My son was born at 8:15 a.m. on Halloween, a long, skinny four pounds and crying in great angry gulps. With a kindness I’ve never forgotten, the anesthesiologist leaned down and said to me, “A lot of full-term babies don’t even sound that loud.”

The doctors laid my baby on my chest in his footprint-patterned swaddle, and for a moment he stopped crying. Then he was whisked away to the neonatal intensive care unit and I didn’t see him for 30 hours.

That’s how my life as a parent started.

In the United States, 10 percent of babies, or more than 380,000 a year, are born premature, before 37 weeks of gestation. The majority will need time in the NICU, meaning parents are shut out from many of the rituals surrounding a birth. You don’t leave the hospital with your child. Grandparents and friends can’t hold your newborn.

Now that my son is 7 and my daughter is 5 (she was born 19 months later, also premature), I think about how much support our family received in those early weeks, but how little guidance there was about how the experience could impact us over time. I wonder if who I am as a mother was influenced by that early start.

I interviewed parents of preemies, and while each experience was different, there were many consistent themes. Here are some of their stories.

The delay of grief

More than a year after my son was born, one of my closest friends had a placenta abruption and delivered her son at 34 weeks. She called me while I was in the car, and I tried to be as calm and loving as possible. Afterward, though, I pulled over in a parking lot and starting sobbing. My hands were shaking.

I cried with a force I’d never felt when my own pregnancy was going off the rails and all my focus had been on my baby. Until that morning, I hadn’t realized that my son’s premature birth, which I’d filed away as a bumpy start to an otherwise normal parenting journey, had imprinted in my brain like a trauma.

Other mothers said it was not until they had a full-term child that they fully processed their grief. “I didn’t really have a sense of loss or understand what I had missed until I had my son,” says Ame McClune, whose twin girls were born at 24 weeks and required feeding tubes and full-time nursing care for several years. “With my twins, I took it in stride because it was all I knew. Now, here was a baby I could hold and breast-feed and cuddle. I loved it. I had no idea.”

Teira Gunlock, whose daughter Lake was born at 29 weeks when Gunlock developed severe preeclampsia, was diagnosed nine months later with PTSD. “While everything worked out, it was a traumatic experience,” says Gunlock, who for six days had not been able to see her baby. “It makes me emphasize my daughter’s emotional health and growth in my own parenting more than I likely would have."

Taking setbacks in stride, supercharged gratitude

At some point in everyone’s parenting journey, things don’t go according to plan. But preemie parents get that message early.

“Nothing is a crushing blow,” McClune says. Instead, when there are challenges, she just thinks, “Okay, how do we deal with this?”

In my experience, it was freeing to step off the hamster wheel of worry over milestones, because my children weren’t going to hit any of them. Instead, the NICU distilled things: Are we healthy? Are we happy(ish)? Are we okay? Given the anxiety many parents have over their children’s accomplishments, that perspective can feel like a gift.

Preemie parents also occupy a strange space between intense thankfulness and the early recognition that things can go wrong. In the NICU, most parents understand that there are babies in more precarious positions that their own and are sensitive to that.

The experience also yields daily opportunities for gratitude — to the nurses and doctors caring for your child; to the progress your baby is making; to the much-anticipated car-seat day when you get to take your baby home.

“I think about how lucky we are that both my daughter and my wife survived, and that hits me hard sometimes,” says Michael Zimmer, Gunlock’s husband. “We benefited from scientific advances that stemmed from a lot of tragedy in the past. That provides perspective — our daughter, and my wife, frankly — have a chance at life they might not have had 50 or even 25 years ago.”

Danger ahead

If having a preemie makes you more resilient as a parent, it can also put you in a defensive crouch, waiting for the other shoe to drop.

When we brought my son home from the NICU after two weeks, my husband and I felt the normal terror of first-time parents with our own, special terror thrown in. He had been hooked up to monitors and cared for by professionals since he was born. Once he was home, though, he had to rely only on our loving, possibly incompetent care. That first night, my husband slept on the floor next to the bassinet while I feverishly pumped milk.

Gunlock and Zimmer spent the first year on high alert after their daughter had a choking episode in the NICU, and then again a few days after she came home.

Several parents told me that the strengths of the NICU — the care your baby receives; the nurses you learn from — can also feel like a weakness when you leave, because you think you will never measure up. That fades over time, outweighed by the support and confidence you built during those early weeks, but a tiny part of you always remains on alert.

Naming the sadness

All these years after my children were born, I still feel sad my body didn’t get them over the finish line. Not guilty, not angry, just sad. Is this normal? Is this weird? I don’t know.

I regret that I never got those final weeks of nesting, that I missed my baby shower, that I never felt a contraction. To many people, I’m sure that skipping labor twice makes me lucky. But it feels strange.

Stacey D. Stewart, chief executive of the March of Dimes, a nonprofit that works to improve maternal and infant health outcomes and supports more than 50,000 families a year who are in the NICU, says there needs to be more attention given to the impact the experience has on parents’ mental health.

“You’re pregnant and then one day you’re not, sooner than it was supposed to happen,” she says. “There’s a lot of anxiety and grief and helplessness and fear. It takes an immense emotional toll.”

It can also be very isolating. “I found it incredibly lonely,” says Kate Bosanquet, who had her daughter at 31 weeks. “I missed out on most of my prenatal classes, and while my group was very sweet and continued to meet, we weren’t having the same shared experiences you hope for.”

It doesn’t help that the entire baby industrial complex caters to parents of full-term babies. There’s the books and websites telling you your baby should be doing things months before she will. The carrier that requires your child to be a monstrous eight pounds. The email updates that continue to cheerfully inform you about the progress of your pregnancy when your baby is already out in the world. It can all hurt. One mother told me she wished there was a switch to turn off all the marketing and email that assumed she’d delivered full-term. (March of Dimes has a My NICU Baby app for parents of premature and full-term babies that started out in the NICU.)

And yet many of us hope and believe that these birth stories will become a source of strength for our children.

When my son was in kindergarten and it was his turn to be “Friend of the Week,” he shared that he weighed four pounds at birth, telling his class he “surprised us” seven weeks early. To him, it was an interesting fact and also, I think, a small source of pride.

It should be. Preemie babies, and their parents, have to come so far. I hope that every mom and dad who started out that way — confused, scared, fierce, loving — feels pride in their parenting. They’ve earned it.

Anna Nordberg is a writer in San Francisco. She is working on a memoir about becoming a mother without your mom. Find her online at annanordberg.com.

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