What if my baby delivers prematurely?

7.7% of babies in Australia born in 2012 were preterm with most being late preterm birthsHema Sheel (6) (34 weeks gestation on)1. This Australian Government report states ‘a small proportion of mothers gave birth at 20–27 weeks (0.8%) and 28–31 weeks (0.7%), while 6.2% gave birth at 32–36 weeks’1.

While Norwest Private and the Sydney Adventist Hospital (like all private hospitals) hospitals do not have a Neonatal Intensive Care Unit (NICU or Level 3 Nursery), they do have Level 2 Nurseries. If you go into labour at 34 weeks on (a late preterm delivery) you can be delivered at the hospital here you are booked.  This is the case for most preterm deliveries. Your baby would be managed in the Level 2 Nursery of the private hospital where you are booked.

If you did labour or need delivery before 34 weeks gestation you will need to be transferred to a public teaching hospital that has a Level 3 Nursery. The closest teaching hospital is tried first (Westmead Hospital for Norwest Private and The Royal North Shore Hospital for the San). If that hospital can’t take you then another hospital is requested.

Your baby would be transferred back to the Level 2 Nursery of the hospital where you are booked as soon as suitable.

My hospital appointments are at Norwest Private Hospital and the Sydney Adventist Hospital. At the public teaching hospital that you are taken to you will be under the care of an obstetrician who has an appointment at that hospital. But please keep me informed and send me photos. Also I would like to see you for your six week postnatal visit.

It is safer to transfer you while pregnant than to transfer your baby after delivery. That is because your baby may need special attention immediately after birth and is safer to have the NICU a short distance from where you deliver.

If there is no time to transfer you and there is a real concern that you will deliver in the ambulance then I will do your delivery at Norwest Private or the Sydney Adventist Hospital with the paediatrician present. Your baby will be taken to the Level 2 Nursery. The Newborn Emergency Transport ambulance Service (NETS) will come, stabilise your baby and take your baby to the public teaching hospital that has a Level 3 Nursery that has agreed to take your baby.

Occasionally a patient is told by well-meaning family or friends as there is a chance she delivers prematurely she should book at a public teaching hospital to have her baby rather than Norwest Private and the Sydney Adventist Hospital. My answer is: ‘Nonsense!’ The likelihood of preterm delivery less than 34 weeks is less than 3%. So she will have to experience all the challenges of delivering at a public hospital (see Public or private – What is the difference?) for something that is very unlikely to happen. Even if she attends a public hospital, there is no guarantee that she will deliver at that hospital if she goes into preterm labour. If that hospital’s NICU is full when she is likely to deliver then she will be transferred to another public teaching hospital that has a NICU cot available. I was once organising the transfer of a patient who was going to give birth prematurely to Nepean Hospital only to be told their last spot had just been taken by a woman being transferred from the John Hunter Hospital Newcastle. The John Hunter Hospital has a NICU but it was full.

1 http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129550054

Posted by Dr Gary Sykes on -

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