Birth is miraculous, but it can be perilous. Years and years ago I remember my obstetrics nursing professor saying something along those lines as she emphasized how fortunate we were practicing maternal-child nursing in this day and age…which was more than twenty years ago. She described in detail how the delivery team often would collectively hold their breath until that first loud, lusty, cry of a healthy newborn baby was heard. Yet with all our advances and better understandings and technological advances we, as maternal-child caregivers, still appreciate every day the potential for peril. We still find ourselves collectively holding our breath until that newborn takes his or her first breath…and the breath after that…and the breath after that…and on and on.

Recently I was fortunate enough to be asked to read and share with you all a book titled Fragile Beginnings by Adam Wolfberg, M.D. As an obstetrician, specializing in maternal-fetal medicine, Dr. Wolfberg is more than qualified to explore with his readers the complex world of newborn intensive care. But he is even more so qualified as he is the father of Larissa, born at 26 weeks gestation and weighing just under 2 pounds. As he recounts the precarious delivery of his third daughter, I found myself literally holding my breath. From Larissa’s own fragile beginnings, Dr. Wolfberg explores and details current scientific practices and discoveries along with the profound emotional and ethical issues raised by the advancing technology that makes it possible for us to save babies born on the cusp of viability. He shares the decisions that he and his wife, Kelly, faced when it was discovered that Larissa had suffered a profound hemorrhage into her brain when she was just days old. And he explores the decisions other families in the NICU must make for their own babies…as well as the decision of a patient of his who presented with ruptured membranes at 23 weeks and 4 days…not a decision expected in a facility with highly trained professionals prepared to do everything to save the life of a severely premature baby.

Fragile Beginnings is not a how-to guide to survive and understand life in the NICU for new parents, but I believe that it is still a must read for anyone touched by premature birth or high risk pregnancy. Given that half a million babies are born prematurely in the United States every year, that is a lot of people who should take the time to sit down and read through this gripping medical narrative. I believe it offers but a glimpse into the ever changing and evolving world of neonatal care which is really only in its own frontier.

Naturally I could not put this book down for so many reasons. As a NICU nurse, who began her career during one of the more exciting moments in the history of neonatal care when artificial surfactants were first receiving approval for use in the NICU from the FDA, I found myself enjoying his tracing of the history of neonatology as well as the background of some of the great minds in neonatal medicine today. As a healthcare professional who finds one self on the other side of the incubator, I identified with Dr. Wolfberg’s difficulty with knowing “too much” of what was clinically going on with his baby girl. Even his recollection of his 23 weeks and 4 days patient and her decision hit close to home briefly knocking the wind out of me. And as a parent of a remarkable micropreemie, also born on January 11, I couldn’t help but relate to his account of the work involved after your miracle baby is big enough, strong enough, healthy enough to go home at long last.