If the hospital you gave birth in doesn't have the resources to care for them, they may need to be transferred to another hospital that has specialist intensive care facilities. Their medical needs will usually depend on their gestational age.
In utero transfer
Transferring your baby in utero (in your womb) is done where possible as it is safer for the baby. If your healthcare team have spotted that you are at high risk of having a premature baby who may need specialist care, they will do their best to ensure that you give birth in a hospital that has the facilities necessary to cope with these needs when your baby is born. This means that you may be asked for your consent to be transferred to another hospital in an ambulance while you are in labour or if you are at risk of going into labour soon. If there is a risk that your baby will be delivered en-route, or if there is a risk to your health, the transfer will not take place. Read more about in utero transfer here.
Levels of care
Special care baby unit (SCBU)
Also called the special care baby unit (SCBU, pronounced 'skaboo') or special care unit (SCU), these provide the most simple level of care for babies in their local area and stabilise a baby's condition before transferring them to another unit or provide emergency care if necessary. They may also provide some high-dependency services. They receive babies from other units once they are well enough to be cared for there. These were previously called Level 1 care units.
Local neonatal units (LNU)
Local neonatal units (LNUs) provide special care for babies in their local area, except for those who are very unwell and need complex or longer-term intensive care. The majority of babies over 27 weeks of gestation will usually receive their full care, including short periods of intensive care, within their LNU.
Neonatal intensive care units (NICU)
These specialist units have the facilities to care for critically ill premature babies. Babies will be transferred here from around the country to access the specialised expertise that they offer. They provide the whole range of medical neonatal care for their local population, along with additional care for babies and their families referred from the neonatal network.
Moving your premature baby to another hospital
Transporting a critically ill premature newborn is not easy but a specialist neonatal transfer team will ensure that the journey is as comfortable and as stable as possible for them. They will be taken in a special portable incubator to the nearest hospital that has the space and the facilities to care for their needs. Staff at that hospital will be alerted and prepared for their arrival.
Can I go with my baby?
If you still need hospital care yourself you will need to stay where you are until you are well enough to move. Your partner or a close family member can visit them and report back to you. If you need longer term care you may be able to be transferred once you are stable if there is a bed available.
Seeing your baby being wheeled away can be a very painful experience if you are desperate to hold and care for your little one. When a baby is born prematurely, time is often of the essence, and the team need to focus on making them stable as quickly as possible.
Focus on the fact that your baby needs this care, and that your time will come. As soon as your baby is stable, someone will come and update you.
After your baby is transferred you will have a chance to recover from the birth and sleep a little. You will have been through a lot, and your head may be spinning with everything you've been told about the health of your baby. Try to take this time to rest. You will need to keep your strength up so that you can meet the challenges that lie ahead.
What is 'back transfer'?
'Back transfer' simply means transferring your baby back close to you. It occurs when your baby is well enough to be cared-for at your nearest hospital. Your role in your baby's care is important for their wellbeing (visiting, holding, breastfeeding) and therefore the health professional team will aim to bring the baby back close to you if they have been transferred away when they feel they are well enough to be cared for there.
Support for you after the birth
This may be the first chance you've had to stop and notice how you are feeling. You may be desperately worried about your baby, and a lot of women have overwhelming feelings of grief and guilt. Try to talk things through with a loved one, or to a friendly member of staff at the hospital. To read more about your emotional health, see our section on Looking after yourself.
The best thing you can do for your baby is to look after yourself. That way, you will be better equipped to handle the challenges that face you and your family.
The neonatal intensive care unit (NICU)/special care baby unit (SCBU)/neonatal unit becomes the centre of the universe for parents of premature babies, so it's important to familiarise yourself with the way it operates.
The first few days after giving birth to your premature baby can pass in a daze. Here's what to expect...
Whatever your premature baby's birth was like, it will have taken a lot out of you, so try to rest and gather your strength for the days ahead. The medical team will assess your baby's health and start treating them if necessary.
Skin-to-skin contact with your premature baby is a wonderful way for you both to bond. It also provides health benefits.
The healthcare team will cater for your baby's medical needs, but they need you too. As you get to know your premature baby, you will begin to work out what they need.
Your premature baby's diet will be carefully balanced to suit their tiny digestive system while meeting the needs of their growing body.
Positioning your premature baby correctly can make them feel secure, improve their breathing ability, strengthen their muscles and reduce the risk of cot death.
You may be asked if you would consider taking part in research into premature birth. We explain what this might involve.
We answer some of your questions about your premature baby's time in the hospital and neonatal unit.
You're bound to feel anxious if your premature baby needs surgery, but try to focus on the positive: the operation is likely to help improve your baby's chances.
During their stay in the baby unit, your baby will have all kinds of checks to monitor their progress.
If your premature baby has any of the conditions below, ask the healthcare team to explain anything that you don’t understand.
Babies born prematurely are more likely to have problems with their eyesight and hearing, but in most cases treatment is successful.
Premature babies have less developed immune systems and are more susceptible to infection, but there are ways to reduce the risk.
It's worrying if you discover that your baby has a heart problem, but most defects are treatable and some do not even need treatment.
Many premature babies need help with breathing for a while. This is known as ventilation.
- BAPM (2008) Management of acute in-utero transfers: a framework for practice,British Association of Perinatal Medicine
- Mears M, Chalmers S (2005) Neonatal pre-transport stabilisation – caring for infants the STABLE way, Infant, Vol 1, p1
- NHS Cambridge University Hospitals (accessed Feb 2012) Acute Neonatal Transfer Service (ANTS), http://www.cuh.org.uk/rosie/services/neonatal/transport_services/faqs.html
- NHS and Department of Health (2009) Toolkit for high quality neonatal services, p10
ℹLast reviewed on April 1st, 2014. Next review date April 1st, 2017.