Premature in a Pandemic: Part One

MARYLAND – September is NICU awareness month, a month dedicated to raising awareness about what happens inside of neonatal intensive care units across the country. To honor it, 47 ABC spoke with one local doctor and local mothers and fathers who experienced the NICU, especially the past two years, during the covid-19 pandemic.

Samantha Marshall is one of those moms. “I remember getting up, because I had to get general anesthesia, and the first thing I said was, ‘did she make it?'” she said of the day her daughter, Callie, was born. Callie was born at 27 weeks last June after Samantha suffered severe preeclampsia. At just one pound, 12.9 ounces, Callie was immediately carted away to the NICU, where she was in the care of a handful of doctors and nurses.

“It takes a special person to be a doctor or a nurse, but it takes somebody even more special to do that,” Samantha said.

Doctor Michelle David-Hughes is one of those people, working inside of Tidal Health’s Special Care Nursery, their version of a NICU. She’s been doing this work for two decades, but says the past almost two years now have been especially challenging for parents who give birth during the pandemic.

“Because of restrictions, we don’t have any family members able to be in except for the mom and the dad, or her immediate support person,” Dr. David-Hughes said.

That support person, in a lot of cases, is the baby’s father, but it can be another family member or somebody close to the new mom. But Dr. David-Hughes says sometimes throughout the pandemic, even moms were limited in how they could see their own newborn babies.

“We also had a limited time where, once they left the hospital, there was limited availability for them to come back in and see their newborn when they were sick and in the hospital,” she explained.

That meant doctors and nurses sometimes spent extra time with these newborns, essentially becoming their primary caregivers. Doctors spent even more time one-on-one with the newborns, working with them through wires and monitors and incubators.

“Infections, respiratory breathing after birth are some of the other common things we get for some of the more mature babies that have something that wasn’t anticipated right at birth that might need a little extra attention that can’t just be done right in the room with the mom or with the parents taking care of them,” Dr. David-Hughes said.

Racheal and Kevin Collins know what it’s like to put that duty in a doctor’s hands. Their son, Everett, was born about three months ago, but was immediately taken to the NICU with oxygen issues. Most times, Racheal and Kevin say they couldn’t even be with Everett together as a family.

“They would only let one of us in there at a time, so if I went in there, she was worried about me being in there and wanted to go, so I’d have to come back and switch out back and forth,” Kevin explained.

And while doctors and nurses can make up some of that time by holding the babies or giving them special attention, it’s not the same as having mom and baby together. But maybe even more devastating than the physical separation is the emotional toll that takes on new moms and babies.

“Skin to skin, and what we call kangaroo care, is physiologically normal for a baby, and actually helps them regulate, even a pre-term baby, their breathing, their heart rate, and many things like that,” Dr. David-Hughes said.

And because moms can’t have visitors other than their immediate support person, sometimes they can feel isolated, especially in a time when families are used to being together.

“When they’re by themselves or don’t have any additional family to support them, hear medical questions get answered, they’re a little bit more on their own,” Dr. David-Hughes said. So for her, part of adapting during the pandemic was finding ways to not only keep babies medically safe and loved, but to keep new moms and dads comfortable as well. “I’m a mom myself, so knowing what that moment means for a family or a parent, especially for a sick newborn, unexpected, whether they’re getting good news or bad news, there should be some positivity in that,” she said.

She’s been doing this for a long time and has plenty of what she calls “graduates,” babies who left the NICU and went on to be healthy children. So even despite the challenges from the pandemic, she says when she sees mom and dad leaving the hospital with their bundle of joy, she knows her work is done.

“I don’t get to see my graduates as much because they don’t get to come into the hospital and visit, we can’t have any of the big reunions, but it’s very gratifying to see kids that are now 4, 5, 6, even 20 because I’ve been doing this a while, grow up and have good lives,” Dr. David-Hughes said.

She says another thing that the pandemic has impacted is breastfeeding, and when moms can’t do kangaroo care with their babies, they can’t breastfeed. That means for vaccinated moms, their babies aren’t getting antibodies that the doctors say could help them.

Part Two of Premature in a Pandemic will air on Thursday, September 30.