NICU Basics for Doulas
Most of us spend our birth work hours in labor rooms, living rooms, and postpartum kitchens. The NICU has been the place our clients went after we said goodbye at the door.
That's starting to shift.
Slowly, more families are asking their birth worker to stay close when baby needs extra care. Some hospitals are opening the door a little wider. And even when we can't be in the unit, our clients are texting us from it, trying to make sense of what they just heard on rounds.
The more we know, the better we can serve them.
So for this Monday Mentoring, BirthPro mentees get a NICU basics overview from Heidi Terpening at Azure Coast Doula, a NICU nurse of 27 years. Consider this post a little warm-up before the session.
Walking in for the first time
Picture a parent a few hours after birth, maybe in a wheelchair, maybe still shaky from the epidural or the surgery. They scrub in at a sink. They walk past rows of little beds with lights and screens. Somewhere an alarm goes off and nobody seems worried about it except them.
Then they find their baby, under a clear cover, with wires and tubes and a tiny hat.
It's a lot.
Words like desat, gavage, and corrected age start flying. The team speaks fluent NICU. The parent is still catching their breath.
This is where a birth worker who knows the language can help. The medical team holds the clinical answers. We can sit with a parent after rounds and say, "Let's go over that again together," in plain words, at whatever pace they need.
A starter glossary
Here are some terms families hear in the first days. Heidi will go deeper, and every unit has its own shorthand, so treat this as a beginning.
The space and the people
Term | What it means | One way to say it |
NICU levels (I to IV) | How much specialized care a unit offers. Level IV units care for the most complex babies and surgeries. | "This tells you what kind of care this unit is set up to give." |
Neonatologist | A pediatrician specializing in newborns who need intensive care | "The baby doctor who leads the team here." |
NNP | Neonatal nurse practitioner, an advanced practice nurse who writes orders and manages care | "A nurse practitioner who works closely with the doctors." |
Rounds | When the team meets at the bedside to review each baby and make the plan | "Parents are usually welcome. It's a great time to ask questions." |
Isolette | An enclosed, clear bed that keeps baby warm and protected | "A little incubator that holds heat and quiet." |
Radiant warmer | An open bed with a heater overhead, used when the team needs easy hands-on access | "An open bed with a warming light above." |
Breathing and monitors
Term | What it means | One way to say it |
Pulse ox / sats | A sensor, often on a foot or hand, measuring oxygen in the blood | "That glowing light tracks how much oxygen baby has." |
Desat | Oxygen level dips below the target range | "Baby's oxygen went lower for a moment. The team watches how often and how quickly it comes back." |
A's and B's | Apnea (a pause in breathing) and bradycardia (a slower heart rate), common in premature babies | "Little pauses that many preemies have while their breathing control matures." |
Nasal cannula | Soft prongs in the nose delivering oxygen or airflow | "A light breathing boost through the nose." |
CPAP | Continuous positive airway pressure, steady air pressure that keeps small lungs open | "Gentle pressure that helps baby's lungs stay open between breaths." |
Ventilator | A machine that breathes for baby or supports each breath | "The machine is doing some of the breathing work so baby can rest and grow." |
Surfactant | A substance that keeps the air sacs in the lungs from collapsing; premature babies may receive it as a medication | "Something mature lungs make on their own. Baby's getting a little help with it." |
Feeding and growing
Term | What it means | One way to say it |
IV / TPN | Fluids or full nutrition given through a vein | "Nutrition going straight into the bloodstream while the gut gets ready." |
UVC / UAC, PICC | Lines placed in the umbilical cord or a larger vein for fluids, medications, and blood draws | "A more stable line so baby doesn't need as many pokes." |
Gavage, NG or OG tube | Milk given through a small tube from the nose or mouth into the stomach | "Baby gets milk without spending energy on sucking yet." |
Donor milk | Screened, pasteurized human milk from a milk bank | "Banked milk that can fill in while your own supply comes in." |
Feeding cues | Signs baby is ready to try feeding by mouth, like rooting or sucking on a pacifier | "Baby's showing us they're getting ready." |
Bili lights | Phototherapy, blue light that helps break down bilirubin and treat jaundice | "The light helps baby clear the yellow color from their skin." |
Time and milestones
Term | What it means | One way to say it |
Gestational age | Weeks of pregnancy at birth | "How many weeks along baby was when they were born." |
Corrected (adjusted) age | Age counted from the original due date, used to track development | "We count from your due date so milestones make sense." |
Kangaroo care | Skin-to-skin holding with a parent | "Holding baby on your bare chest. It helps with warmth, breathing, and bonding." |
Discharge criteria | What baby needs to show before going home, often steady breathing, holding temperature, and feeding well by mouth | "The checklist for heading home." |
Where we fit
Knowing the words is one piece. Knowing our lane is the other.
Our role is translation and presence. Questions about a specific number, test, or treatment go back to the team, and we can help a parent get ready to ask them.
A few ways that looks in practice:
Write questions down together. Rounds move fast. A short list on a phone makes it easier to speak up.
Encourage parents to join rounds when the unit welcomes it. They're part of the team.
Support milk expression early. Pumping within the first hours after birth, and often after that, helps build supply. Connect families with the unit's lactation staff.
Talk up kangaroo care. Many parents assume they can't hold a baby with wires. Often they can, with the nurse's help.
Care for the parent's body too. They're postpartum. Water, food, pain relief, rest, a real chair.
Notice the emotional load. Fear, guilt, numbness, and big love can all show up in the same hour. Know your local perinatal mental health resources and when to refer.
Remember partners and siblings. Everyone in the family is adjusting.
And if you're ever unsure whether something is yours to answer, it's always okay to say, "That's a great one for your nurse. Want to ask together?"
Meet Heidi
Heidi Terpening spent 27 years as a nurse, in both Labor and Delivery and the NICU. Today she's a birth worker too, with Azure Coast Doula. She knows the unit from the inside, and she knows what it feels like to stand beside a family who just walked in.
She'll walk BirthPro members through NICU basics: what the space looks like, who's who, and the words families hear most. Bring your questions. I promise...NICU is a mystery to a LOT of us!
The tide is turning toward the NICU, one family at a time. The care you already bring to a birth room travels with you through those doors.
See you with Heidi on Monday, Nov 9! 💖
