Nicu Vs. Local Hospital

Not sure what I should do here. My current OB works through a local hospital that is only 5 minutes from my house. Very small, with more personal care offered. Before I found out I was having twins, that hospital seemed just fine.

Now with the two is going directly to a NICU necessary? There is a level 3 NICU within 20 minutes of my house, that of course my current OB office does not go to I just found out. My current OB does not seem to think the NICU is necessary and if something does come up as we get closer they will transfer me or them there as needed.

I am not committed to my current OB, I just want the safest plan for both me and the babies.

I am 22 weeks and things seem so far so good.

 

It's totally up to what you are comfortable with. We specifically picked an OB that went to the hospital that had the level III NICU ... There is a closer hospital to our house, but I think they might be a level II NICU ... and my OB actually doesn't have rights at that hospital. My issue was that I didn't want to be in a situation where my babies were not at the same hospital as me, and that's the risk you take when having the babies at a hospital with a lower NICU. They will easily transfer the babies to the best place for them to be ... but that might mean you are not at the same place as them. But, your babies might cook long and big and not need any NICU time ... so you just really need to figure out what is most important for you . ..

good luck!

 

I am going to give you my situation, and I hope this helps. I see midwives that go to a majority of hospitals in my area (there are 2 with Level 3 NICU's, and 4 smaller hospitals). I want to have the twins at one of the smaller hospitals. I was told that I will go to the smaller hospital after 34 or 35 wks. If I go sooner, I will go to the hospital that is closest to me with the level 3 NICU. I wasn't sure if they delivered at that hospital at first since they don't really "advertise" going there, but they said that if I go there, they will deliver me. The smaller hospital is about 15 minutes away and the NICU one is about 10 minutes....the other NICU is more like 15-20. So that is what the plan is for me.

My advice would be that if you have them earlier than 36wks, you may want to go to the NICU hospital. I think it would be difficult for you to be at one hospital, and the babies at another...especially if you have a c-section which requires more hospital stay. I would talk this over with your doctor again because even though things are good now, they may not be in 10wks from now. Just some advice!!

April

 

My peri told me that if I deliver between 33-34 wks I would be fine at my OB's hospital a NICU II.
Any earlier I'm to go downtown with a NICU III. Of course I am to ask my OB on Thursday if she is comfortable with that.

 

I actually struggled with this same dilema for a long time. The hospitals by us have no NICU whatsoever and they said if the babies were born and needed NICU they would have to lifeflight them to Children's Hospital. I absolutely loved my OB and stuck it out with him until 30 weeks when I decided that our hospitals just were not used to twins (after I had been trying to get NSTs there twice a week w/o much luck) at which time I talked to my OB who transferred my down to the Perinatologists at a hospital about 1 hour away but it is suppose to be the best hospital in California to deliver at. It was a very hard decision to make but now that I have transferred I am extremely relieved that my babies will be getting the best care possible...even if they never need NICU it is a hospital that is used to delivering twins.

 

My situation is somewhat similar, although the nearest NICU is almost 2 hours away! Our local hospital has no NICU and I was nervous about that. I won't go into all the details, but basically we are "moving" up close to the NICU III hospital in less than two weeks. My peri has more experience delivering mono/di twins whether "full term" or not, and it's just a better hospital overall. We started hearing some bad stories about the local hospital here, so full term or not we would rather deliver at the other one. Take those kind of things into consideration too (not just the NICU). Since your "better" hospital is really not that far away and you wouldn't mind changing OBs, that's what I would do.

 

My local hospital has no NICU. If I need to deliver before 36 weeks then I'll be transported to the hospital with a Level III NICU about 45 minutes away. Luckily, my local hospital delivers quite a few full-term twins as does my OB. We've opted to stick with what we know and try for the local hospital. I have heard great things about the NICU hospital though so if I have to deliver there I know I'll be in great hands - as will my babies.

 

Just to give you my opinion - My pregnancy was great with no incidents or concerns whatsoever. Unfortunately when my twins were born (37 wks 4 days), my daughter needed a level III, and the hospital I was at only had a level II. Everytime I tell my "birthstory" I wish that I had gone to another hospital to deliver. The day after my daughter was born they wheeled her into my room to say goodbye. I had to wait until I was discharged late the next day to go and see her, to meet those caring for her, and to see where she was. It was a terrible 24 hours, especially with all the post delivery hormones running wild. I would trade being in the same hospital with her for my ob.

In the end make the decision that feels right to you.

 

I was in the same situation as you, I had decided to stay with my OB and take the chance, well at 30wks I was contracting, I was admitted to the hospital w/out the NICU the Dr thought they would just monitor me do the mag etc. when he checked me I was dialated to a 3, I was put in a ambulance and transfered within a hour to a hospital 30min away. It was hard, I had to have a new Dr(which turned out to be a blessing) he was so much more qualified to deal with a twin pregnancy with complications. If I had it to do over again I would pick a Dr and Hospital that had a NICU. It would have been devestating having my babies shipped off, and the worry over what was happening during transport etc. Sorry this is so long but for me I would defanitley do a a NICU hospital.

 

I would go with the hospital with the best nicu - twins or not. One factor that was VERY important to me when I chose my ob (which i did before even trying to get pregnant) was that I deliver at the hospital with the highest level of nicu in town, even if it meant driving a little further away from home. The reason for that is that I have had friends with single babies who ended up delivering in the small, personal hospital while their premature babies were transported to the bigger hospital for nicu care. In one mom's case, she had had such a severe case of eclampsia when she delivered that she was stuck at that local hospital for TWO weeks before they let her out to go see her baby (who was 20 minutes away in my hospital's nicu). That was awful for her and I agree: it would suck to be in one hospital while my baby (or babies in our case) was across town in another. Twins or not, it was not a chance I was willing to take, so I picked the hospital with the best nicu in town.

If your heart is set on the local hospital, then I would agree with the pp who said that if you deliver before 2 weeks, then the local hospital is probably fine. but if you go any sooner, your babies will probably benefit from the bigger hospital.

 

I would probably go with the better NICU. The reason is they probably have seen any thing and everything that could happen. So, even if you didn't use the NICU - there would probably be little that would surprise them.

 

I was in a similar situation, but my OB did have priviledges at the other hospital 20 min. away (the other is 5 min away). When I ended up on bedrest they put me in the hospital with the NICU just in case. She was driving back and forth just to check on me (I was her only patient there).

After that little stay, she decided that I should probably pick a high risk doctor (peri) and see that doctor. So I did switch OBs later in the game. I was really glad that I did switch and that I was able to deliver at the hospital with a NICU...just in case. It was nice having my doctor there with me post-delivery, and even though we never needed the NICU, I was glad I was prepared.