Miracle.

Our baby is a miracle.  I know, all babies are miracles, really, but let me just lay some things out for you here.  A baby is considered premature if he/she is born before 37 weeks gestation.  One out of every 8 babies is born premature, and prematurity is the leading cause of infant death.  A micropreemie is a baby born before 26 weeks gestation and around 1 3/4 pounds.  If a baby is born before 20 weeks, it's considered a miscarriage; at 22 weeks, very few doctors will try to resuscitate the baby because there is such a large chance of death no matter what they do, or if they survive it's almost certain the baby will have severe neurological problems.  The gestational age that's commonly considered the limit of survival outside of the womb is 24 weeks.  When was Aubrey born? Twenty-four weeks and 3 days.  The fact that she was born crying and kicking is amazing. She is a miracle.

Babies born in the zone between 23 and 25 weeks of gestational age are faced with a plethora of problems to overcome.  The first huge obstacle is breathing: even babies born before 37 weeks  face potential lung problems as that is usually the last system to finish developing in utero.  A baby born at 24 weeks has not begun making the air sacs it needs in the lungs to breathe properly.  Also, a substance called "surfactant," which helps the lungs open up at birth so the infant can breathe, hasn't begun to be produced until between 24 and 28 weeks gestation, and is not produced in sufficient quantities until 35-37 weeks.  Corticosteroids are given in shot form to the mother if the doctors think the baby will be born prematurely (thankfully I received 2 shots before Aubrey arrived)--this helps the baby produce surfactant.  Many preemies have respiratory distress syndrome, or RDS, which is a condition that makes it difficult for the oxygen that comes through the lungs to pass into the blood.  Aubrey was given artificial surfactant, but only needed the assistance of a ventilator to help her breathe for about 2 days after she was born.  She has been breathing on her own (with the exception of 2 days back on the vent to rest her lungs) since then.  Many preemies spend weeks and months on a ventilator.  She is a miracle.

Another enormous obstacle preemies face is sepsis, or infections in the blood.  Aubrey's skin was so thin and fragile when she was born that we could see her capillaries through it all over her body.  Skin is normally the body's first line of defense against infection; added to that, she had many foreign objects going into her in the form of IV lines--those were places in which bacteria could easily invade her tiny body.  Also a cause for concern was the fact that since she was born before the third trimester, she didn't receive any of the immunities that newborns are supposed to get from their mothers in the last 3 months of pregnancy.  These factors left her wide open to an array of infections, including necrotizing enterocolitis, which causes death of intestinal tissue in preemies and can be fatal.  Dr. Sharp told us early on that most preemies have an average of 4.5 infections while in the NICU.  As of now, Aubrey has not had a single one (we are praying it stays that way).  She is a miracle.

Something else that worried us right after she was born was her PDA, or patent ductus arteriosus.  It's basically an open blood vessel between the heart and lungs that closes on its own after a baby is born at full term.  If it doesn't close, blood can flow into the lungs instead of around them, and that's not good for a preemie whose lungs are already overworked.  Sometimes surgery is needed to close it.  Aubrey's closed on its own within about 2 weeks.  She is a miracle.

A doctor came in and did an ultrasound of Aubrey's brain shortly after she was born.  He was looking for intraventricular hemorrhaging, or bleeding in the brain.  It can cause pressure to build up in the brain and eventually cause brain damage.  It's most common in babies born before 30 weeks gestation.  Aubrey's brain scan was clear.  She is a miracle.

Aubrey has had her beautiful eyes checked several times now; the doctor was checking for retinopathy of prematurity, which is abnormal or disorganized blood vessel growth in the eyes.  The doctor said her pretty peepers look good so far.  She is a miracle.

I realize that there are still so many things we don't know, so many variables yet to be uncovered.  Could Aubrey have vision problems or be developmentally delayed in some way?  She was born 16 weeks too early.  Of course it's possible.  At 24 weeks, she only had a 56% chance of survival.  She has beaten so many odds already that we know only God is responsible for her still being here with us and as healthy as she is.  I took as good care of her as I knew how for 24 weeks, and God placed her in the hands of very capable doctors and nurses after she skidded into the world.  We've watched her grow in ways that are not supposed to be seen by human eyes; that in and of itself is something from a sci-fi novel.  She's been called a fighter, feisty, an over-achiever...yes.  She is all of those things.  But most of all, she is a beautiful, perfect miracle; one we can't wait to bring home and watch grow into an even more amazing little girl.

-Keli