Your Maternity Journey Vol. 6

A Thoroughly Modern NICU

There’s no doubt that preparing for a baby is exhilarating, but it can also be stressful. You’re taking care of yourself, eating right, and doing everything possible to ensure that your baby arrives healthy and safely. While we all work to help ensure everything goes smoothly, sometimes it doesn’t. In those situations, you need an experienced team of experts and the best resources available to help your newborn. We hope you and your baby will never need the services of a NICU, but knowing you have access to that level of care will give you peace of mind.

The MarinHealth Medical Center Level II Neonatal Intensive Care Unit (NICU) is the only place in Marin County that is fully equipped to care for infants needing extra medical attention. Staffed and equipped to treat all different complications that may present when a baby is born, including conditions related to prematurity, we provide neonatal intensive care for babies born at 32+ weeks gestational age and weighing more than 1500 grams. Babies born earlier than 32 weeks or with especially challenging health issues are transported to UCSF Benioff Children’s Hospitals in San Francisco or Oakland for intensive care. After these babies improve, they may be transferred back to our NICU, where they will be cared for until they can be discharged to the loving arms of their families.

UCSF Perinatologists and Neonatologists
High-risk pregnancies are stressful enough without having to leave Marin for treatment. That’s why we have UCSF Health experts onsite to help moms bring high-risk pregnancies to term and to care for newborns with special health issues. In addition, pregnant women with type 1, type 2, or gestational diabetes can get special advice and supervision from our Braden Diabetes Center.

Unlike the one-room NICUs of old, our state-of-the-art, 7-bed NICU has a bay for each tiny patient so that parents can bond with their newborn in private. We even have a special room for twins! All of our technology, including isolettes, ventilators, intravenous pumps, radiant warmers, and pulse oximeters, is best in class. Our services include advanced respiratory therapy, developmental care, phototherapy, daily nutrition consultation, NICU pharmacists, lactation assistance, and family support. We offer expanded testing and screenings for newborns, and we have onsite audiology equipment for hearing screenings.

Our NICU is staffed around-the-clock with an in-house pediatric hospitalist who specializes in neonatology (the care of newborns). The care team also collaborates with the infant's private physician and we consult with the UCSF Benioff Neonatology team 24/7. Our interdisciplinary team meets twice a day to discuss every mother and baby.

Supporting Parents

Caring for a delicate, underweight baby can be quite intimidating, especially for first-time parents. Our expert NICU nurses give parents hands-on instruction in feeding, bathing, and diapering their tiny newborn. We offer special support for the parents of our NICU babies, including rooms parents can stay in overnight while their baby is in the NICU (pending availability).

Take a virtual tour of MarinHealth Medical Center’s NICU to learn more about the extraordinary care we provide.

The Bump is Just the Beginning: Surprising Pregnancy Body Changes

Pregnancy is a series of small changes on the way to the big change: becoming a mother. It’s only natural to focus on that ever-growing bump, but your body is literally changing from head to toe. If you’re puzzled by some unexpected symptoms or issues, you aren’t alone. Just take a look at all of these changes that can be a perfectly normal part of pregnancy:

Bleeding gums. Oral health is especially important because many women get more cavities during pregnancy. Some women also experience bleeding gums, gingivitis, and halitosis so this is no time to skip your dental appointments.

Extra saliva. Pregnancy hormones can cause you to salivate more, and more frequently. Nausea increases saliva production as well.

Voice changes. Estrogen and progesterone may cause a slight swelling in your vocal cords. Singers sometimes find they lose a few high notes while gaining a lower register they never knew they had!

Nasal congestion. In some cases, bad morning sickness or heartburn comes with a stuffy nose. Try sleeping with your head elevated, take a warm shower, or fill a sink with hot water and “steam” your face to clear sinuses. (Avoid saunas, hot tubs, and steam baths which elevate your body temperature.)

