A One of A Kind Find: The Special Care Nursery At CMC

What you never knew about CMC’s Special Care Nursery, but should!

Published 9/18/2018
Written By Farrah Sheehan Deselle, MSN, RN, CLC, CCE (BFW)

“We provide the first of its kind, cutting edge care right here in Southern NH,”  shares Nicole Pendenza, BSN, RNC–NIC, Director Maternal, Child and Women’s Health Services at CMC.

Did you know that The Special Care Nursery at Catholic Medical Center is the first Level II nursery built on the Swedish “family care” model in the entire United States? Yes. You heard me right.  Right here in southern NH!

We have the first nursery ever built in the United States that cares for premature infants born at 32 weeks gestation or greater, where babies are cared for alongside their mothers without separation. Infants and mothers share their very own room beginning at birth and throughout the duration of the infant’s hospital stay, even after mom is no longer a patient herself.
A little bit about Neonatal Intensive Care Units:
Did you know that most infants requiring specialized care in the United States and around the world are cared for in Neonatal Intensive Care Units (NICUs)?  

Did you know that because of their design, NICUs impede maternal/infant contact, such as holding, skin to skin and early initiation of breastfeeding?

These highly specialized hospital units were built in the 1960s, 70s and 80s as technology advanced and allowed for even the youngest, sickest babies to survive and often thrive. But, they were designed to save babies lives when the science around premature survival focused on technology, with less (in some cases no) awareness about the importance of the relationship between the infant and mother or parent. Over the past 10-20 years, thanks to developments in brain and behavioral research, we have learned about the innate wisdom of the mother infant dyad; the desire, emotional, and physical need of the two to be together at birth, and the amazing outcomes that occur as a result of keeping mom and baby in close proximity, even if baby needs highly specialized care. Now, most NICUs encourage parent participation; holding babies skin to skin (known as Kangaroo care); breastfeeding; and cuddling. But in NICUs there is rarely a place for parents to stay overnight, to make themselves at home, or to be the primary care takers of their infants.  Families have limited privacy and because there is not a place to stay all night, they cannot participate in 24 hour care of their infant. As a result, parents often feel like the visitor instead of the parent, and infants are left without the constant parental contact that helps them grow, develop and get home as soon as possible!

NICUs are categorized into levels. A level III NICU cares for the sickest, youngest babies, usually born before 32 weeks gestation, sometimes needing mechanical ventilation because they cannot breath on their own yet, or babies who are born very sick with complications requiring surgery or other interventions.  A level II NICU can provide care for babies who are born around 32 weeks gestation and older and who may need oxygen or help with breathing without long term ventilation. They may need incubation for warmth/temperature regulation, and help with feeding, such as tube feedings or supplementation while mom’s breast milk is coming in. Most infants who are born requiring specialized care fall into this category. In fact, according The March of Dimes, late preterm births, (infants born 34 to 36 weeks gestation) account for 75% of all preterm births in the United States. Of all babies born in the United States, according to the Center for Disease control (CDC) 1.6% of them are born very preterm, needing the care of a level III NICU.   

The Special Care Nursery at CMC:
Recently, a new mom who spent time in the SCN with her baby for a few weeks after transferring from another hospital said to me, “This place is a hidden gem!”

Our Special Care Nursery opened in April of 2010. Since then we have cared for over 1000 infants.  We care for babies who are born a little early, who need a little extra help after birth, who need to stay for a couple extra days because of jaundice or low blood sugar. We care for babies whose moms are being treated for addiction and who were exposed to drugs or medications. We care for twins and for babies who no longer require Level III care and transition to our Special Care Nursery as the next step home; and because of our family care model, we also care for the moms.
The Special Care Nursery (SCN) at The Mom’s Place is a state-of-the-art neonatal facility designed to meet the distinct needs of our babies and their families and to facilitate bonding and attachment between parents and their newborns. In our SCN, early parental involvement as the primary care giver boosts parental confidence and helps parents feel ready when it’s time to take their baby home. Lauren Martone, mom to Carter, who spent time in the SCN in 2014, says after her son was transferred to CMC from a Level III NICU, “I was able to really finally feel like a mother to my son, I was able to hold Carter as often as I wanted.” She says “the rare design of this unique nursery gave me a gift during the most difficult journey of my life. Being able to stay with Carter and really embody the parenting experience was priceless."

