In the beginning, Ruscica and D’Ambra brought their parents and friends to the NICU to see their son. D’Ambra worked part-time and took a bus and then a train from their home in New Jersey to Morgan Stanley Children’s Hospital, in northern Manhattan, each day. But every day, it seemed, the bus and the train got emptier. March was like a narrowing tunnel, the light at the far end shrinking too fast. Soon, only Ruscica and D’Ambra were allowed on the ward. And then, one day in mid-March, the couple was told they had to choose which of them would be allowed to visit Caelan from then on.
“We get it,” D’Ambra says. “It’s a pandemic. We want Caelan to be safe, and there are how many other babies in there?” New York City was on its way to becoming a global coronavirus hot spot. But D’Ambra still found it crushing to leave the hospital that day, not knowing when he would see his son again, leaving Ruscica to face the terrors and tedium of the NICU alone.
The hospital had already been working on a pilot project to allow for virtual NICU visits, a HIPAA-compliant two-way video feed for parents to sing, pray, or read to their children, or even engage with the medical team on its daily rounds. Prompted by a New York measles outbreak in 2019, which had forced the NICU to ratchet back on visitation, the program had launched, tentatively, in January, but the pandemic prompted a rapid expansion. D’Ambra was able to beam in daily and to know that Caelan would at least hear his voice. For nearly a month, until his son’s discharge on April 14, the feed was their only form of contact.
Connecting parents and babies was only one complication for hospitals; managing another tenet of preterm care—providing as much breast milk as possible—also became fraught. Many preemies are born without the capacity to latch, suck, and swallow, so many birth mothers wind up pumping their breast milk, whether for feeding through a nasogastric tube that sends the milk directly to the baby’s stomach, or to be saved for later use when they’re able to swallow.
Often, that’s not as simple as it might sound. Preterm birth can complicate lactation, reducing milk supply, and while the ability to provide milk for your child can feel like a gift, it’s a heavy burden when it doesn’t go well. “I gathered that my daughter would be less likely to die if I could manage to … wring some milk out of myself,” the author Sarah DiGregorio writes in “What We Made,” an essay on pumping in the NICU. In the pandemic, hospitals have had to draft pages-long protocols for collecting milk. Both in the hospital and at home, mothers have had to work extra hard to keep their milk and equipment sterile, as have the hospital workers who then deliver their milk.
Spending days and weeks alone with her son in the NICU, Ruscica was almost constantly on edge, and pumping added to the stress. She tried to follow the pandemic sanitation protocol while pumping, but the crises kept coming. Sometimes his face turned blue from lack of oxygen and his monitor’s alarms would sound and she would jump up in terror, afraid that her child was dying, and spill the milk she’d carefully collected. After each of his emergencies had passed and her racing heart had slowed, there was nothing to do but clean herself up and start all over again.
Even in normal times, the rules of the NICU are not so different from those governing life in a pandemic. Here, parents are too often stripped of the small intimacies most others take for granted, and they endure the kinds of little losses we have all been grieving in this last year. Lindsey Pervinich did not get to feel the warmth of her baby against her chest immediately after giving birth, and a moment that might normally be filled with joy and relief was instead shot through with fear.