Baby Jack arrived, safe and sound. While his mother shivered uncontrollably from the effects of the anesthesia, Daddy and doctor hustled the newborn to the awaiting cubicle where he passed his first test with flying colors. But within minutes, the sigh of relief felt throughout the delivery room was interrupted as Jack’s prematurity manifested itself. Without explanation to mother, father, or grandmother, Jack was whisked away. With father in tow and Nani close behind, Baby Jack sped to the Neonatal Intensive Care Unit (NICU).

Preterm birth, the latest research shows, is the leading cause of infant mortality in the United States. According to CDC researchers, birth before 37 weeks of gestation accounted for at least one-third of all babies' deaths in 2002. Most of these, two-thirds, occurred within the first twenty-four hours. The technology and expertise of the special personnel in the NICU would give Baby Jack, born at 35 weeks, every opportunity to survive and beat the odds. If, along with nutrients, Baby Jack had acquired the indomitable spirit of his mother, his chances of survival looked good.

After two uneventful, textbook pregnancies, Kelly’s third pregnancy with her first son ran into problems at fourteen weeks. Continual bleeding, at times heavy, was diagnosed as placenta abruption. The large blood clot behind the placenta was reabsorbed partially over time, but ultrasounds also showed placenta previa, a low lying placenta that covered part of the cervix. These two major complications posed a threat to both the baby and Kelly.

Hope, though, burned brightly throughout Kelly’s ordeal. It enabled her to meticulously follow her doctor’s orders. She ate nutritiously and didn’t smoke or use alcohol. She visited her obstetrician regularly. Between hospitalizations, that meant twice weekly visits to the office or the hospital. Non-stress tests and ultrasounds for the baby became routine.

Most difficult of all for Kelly was the imposed bed rest. Caring for two active daughters, ages three and five, meant enlisting additional help from the already overburdened dad-to-be as well as friends, neighbors, and family. Meals were pre-cooked, babysitters volunteered their time, and Nani resurrected her chauffeuring talents. Kelly’s faith bolstered her. She prayed, she remained inactive, and she waited. All with the goal of prolonging gestation and increasing the baby’s weight. The amazement in the doctor’s eyes when Kelly continued to appear week after week for her appointments was subtle, but nonetheless evident to both Kelly and her mother.

During Kelly’s last hospital stay, with her “high risk pregnancy” doctor on vacation, Kelly faced her greatest challenge. The inexact science of medicine reared its ugly head. Two days after being dismissed from high risk care, Kelly once again suffered an emergency. The four doctors in her chosen medical practice couldn’t agree on what to do. Two wanted to “wait and see,” to give the baby more time in its natural environment. The other two wanted to go ahead with a planned delivery and thus avoid an emergency C-section. The hospitalist stepped in with another opinion. Each day the plan, or lack of one, changed.

Frustrated by the conflicting opinions and her worsening condition, Kelly and her husband decided to move from the community hospital to a major medical center in Boston. The evening the decision was made, nurses helped Kelly and her husband think through their options. Their expertise and caring gave Kelly the strength to listen to her inner voice. She urgently felt the need to bring Baby Jack into the world.

Kelly’s faith carried her through. The following day, in a planned C-section, the beautiful baby shed his yellow and cracking placenta and the grey umbilical cord that crumbled in the nurse’s hand. He wailed his first cry. Statistics show that only 7% of the deaths attributable to preterm birth occur after the first four weeks. Baby Jack made it through the first two weeks in the hospital, learning how to continue breathing on his own through the night and through his feedings and learning how to regulate his temperature. Now nine weeks old, Baby Jack has an emerging smile, and Kelly and her family maintain hope that the smile means “all systems are go” for Baby Jack.