Welcome to the start of REPRO MATTERS: A Series on Reproductive Matters From A Feminist Perspective. In future blog posts, I’ll explore a number of issues related to reproductive health and rights, including birth control, pregnancy loss, prenatal and postpartum mental health, safe sex, consent, birth injuries, abortion, and more.
I’ve spent a lot of time writing about childbirth (and loss), and life in the NICU. These topics are near and dear to my heart. Ever since my daughter was born (and died) and my son was born ill (but survived), I’ve been exposed to a whole other realm of pregnancy, birth, and motherhood (and therefore, other reproductive matters) I never knew existed.
Because I’m so entrenched in the world of high-risk pregnancy and infant loss, it’s easy for me to assume that everyone else is just as well-versed. But truth is, most folks don’t know much about the NICU (or related topics) at all. Although TV shows like This Is Us and Grey’s Anatomy have highlighted the struggles of parents experiencing a difficult birth or loss, these topics are still fairly taboo.
As a feminist, as a loss mom, as someone who has experienced high-risk pregnancy, as someone who has spent months on end inside a NICU…I feel it’s my responsibility to discuss these matters and spread awareness beyond textbook definitions.
So, What Is The NICU?
The NICU, or neonatal intensive care unit, is the unit within a hospital that specifically cares for sick and premature newborn babies. The NICU is staffed by neonatologists (who specialize in caring for sick and premature infants), NICU nurses, and other specialists. Depending on your hospital, there may or may not be a NICU on-site. There are also different level NICUs.
A Level I is mainly used for babies who are 35 weeks or older, and/or as a temporary home for babies who need to be transferred over to higher level NICUs. At Level II, you’ll find newborns as young as 32 weeks, or ones who are recovering from a stay in a Level III or IV. This is also the holding place for babies who need to be transferred out for more intensive care. Level III NICUs have pediatric surgeons as well as a variety of specialists available around the clock, the ability to provide long-term life support, and care for infants born at any gestation. Although these facilities are rare, there are also Level IV NICUs, which provide the highest possible level of care.
Pregnant persons should always look into whether the hospital at which they plan to deliver has a NICU, especially if they are high-risk. Those planning on having a home birth should also look into whether there is a NICU nearby in the event of an emergency. While I firmly believe all parents should give birth where they feel most comfortable and what is best for their family, as someone who has experienced a loss as well as a home birth-to-hospital transfer, I prefer to err on the side of caution. I wouldn’t recommend being further than 10 minutes from a Level II NICU, especially if you’re a first-time parent.
Why Feminists Need to Know About The NICU
Even if you decide not to (or are unable to) have any children of your own, your feminism should still be intersectional enough to exclude the experiences of pregnant persons, parents, or children.
The NICU is an important place for many families. While no pregnant person (mom or otherwise) wants to think about the possibility of their baby being born too soon, it’s better to be informed and prepared just in case. According to the CDC, prematurity affects roughly 1 in 10 births, with black mothers having statistically higher rates of preterm labor. And according to the March of Dimes, prematurity rates have grown for the first time in 8 years.
Folks can take precautions in the hopes of avoiding preterm labor, or at the very least, educate themselves and others on the causes and symptoms. But one has to wonder, why are prematurity rates going up in this country?
Low socioeconomic class clearly increases these risks. Is it related to lack of access to proper health care? And why do so many people lack access to proper health care? Here’s a simple chart for that from the Kaiser Family Foundation:
People WANT health insurance. People NEED health insurance to obtain proper medical care. And because we don’t make it accessible to mothers and parents-to-be, it increases the chances that pregnant persons will either lose a pregnancy or find themselves giving birth to an ill child.
We also have to ask, why are black women disproportionately experiencing higher rates of preterm labor? Is this a class issue as well? Undoubtedly. According to the Economic Policy Institute, black americans have the highest poverty rate in the country, at 27%, while nearly half of all black children are born into poverty. That means black mothers and black parents are struggling to afford health care, are unable to receive the same quality of care as most white folks, are at greatest risk of being able to detect any health problems within mothers/parents and babies, etc. This means more black parents could end up with babies in the NICU, but worse, it could mean many more black parents could end up NEEDING the NICU but are unable to get to one that can care for their babies, meaning their babies could end up sicker or dead. That is not just a problem for parents with NICU babies. That’s an epidemic affecting low-income families and especially families of color across the board.
Mental health issues and also factor into prematurity. Why are we still not doing enough to address mother’s and pregnant person’s mental health needs? Why are so many women and other pregnant persons suffering in silence with prenatal and postnatal depression and anxiety? These issues can adversely affect a pregnancy by causing the pregnant person to seek less help for themselves, to care less for their bodies at a time when they need to make their health a top priority. But who is working toward destigmatizing mental health issues and making access to mental health care easier and more affordable? Medical disorders like thyroid issues, (all of which disproportionately affect women) are also major factors. So we have to also ask, why do female-bodied persons experience these issues at a higher rate than male-bodied persons?
There are so many questions, and no simple answers when it comes to why the NICU is such an important place and why we all, as feminists, need to come together to combat the reasons folks end up there in the first place. Caring about health care accessibility, about improving the financial state and agency of people of color? These things ALL tie into the NICU at the end of the day. Food for thought.
In my next installment, I’ll be discussing experiences in the NICU and tips for surviving as a new parent/supporting your friends and family in the NICU.