or continuous positive airway pressure (also known as CPAP). They must have certain equipment (ex. portable chest radiograph, blood gas laboratory) and specific personnel (pediatrician or special physician, specialized nurses, respiratory therapists, radiology technicians, and laboratory technicians). They must also be able to provide continuous and ongoing care, as well as address any emergencies that may arise.
Level III NICU units offer certain specific personnel continuously, including neonatologists, respiratory therapists and neonatal nurses. They also have the equipment to offer life support for as long as it is needed. Those infants born at 28 weeks gestation or weigh 2.2lbs or less usually enter the Level III NICU and graduate to a Level II and so forth until leaving the hospital.
Within the Level III NICU units there are three levels:
Level IIIA are used for infants born at 28 weeks gestational age or more. They offer minor surgical procedures and mechanical ventilation.
Level IIIB should have all of the above, and the capability of performing major surgery. They should also be able to provide superior imaging beyond x-rays, and be able to perform surgeries that require anesthesia.v
Level IIIC should have all the capabilities of a level IIIB, have advanced ventilation equipment, and be able to operate (including open heart surgery) if there are congenital heart defects.
As daunting as this article is, it is important that you are aware of the differences in NICU units and inform yourself of the services that you might need. If you have any doubts as to what your hospital's NICU unit is capable of, contact them and set up an appointment. Many hospitals provide tours and informational guides about their center's services. Don't be afraid to ask any questions, including how many beds are available within the NICU unit and what were to happen if there weren't enough beds for your babies. Where would they be transported to? What are the visitation hours? Do they have a system for those that would like to provide their own breast milk? Being prepared for any situation is vital, and it can help to ease your uncertainty as well!