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Inova's Miracle Manger

Loudoun Inova's NICU Treats Newborns After Just 28 Weeks in the Womb

So, imagine you’re on a 90-mile road trip to see the in-laws, riding on of all things a donkey, and you’re very, very pregnant. After days on the road, you’re exhausted and there’s no place but a stable to sleep. Even in such conditions, with the grace of God, a manger might suffice.  

Now, imagine that – rather than being born in the fullness of time – the infant was only 28 weeks along in his mother’s womb. What would have been his chances then?

Here in Loudoun County’s new state-of-the-art, 24-bed, level-three Neonatal Intensive Care Unit (NICU), they’re excellent, even at the height of a pandemic. According to the March of Dimes, as recently as two years ago, one in 11 babies in Virginia were born prematurely -- though only in extreme cases after just 28 weeks in utero. The mother of one such premie, Lindsey Holdaway, related what that was like:

"My daughter was born at Inova Fair Oaks. I had HELPP syndrome (a severe form of preeclampsia which causes organ failure) and COVID positive upon admission for a C-section to take her out at 28 weeks. She was at Inova Fairfax for about two months and then transferred to Inova Loudoun for almost 3 weeks. Her weight at birth was 1 lb., 15 oz. Her weight in order to be discharged needed to be above 4 lbs. Having a baby in the NICU was challenging enough, but the added fear of passing COVID to her tiny child added a layer of stress. "The first time I kissed my baby on her forehead was the evening before we took her home. We were staying in Inova Loudoun NICU's luxurious overnight suite. I had just finished feeding her, had taken off my mask and absentmindedly dropped my chin and planted a tiny kiss on her sweet, soft forehead. I recall gasping and being shocked that I had not kissed her sooner, but, honestly, I had not felt comfortable doing so prior to that moment.”

During the time her daughter stayed on at Loudoun Inova's NICU, Lindsey worked on her laptop from her baby’s room during the day, then left to sleep at home. “During the night shift, I called every three hours and was always welcomed by the nurse." When she called, the charge nurse on duty passed her to her baby's nurse who, "had my daughter, Arabella, in her arms and was holding her, singing to her, snuggling her, and just providing her love. I have never felt so comforted to know that my child was being given such wonderful, loving attention even when I wasn't there.”

Melanie Schmidt’s daughter Gia (pictured here) spent only one night in the NICU, but the experience of having a private room and knowing that her daughter was just one floor below made all the uncertainty and separation bearable.

“The first time I walked into her room, she was hooked up to all kinds of wires,” as well as being fed intravenously to counter low blood sugar. “I remember having all these little outfits that I had packed,” she says, to show off the first grandchild on both sides of the family. Seeing her disappointment at not being able to fuss over her, her nurse Lisa said, “let’s have a photoshoot,” and swaddled her over her wires so they could take pictures. “It was something so small, but it literally made my day,” Melanie said.

Among NICU's other high-tech accoutrements are incubator webcams, so Melanie was able to text the login to her extensive Italian family. Soon her parents, siblings and cousins were all alerting her whenever Gia opened her eyes or spit up, she laughed.

For those who need to leave the hospital with monitoring equipment, there’s even a special Family Transition Room resembling a hotel suite with a queen-sized bed and bassinet, plus emergency call button for the nurse. “It’s a test-run space for families before they’re discharged so they can build the confidence to say, ‘okay, I can do this,’” Melanie explains.

NICU patient alumni are so grateful for their care that they have, for 15 years, conducted annual reunions with hospital staff. This year's Halloween tribute featured an outdoor drive-by parade with at least 150 children whose earliest days were spent in the constant care of unit nurses and specialists. Even the tower's designer had a son whose early days were spent there. He drew on his own experiences and those of parent advisors to help design the current NICU, from a  patient's perspective.

The new NICU is part of Inova’s new 228-bed patient tower in Lansdowne, and represents a doubling in size of its birthing services. In construction since 2017, the tower opened in April, just as the need for COVID care peaked in Northern Virginia.  

A woman of strong faith, as well as a licensed minister, Inova Loudoun President Deborah Addo credits God's timing with the facility's completion. Noting this magazine’s own Proverbs 3:5-6 credo, she said, “I absolutely believe that when it says, ‘In all thy ways acknowledge Him and He will direct thy path.’ that my path has been directed. I don’t think it is accidental that we opened that new hospital tower at exactly the right time – in April. It was just before the height of the pandemic in this region. Had we not done that, we would have been overwhelmed with patients and no place to put them. That was another one of those things where people might call it coincidence, but for me it was divine intervention. I ask God every day to order my steps so we’re able to do the right thing for our community.”

What that looks like for Deborah is growing as the community grows, and drawing on the extended INOVA facilities for expertise, equipment and research as needed.

“On a day like today we have 17 newborns in the nursery, and 11 babies in the NICU. You look at that and say, there are some things that we’re doing very, very well but there still is opportunity for growth.” The work of Inova doesn’t end when a patient is discharged, but continues through consideration for their eating habits, living conditions and access to care. “I think COVID showed up in a way that told us the differences in our demographics and those who were hospitalized vs. those who were not,” she explains. 

Reflecting on 2020 she says, "While COVID 19 has been A story I don’t want to make it THE story because in the middle of everything else, on a day like today we have probably 14 COVID positive patients, but 35 in our NICU and The Birthing Inn facility. While for some life is complicated and for some it has ended, we have seen many more beginnings at our hospital than we’ve seen endings."

“I’m proud of where we are but I don’t want people to think that just because we live in the healthiest and wealthiest and highest educated region that we don’t still have pockets that aren’t experiencing the same outcomes that everybody else is. There’s a lot of work to be done... God is still in control of it all."

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