When Megan Balderson was 16 weeks pregnant with her first child, she was diagnosed with placenta previa, a condition where the placenta lies low in the uterus, which can cause severe bleeding in the mother and lead to premature delivery.
“We knew from that point that we needed to get to at least 28-30 weeks gestation so the baby’s lungs would be more developed,” recalled Megan, whose pregnancy was considered high-risk.
In July 2017, Megan and her husband, Mark, were visiting family about two hours from their home in Richmond when Megan experienced heavy bleeding. Mark drove her to the closest community hospital, which did not have labor and delivery care or a neonatal intensive care unit. After trying to get Megan transferred to a hospital closer to home, Mark said VCU Health agreed to send the airflight team. Within 90 minutes Megan was in the hospital where she was closely monitored for the next week.
Although the baby’s development was progressing well, Megan developed pre-eclampsia, a potentially dangerous complication characterized by high blood pressure. When both Megan’s and the baby’s blood pressure dropped, Megan was rushed to the operating room for an emergency cesarean section. Even though her blood pressure returned to normal before surgery, because of her other pregnancy complications and, at the advice of her doctors, Megan delivered daughter Aubrey by C-section later that day.
“Aubrey weighed three pounds, one ounce,” Mark recalled, “and could fit in the palm of my hand.”
Our NICU team was also in the operating room ready to care for Aubrey, another benefit of delivering at VCU Health where both moms and babies can get the expert care they need for complex medical conditions. Mark said seeing that the team didn’t appear rushed eased the new parents’ concern. However, just as he was preparing to go to the NICU, Megan began hemorrhaging and needed an emergency procedure. It would be another four hours before Mark could visit Aubrey.
“The doctor told me, ‘Don’t be surprised if you don’t get any reaction from your daughter right away because she’s only 32 weeks old,’” Mark said. “But as soon as the NICU door opened, I started talking, and Aubrey immediately turned to me and started crying.”
For the next few days, Mark spent hours providing skin-to-skin contact until Megan was healthy enough to meet Aubrey. Initially nurses brought Aubrey to Megan’s room. Once Megan was well enough, she visited Aubrey in the NICU. After she was discharged, Megan visited the hospital daily, arriving before Aubrey’s first feeding and staying until late in the evening. Mark worked during the day and visited the hospital at night and on weekends. Although the NICU’s private rooms have space for parents to stay overnight, Megan and Mark live close enough that they were able to go home at night.
Within a couple weeks, Aubrey moved from an incubator to an open crib, and while she didn’t need supplemental oxygen for long, she used a feeding tube during most of the eight weeks she spent in the NICU. During that time, Megan also developed strong bonds with Aubrey’s care team, especially her NICU nurses.
“The nurses helped me navigate everything,” Megan recalled. “When we brought Aubrey home, it was an easy transition because of the support we’d had from the nurses.”
Our NICU was the state’s first when it opened 50 years ago and is the region’s highest level NICU today. This year, neonatology was one of eight CHoR specialties listed in U.S. News & World Report’s 2023-24 Best Children’s Hospitals rankings. Designations are based on factors such as clinical outcomes, level and quality of hospital resources directly related to patient care and expert opinion among pediatric specialists.
In the NICU, patients have access to care from any specialist as well as pulmonary and cardiac resources. The NICU team includes neonatologists, neonatal nurse practitioners, nurses, therapists and other dedicated roles to support patients and families.
Parents are encouraged to be involved from the beginning, learning to care for their baby while in the NICU and in preparation for returning home. Once patients are discharged, we continue following them through our Neonatal Continuing Care Program.
When Aubrey was six months old, she was evaluated through this multi-specialty clinic, where specialists noticed the optic nerves in her eyes hadn’t developed. She also was followed by our ear, nose and throat team for the first year to monitor her ears. When she was three years old, Aubrey began wearing glasses to help two stigmatisms and continues to visit our ophthalmologists annually. She has otherwise met or surpassed all developmental milestones.
Because they had such a good experience at CHoR, when Megan got pregnant with their son, Wells, she and Mark chose to deliver at VCU Health, just in case they needed NICU care. Although they didn’t need them, Megan said knowing the resources were available was “very calming.”
Mark and Megan are thankful for the chain of events that brought them to CHoR and our neonatology program.
“You know you’re in the best hands,” Megan said of the NICU team. “Aubrey got the best care at CHoR.”
Story by Alissa Poole originally appeared in Children's Hospital Foundation magazine, Young at Heart.
Photos of Aubrey and Aubrey/Wells by Doug Buerlein
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