Wednesday, June 17, 2009

The trouble with NICUs

I have been chewing this one over for more than a month because the idea is so distasteful. But alas, I feel compelled to write about it because a friend's baby, born a little bit early but weighing more than 5 pounds, was in the NICU for no great reason and she had to go home without him.

So here it is: At a recent maternity care conference, a couple people had the courage to speak out regarding the "elephant in the room," ie. neonatal intensive care units as the new cash cows for hospitals. These specialized units are popping up even well outside the realm of the urban teaching hospital. And more babies are being sent there. If more babies need NICUs than ever before, that is alarming and we need to ask ourselves why (too many c-sections, perhaps?. If more babies don't need them but the hospitals do, that is horrible, and probably unethical.

For skeptics who may ask, "What is the harm in providing extra services for borderline cases," such as my friend's baby?

Atul Gawande's piece in a recent New Yorker explains it far better than I could.