NEW YORK - My wife Ivandy wasn't due to deliver our son for another three months when her water broke. We rushed to the hospital where doctors said our baby's world was drying up around him.
Nicholas was born weighing just 2 pounds, 2 ounces. His face was the size of an old-fashioned silver dollar and his life seemed to hang from a passel of tubes and wires connected to beeping and sputtering machines.
In the days ahead, I learned to read monitors and hang on nervously as Nicholas' oxygen levels dipped and rose along with my heart. The Neonatal Intensive Care Unit became our second home. As parents of preemies, we were plunged into a community of experts and caregivers that we hardly knew existed before. And we had to learn to cope not just with our son's needs, but also with our sorrow, emotions and anxieties.
The Associated Press
In this 2010 photo, Melissa Orlando feeds her twin daughter Mallory at her Parker, Colo., home. Orlando, a 26-year-old Colorado art teacher, gave birth too premature twins, Mallory and Fiona.
Before Nicholas' birth, I'd seen pictures of tiny intubated children in incubators and assumed their mothers had health problems or issues like drug abuse. But I learned that about half the women who have pre-term babies don't fall into any known risk category, as was the case with my wife, Ivandy.
About 12.9 million premature babies are born around the world each year. As medical advances allow more children to stay alive, that number is growing. In the United States, the number of pre-term infants has increased by 36 percent over the last 25 years. Only recently have doctors started looking beyond survival and focusing on improving outcomes for premature children outside the NICU.
Children born prematurely may have learning disabilities, attention deficits, cerebral palsy, vision and hearing problems, respiratory illnesses and other conditions.
Doctors are also finding that the trauma of premature birth can be devastating to parents, who may suffer from depression and anxiety disorders, including post-traumatic stress disorder - the same condition that can afflict troops returning from war.
"Prematurity is not just a medical crisis, it's a family crisis. There are confusing, conflicting emotions," explains Mara Tesler Stein, a clinical psychologist and co-author of "Parenting Your Premature Baby and Child."
Stein compares parents' experience of grieving after the birth of a premature child to that of losing a loved one - an especially confusing emotion when you are in fact gaining a loved one.
Our first family portrait shows my wife in a hospital bed and me leaning over, smiling and holding a Polaroid of Nicholas alone inside a plastic box, swallowed by his diaper, sensors trailing from his tiny fingers and feet, an oxygen tube taped to his nose.
My wife and I didn't know whether to be happy or sad. Should we send out birth announcements? What if the baby doesn't make it? When I spoke to my father prior to Nicholas' birth, he was already offering condolences.
We attended one last baby preparedness class after Nicholas was born but it felt awkward explaining to the expecting parents our baby was already born but not yet home. It also felt like time better spent in the hospital with Nicholas.
Most parents agree the hardest part of having a premature child is leaving the baby alone in the hospital's intensive care unit.
"I felt like I was abandoning them," explains Melissa Orlando, a Colorado art teacher who gave birth to premature twins.
"Goodness, they didn't know if I was going to come back. I did a lot of talking with them explaining I was going home to sleep," she said.
The next hardest thing is the uncertainty: No one could give us a definitive prognosis for our baby because every premature child is different.
Orlando's twins quickly become over-stimulated, hiccuping and turning white if they were handled too much - a common condition among preemies.