About Your Stay in the Special Delivery Unit | The Children's Hospital of Philadelphia

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About Your Stay: Frequently Asked Questions

As your baby’s birth approaches, the details about what will happen in the Garbose Family Special Delivery Unit (SDU) become more important.

We’ve put together a list of questions frequently asked by families who are planning their high-risk delivery in the SDU. Our hope is that by giving you some answers, we can alleviate some of your concerns in the days and weeks ahead.

Keep in mind: Every birth in the SDU is one-of-a-kind. These answers are meant as a guide only.

Our doctors, nurses and other healthcare professionals develop a birth plan that is individualized to your and your child’s specific needs. Our staff members are happy to answer any individual questions you may have.

When will I give birth?

We encourage most women to go as close to full-term in their high-risk pregnancy as possible, but there are many factors that could result in an earlier delivery. For example, your baby’s diagnosis, condition and the course of his or her illness may indicate an earlier delivery. Anything that impacts your health as the expectant mother can also impact the timing of your delivery.

Feel secure in the knowledge that we will closely monitor you and your baby during your pregnancy, labor and birth so we deliver your baby at the right time for your unique situation.

What happens if I go into labor before I’m scheduled to give birth at CHOP?

It depends on where you are when you go into labor. If you live in the Philadelphia area or have relocated to this area for the remainder of your pregnancy, you should call the Special Delivery Unit. An obstetrician or midwife will do an initial assessment, and then ask you to come into the SDU to be evaluated.

If you are far from the Hospital, you should call the SDU and speak to the obstetrician or midwife who will encourage you to go to your local doctor or hospital to be evaluated to determine if it is safe for you to travel. If you can travel, we’ll ask for a maternal transport to CHOP. If travel is not safe for you or your baby at that time, we will provide instructions to personnel at your local hospital for your delivery and the care of your newborn.

We have obstetricians and certified nurse midwives here 24 hours a day/7 days a week. If you have a question or concern about your baby — whether you are in labor or not — you can call and speak directly with an obstetrician or nurse midwife.

Will I deliver by c-section or vaginally?

Your delivery plan is tailored for you and your baby’s needs.

A lot of decisions are determined by your baby’s condition and diagnosis. For example, many babies with cardiac conditions or gastroschisis can be delivered vaginally, while babies with conditions such as spina bifida or giant omphalocele are generally delivered by c-section.

Even if we plan for a vaginal delivery, if you or your baby have any trouble tolerating labor, we will change the plan to deliver by c-section to speed the safe delivery of your baby.

Can I have a support person with me when I’m giving birth?

Yes. Whether you are having a c-section or vaginal delivery, you can have a support person with you during the birth process. Your support person should be someone you can confide in and trust.

For c-section deliveries, you can have one support person in the delivery room with you. For vaginal deliveries, there is more flexibility with the number of people who can be in the birthing room to support you and witness the birth.

Please discuss your plan with your nurse or midwife. She can answer any specific questions you have.

Will there be anesthesia?

Yes. Obstetrical anesthesia is available in the hospital 24 hours a day.

You will meet with an anesthesiologist during your pregnancy to determine your options for the birthing process. Some decisions — like whether to have a c-section or vaginal birth — will depend on your baby’s condition and your health.

For women planning a vaginal delivery, we offer epidural anesthesia to ease some of the discomfort of labor. For c-section deliveries, we generally use spinal anesthesia. For fetal surgery or any type of fetal procedure — such as prenatal repair of spina bifida or treatment for twin-twin transfusion syndrome — we use anesthesia to meet your baby's condition and your needs.

Talk to your nurse or anesthesiologist if you have additional questions.

Who will be monitoring my baby and me during labor and birth?

You will have a team of obstetricians, maternal/fetal medicine specialists, nurses, nurse practitioners, midwives and other healthcare professionals caring for you and your baby before, during and after birth.

What will happen to my baby after he/she is born?

A neonatal surgical team attends every birth. The team includes a neonatologist, neonatal surgical nurse practitioner, several nurses and a respiratory therapist. 

When your birth is getting close, the SDU staff notifies the neonatal surgical team, who assemble in an infant stabilization room next to your birthing room and prepare to receive your baby well in advance of your delivery. The two rooms are connected by a pass-through window so your baby can be easily transported to the expert neonatology surgical team for assessment, stabilization and any procedures that may be required.

This neonatal surgical team has all the information about your baby and your baby’s diagnosis, as well as years of experience treating all birth defects. They are prepared for anything that could happen.

Once your baby is stabilized, your child typically is brought back into the room with you and your family so you can see your baby. Then your infant is transferred to the neonatal/infant intensive care unit (N/IICU) — where the same neonatal team will care for him or her — or to the cardiac intensive care unit (CICU). If your baby is transferred to the CICU, the neonatology team will fully update the cardiac team that will care for your baby.

Where will my baby be cared for after birth? Who will be monitoring him/her?

