NICU Level Importance

Since I am a worry wort, I figured I would ask you all what you thought. The hospital I delivered my daughter at 7 years ago is the same hospital that my twins are scheduled to be born at. I looked it up online and it is has a Level II NICU. Now, I asked my RE what he thought about that and all he said was if your babies are born at 36wks or later, that should be fine....but...what if they aren't? What if they come earlier? Do I need to have a backup plan or will the hospital help me if that time comes? Not sure if I should make an alternate plan and be registered at multiple hospitals or just have one on "stand by" just in case. The next closest hospital is a Level III NICU.

What are your opinions?

 

It does not hurt to be prepared as you really have no idea what can happen with a twin pregnancy. My hospital in our town was just a "special care nursery" 4 years ago when I was pregnant with my twins (they have since been upgraded to a NICU) and my OB told me that I could go there as long as as my twins were born after 30 weeks and if I had them before 30 weeks I'd have to go down the road about 25 miles to the one with the Level 3 NICU. Never in my wildest dreams did I imagine I would need a level 3 NICU as my oldest DD was a week late.


My insurance would not let me register at more than one hospital though, so be sure to check on that. They did say to register at the one I "thought" I would go to and then if something needed to be changed due to an emergency it could.


Well my twins came before 30 weeks so I needed to go to the hospital down the road. It was a level 3 NICU and did a wonderful job with my preemies.


Does your OB participate with the hospital with the level 3 NICU? I would definitely have a back up plan. :good: And I should say as well, I saw many full term babies in the NICU and some were worse off than my babies when they were 3 lbs. So you really never know when your baby/ies might need the NICU.

 

personally, a level II nursery wasn't an option for me. i went to a higher-acuity, not so frilly hospital because i wanted my girls to be in the best care possible. and we certainly ended up needing it.

 

My hospital in town was also a level II. They said they were comfortable with anything after 32 weeks. I would check with the hospital neonatologists and see what they are comfortable with. My OB talked with the ones at my hosp about my particular situation and found out how early they were truly comfortable with. There was a level III just a little further away, but I actually decided on the level II. My babies were born at 31w6d and they had no problems caring for them. For the first few days, they told me that they may have to be transferred due to lung problems, but they handled everything wonderfully. I was very happy with my decision. The NICU we were at was small, but I felt they got a ton of one on one specialized care. We took a tour of the level III and it was huge - babies, drs, and nurses everywhere!! I really liked that I could ask any Dr or nurse about my babies and they could tell me exactly because they had actually been taking care of them. Maybe take a tour and talk to them and see which one you feel more comfortable with. We did look at both because we knew that mine were most likely coming early, so depending on how long I made it I might not have had a choice. Good luck with everything!!

 

Hi there! I am new but the importance of NICU and their ability hits close to home with me so I thought that I would post!! (I am 11 weeks with twins currently) My daughter was born at 28w 5 days. And boy, am I glad I delivered where I did! Having a Level III NICU made all the difference in her health today (which is exceedingly great!) Yes, the hospital was less fancy, yes the NICU was large and there was tons of staff running around. But, they were literally saving lives in there. It sometimes was not always a 'calm' or 'relaxed' atmosphere but they were always on high alert. After all, things don't always go well with one and two pound babies. My girl was 2lb 6 oz and needed alot of competent drs. and nurses and I have no doubt that a Level III is the best place for these littlest of preemies. You never know what will happen. Be prepared. With twins especially, I will be delivering at the same Level III hospital.

 

Personally, I changed hospitals. I delivered my singleton at a birth center that has a Level II NICU. But as soon as we found out it was twins, we did research on NICUs in our area and changed to a hospital that has a Level III. (A friend whose preemie son was in the NICU for two months also encouraged us to do this.) Fortunately it doesn't look like it will be an issue because I am 36 weeks now -- but it almost was, as I was on complete bedrest starting at 25 weeks.

It was very important to me to make sure that my babies and I would be at the same hospital.

 

I delivered at a Level 3 (not early, just made the choice to do so) only because you never know with twins. If the babies were born at the Level 2 and had to be transported to the Level 3, you may not be able to see them for awhile.

 

I've chosen all of my family dr's around the hospital I want to be treated in should I ever need it. My local hospital is 10 min away, but has a lower care level (and not-so-great reputation). The hospital I use is 1 hr away, but highly regarded in the region and they have a Level III NICU. I am so glad we chose to go this route even though the drive was/is certainly more of an inconvenience. My guys ended up needing a brief NICU stay for growing/feeding. Had I given birth in my local hospital, they would have needed to be sent to the other hospital while I stayed local. I would have been so miserable if that had happened.

I fully agree for planning for the worst case scenario, especially with a high-risk pregnancy such as carrying multiples. And if the higher-care hospital is nearby, all the better!