In addition to single-family rooms, the Special Care Nursery includes a family lounge. This area provides families with an array of amenities in a homelike environment. Families have access to a shared kitchen including sink, refrigerator, microwave, toaster oven, coffee maker, washer and dryer and a shared bathroom with a shower and lockers for their belongings. This independent living facility is a space where families can relax, take care of themselves and be with their baby 24/7 before going home. 

Other Benefits of the Special Care Nursery:
The family care model not only helps parents feel more connected to their babies, it provides all kinds of benefits to the infant as well.  When parents stay 24/7 and care for their infants, babies go home sooner, decreasing the duration and cost of their hospital stay.  According to the March of Dimes, the average cost for a healthy baby in the US is $4,389, while the average cost for a premature baby is $54,194, and can reach the million dollar mark for some infants requiring the most specialized, long term care.  Infants cared for in the family care model breastfeed sooner, and often for longer. They require less medication and they are less susceptible to infection. Their growing body and brain can grow and thrive in this supported and nurturing environment.

Nurses love working in the Special Care Nursery too. Nurses who work in environments that are good for families and patients have better job satisfaction and decrease turn over. There is teamwork and an overall positive environment.  

Tanya DiGeorge, SCN nurse manager, says of her experience,  “Coming from a busy level III NICU where parents can’t stay over and truly feel like they are visiting their baby to a place where they are not separated at all is really amazing. In a traditional level III NICU families were often scared to go home and didn’t feel comfortable taking care of their infant. At CMC these families are going home much earlier, well before their due date, often times exclusively breastfeeding and really feeling like they “know” their baby. They have confidence, they feel ready.  To work in such a unique environment, is truly rewarding!”

Preparing for the Unexpected
Most of the time, having a baby who needs extra care, or who is born early is unexpected. Whether you know you are at risk for a preterm birth, or you just want to do a little more preparation just in case, here are some things that might be helpful:
•    Learn about the hospitals in your area. What are their models and levels of care? What is the process for transferring care? What are their breastfeeding rates for premature infants if that is important to you.
•    What are the resources in your community for support and care for premature infants?  
•    What would worry or concern you the most about having a premature infant? What would be the most stressful to you? Talk with your partner and support people about coping with this type of stress. What would you need to help you?
•    What is one thing that you always know is true about you as a mom, even if your baby is born early, or needing extra care? What can you do or say to yourself in times of stress to remind you of this truth?
•    Check out resources on premature birth such as the March of Dimes, whose mission is to improve the health of babies by preventing birth defects, premature birth and infant mortality. 

To learn more about the Special Care Nursery at The Mom’s Place and take a virtual tour, visit us at: https://www.catholicmedicalcenter.org/care-and-treatment/pregnancy-and-childbirth

At The Mom’s Place, our childbirth and parenting preparation classes are developed using the Birthing From Within model (BFW), preparing parents in the body, mind and heart for the full range of experiences.  Our childbirth educators are nurses who work at The Mom’s Place and in our Special Care Nursery and have received training as BFW mentors.  

If you want to learn more about The Mom’s Place, Special Care Nursery, or childbirth and parenting programs, call (603) 626-2626 or visit us online at https://www.catholicmedicalcenter.org/care-and-treatment/pregnancy-and-childbirth

Farrah Deselle is a Certified Birthing From Within Mentor.  She teaches in and manages the Childbirth and Parenting Preparation, Education and Support Program at The Mom’s Place at CMC. She is also a lactation consultant at The Mom’s Place. Farrah has a Master’s of Science in Nursing: Health Systems Leadership. Contact Farrah at: farrah.deselle@cmc-nh.org.