Tummy troubles. Just when the morning sickness is finally behind you, the heartburn begins. Pregnancy hormones cause smooth muscle to relax and this can lead to gastrointestinal (GI) issues such as acid reflux, heartburn, gas, bloating, and constipation. Do not take over the counter medication for these symptoms without first checking with your doctor.

Sensory changes. Many women experience a heightened sense of smell and taste, an evolutionary defense mechanism to protect you from eating something spoiled. Some women get a strange metallic taste in their mouths or develop aversions to foods they normally relish. You may find yourself suddenly disgusted by certain smells, such as smoke, fried foods, meat, greasy foods, or coffee.

Skin changes. The skin is the body’s largest organ and pregnancy can cause it to change in many ways:

• Pregnancy causes the body to make more pigment. This may manifest as chloasma, brownish or yellowish patches on your face. Some women develop a dark line down the midline of the lower abdomen, known as the linea nigra. Your nipples, external genitalia, and anal region may also darken. Existing moles and freckles may get larger and darker. If you develop chloasma, minimize its effects by staying out of the sun as much as possible and wearing sunscreen.
• Increased blood volume during gestation can stimulate the sebaceous glands, resulting in acne.
• It’s not uncommon to notice hair growing on your stomach, chin, arms, and other areas. This will quickly disappear after birth.
• If you are pregnant during the warmer months, you may perspire more and develop heat rash.
• The skin on your belly may feel itchy and dry as it stretches. Your doctor can recommend special creams to soothe dry, itchy skin.
• Stretch marks are very common. While the skin changes listed above will go away over time, stretch marks never quite disappear.

Hair and nails. Many pregnant women notice changes in hair texture. Hair and nails will also tend to grow faster. While some women say their nails are stronger, others find that their nails split and break more easily. Hair and nail changes are temporary and will revert back to normal postpartum.

Bladder glitches. There’s a reason that sympathetic older women will let you get ahead of the line for the bathroom: they remember what it’s like to always have to pee! As your baby grows, your uterus exerts increasing pressure on your bladder. You may even experience leakage when coughing, sneezing, or exercising.

Toilet troubles. The extra progesterone your body produces during pregnancy slows down the passage of food through your gastrointestinal tract, leading to constipation. This can worsen in the third trimester, when your uterus may push against your large intestine, interfering with bowel movements. Straining a lot to go to the bathroom enlarges the veins of the rectum, leading to the formation of hemorrhoids. To stay regular, eat a fiber-rich diet, stay hydrated, and exercise regularly. Stool softeners (not laxatives) may also help, but check with your doctor before taking them, or any over the counter medicine.

Breast enlargement. One of the first signs of pregnancy is an increase in breast size. That first trimester growth may continue throughout your pregnancy. Pregnancy also increases your lung capacity, which may literally expand your chest. You could go up several bra sizes as your pregnancy progresses. Some women experience breast discharge starting in the middle of the second trimester. This is perfectly normal and is a sign that your body is preparing for breastfeeding.

Varicose veins. Pregnancy hormones make your veins larger to accommodate the increased amount of blood in your body. When blood pools in those veins, it can lead to varicose veins. These frequently go away after pregnancy. To help prevent them from developing in the first place, avoid standing or sitting for long periods and put your legs up when you’re seated.

Loose joints. In order to prepare your pelvis and birth canal for delivery, your body makes relaxin, a hormone that loosens the ligaments. This has the overall effect of loosening ALL your ligaments, which can affect balance and stability, especially as your center of gravity changes. This raises your risk for strains, sprains, and overstretching, especially the joints in your pelvis, lower back, and knees. Be careful when exercising or lifting things and avoid sudden, jerky movements.

Fat feet. Are your shoes starting to feel a little tight? You’re not imagining it. Your feet are “growing” for two reasons: relaxin loosens ligaments in your feet, and you are retaining extra fluid. Sandals, slides, and flip flops will be more comfortable, especially in your last trimester. Some women find that their feet remain a half size larger after birth—a perfectly good excuse to get new shoes after the baby arrives!