 

That is a very good point. :good: If this happened you could be in one hospital and your babies in another, that would be very hard.

 

Thank you ladies!! I worry because my OB, although I think she is a GREAT doctor and knows her stuff, doesn't have the best bedside manner and is not quick to give information without me trying to drag it out of her. I will talk to her at my next appointment and see what she thinks. I can forsee her simply saying, we'll see how it goes.

The Level III NICU is in a hospital literally 10 minutes closer to my house than this one with the Level II that her practice is in (which is why she delivers there for the most part), but I don't know if she is able to deliver at the other hospital as it is not the same affiliation. Hopefully she will be receptive to my "plan" on being safe for the babies. I just have the odd feeling I won't make it to my 38wk induction like she plans. I will try, but obviously as you all have shown me, with twins, there really is no plan that can be followed to the T in regards to timing!! Thanks again!!

 

I would like to add that I've seen some fullterm singletons have to be transferred to a Level III NICU while mom is stuck at the first hospital for a few days before being released. I personally wouldn't feel comfortable taking the chance. We're delivering at a hospital w/ a Level III NICU that's nearly 1/2 hour further from the one w/ a Level II hich is closer to us. It's a wonderful hospital and if your doc has privileges at both I'd suggest taking the tour of the other one. If your doc doesn't have privileges... I'd consider switching docs. The most important thing to me is not being seperated from my babies when they're born. 2 different hospitals would not be an option.
Good Luck to you mama!!!

 

I am definitely in the minority on this one. I am a first time mom who is 31 weeks 5 days with twin girls. We toured both a level III and a level II facility - my OBGYN has privileges at both places. Ultimately, we chose the level II after verifying that if something goes wrong, they do transfer to a level III facility, and verifying that the transfer hospital is covered by our insurance.

We chose the level II because:

1) it had a lower staff to patient ratio (we get assigned one nurse, who is only assigned to us while we are in active labor. If her shift ends, we get another. We'll never be alone.);
2) we liked the answers the level II gave about how they respond to preemie twins better than the answers the level III facility gave (maybe it was because they see it so often, but the level III looked at us like we were fools when we asked how treatment for preemis/NICU twins differed. The level II explained what appeared to be a predeveloped plan for how they respond to preemies - and they seemed genuinely excited to care for our twins);
3) we got a better look at the NICU at the level II facility, at the level III facility we were shown a door and told "it's back there."
4) We got to meet the on-staff pediatrician at the level II facility. At the level III we weren't even told the doctor(s)'s name(s).

Maybe the vibe you get from a place is completely the wrong way to choose; however, when we left the level III facility we knew they proviided a higher level of care and that they had strong financial support from a variety of sources, but we didn't feel any type of a connection with them. We felt like we would be just the next in a long line of people that stream through their service. When we left the level II facility, we felt like they were willing to personalize our stay to meet our needs - whatever those needs were.

RECOMMENDATION: I recommend touring both facilities and asking the same questions at both. Also, connect with other moms who have delivered at each facility - they'll be honest about what they thought. Then, make your decision based on what you feel are the essential facts and observations.

PS - We have already had one spin through L&D triage, and the staff there could not have been more attentive. Based on that experience alone, I am confident that I have chosen the right place. It may not offer the higest level of care possible, but I have no doubts that they will work hard for me and my girls.

 

UPDATE: I have found my OB's information online and she IS affiliated with both hospitals. I think I will take your advice and tour both if possible. I will also ask my OB's opinion and hope that she gives me the best advice for my babies and not what is convenient for her.
THANKS!

 

I think that's a good plan. And keep in mind that her advice is just that - ADVICE. If she's affiliated with both, you can do what YOU feel is best in your gut. And there's nothing wrong w/ going w/ the Level II hospital if that's what your instincts tell you to do. You will just need to be prepared to change your plan if need be at the last minute.

Good luck!!

 

I haven't read all of the responses, but one thing to consider is if only one of your babies needed to be transferred to a level III. This happened very recently to a friend of mine. Her babies were born in a level II, but one needed the level III so only one baby was transferred. That meant she and Dad had to visit their boys at two different hospitals, while caring for 3 other children at home, and dad working as well. I would deliver where there is a level III. But hopefully you won't need any NICU

 

We originally wanted the level 3 here because we had heard it was nore cozy and less clinical. When we toured it we hated it! Then we went to the level 4, and totally fell in love. Our new ob delivers there, so it worked out well. Also, a plus for me, they have some postpartums adjacent to the nicu area. The other hosp it was two flights up.

Due to flu season, neither let us see into the nicu.

 

In my honest opinion, if you get to "tour" an actual NICU, that is a warning sign in my book. They should not be letting anyone in there that does not have a child in there presently. The babies in there have pretty much NO immune system and if someone brings an illness in there it can literally mean life or death for some of the teeny tiny babies.