Most babies will go to the neonatal/infant intensive care unit (N/IICU). Babies with cardiac conditions will go to the cardiac intensive care unit (CICU) after birth. Both ICUs are located in the same building as the SDU; the N/IICU is an elevator ride to the second floor, and the CICU is next to the SDU.

On rare occasions, there is a well twin who will initially go to the N/IICU for a recovery phase and may return to the Special Delivery Unit to room-in with you.

When can I see and hold my baby?

Most moms are able to see and touch their babies immediately after birth. In some cases — when the baby is stable — you may be able to see your baby in the birthing room for a short time before he or she is taken to the N/IICU or CICU.

Once your baby is transferred and settled into the N/IICU or CICU, you will be able to visit your baby there. Generally, dads and partners are able to get to the baby’s bedside in intensive care sooner than moms because moms have a recovery period after birth and need to be monitored closely during this time. Our goal is to make sure you are safe and stable so you can better support your new baby.

If your baby’s condition is unstable, we will do whatever it takes to get you to your baby’s bedside.

How soon you can hold your infant depends on your baby’s condition. Some babies can be held fairly soon after birth and others can’t be held for days or weeks after birth. It depends on your child’s diagnosis, condition and the type of monitoring equipment they have.

Even if you can’t hold your baby, you can always touch him or her and do other supportive things for your child. You can talk, sing or read to your baby. You can caress your infant or hold your baby's hand.

How often can I visit my baby?

You can visit your baby as often as you are able. Visiting hours for parents are 24 hours a day.

How often can my family visit my baby?

Visiting hours for family members and friends are generally 10 a.m.-9 p.m. in the N/IICU and CICU. Initially, a parent may need to accompany visitors to visit the baby. If you want grandparents or others to be able to visit your child when you are not there, you will be able to create a list of approved visitors for your child. Your child’s nurse can help you with this.

Can my other children see/visit the baby?

In some cases, siblings can visit the new baby in the intensive care environment, but because the N/IICU or CICU can be intimidating to children, we encourage you to first talk to our child life specialists.

These healthcare professionals can meet with your children during your pregnancy, engage in some play therapy and introduce them to the tubes, wires and monitoring devices helping the newest member of your family. Talk to your nurse in the SDU or your child’s nurse in the N/IICU or CICU to initiate this process.

Can I breastfeed my child?

We encourage you to provide milk to your baby. Whether you can put your baby to the breast is largely dependent on your baby’s condition.

We have a doctorally-prepared nurse leading the lactation department. Diane L. Spatz, PhD, RN-BC, FAAN, is an active clinician, researcher and educator who is world-renown for her expertise in the provision of human milk/breastfeeding in mothers who have infants with complex surgical anomalies. 

Our team of lactation experts do a wonderful job preparing you to provide essential nutrients to your baby by pumping your milk. There are breast milk refrigerators in the Special Delivery Unit, the N/IICU and the CICU where you can store your milk at the correct temperature until it can be used for your baby. Each mom has her own bin and every bottle is labeled with mom’s name and baby’s name.

In addition to our certified lactation specialists, many of the nurses in the intensive care units are trained breastfeeding resource nurses and can answer questions about breastfeeding, pump rentals and insurance coverage for pumps after you are discharged from the Hospital. See our breastfeeding page for more information. 

How long will my baby stay at the Hospital?

It depends on your baby's condition, response to treatment and gestational age at the time of delivery. For example, a baby with gastroschisis may undergo surgical repair within a few days of birth, but the N/IICU team still has to work with the baby to feed orally and ensure the bowels are working properly, which can take weeks to months.

Your doctors and nurses will talk with you about your baby’s specific treatment plan.  Rest assured, when you baby is ready to leave the hospital, you will be prepared to care for him or her.

After I’m discharged, can I stay at the Hospital overnight if I’m visiting my baby?

Some sleep rooms are available at the Hospital. They are generally granted on a first-come, first-served basis and are intended for families most in need — such as if a baby is unstable.

There are reclining chairs at all bedsides in the N/IICU and couches in some of the CICU rooms where one parent may sleep.

We welcome you to be at your baby’s bedside as much as you want, but we also want to make sure moms who’ve recently delivered get the rest and proper nutrition they need to heal.

When my baby comes home, how will I know how to care for him/her?

You’ll get to know your child very well in the Hospital. You will be touching your baby, and helping to diaper and bathe him or her with the help of nurses in the N/IICU or CICU.

You will also learn about your child’s unique care needs. You will become comfortable with the special devices or equipment your baby needs and learn how to provide specialized care for your child.

You can learn basic and specialized skills needed to help care for your child in the Hospital and at home in the Connelly Resource Center for Families, located on the eighth floor of the Hospital.

All parents receive education on infant CPR and car seats, but additional classes are customized to the needs of your child and could include tube feeding, injections, central line care and more. Education sessions are scheduled with a nurse who is able to answer your questions and address specific concerns. 

What other resources for families are available?

There is a wealth of available resources for families including long-term follow-up care, social work, lactation, support groups, pastoral care, language services, child life, directions, behavioral health, our Connelly Resource Center for Families and more. Please see our resources for families for more details. 

March 2012

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