Nursing Book Club

Early by Sarah DiGregorio

An Intimate History of Premature Birth and What It Teaches Us About Being Human

By Sarah DiGregorioJuly 24, 2024

4 min read

Delivering a baby at 27 weeks led journalist Sarah DiGregorio to write a well-researched book about prematurity, from the causes to treatment options to the hard choices facing parents and the healthcare team.

Sarah DiGregorio’s daughter Mira began to fall off the growth curve while still intrauterine, at 24 weeks. Testing showed that DiGregorio had a subpar placenta, so her obstetrician decided to prepare her for delivery at just 27 weeks — very premature. (If you’ve never had a child or worked in L&D, a full-term baby is 37–42 weeks.)

Prematurity From Many Angles

Little Mira was unready for life outside the womb, weighing just 1 pound, 13 ounces at birth. As DiGregorio remarks, “She was your average one-and-a-half-pound baby whose heart stopped several times a day, who needed blood transfusions to stay alive, who needed life support to breathe, eat, and stay warm.”

In the prologue of journalist DiGregorio’s recent book Early, we learn about Mira’s postnatal care (which is also a reminder of the importance of the nurses in the NICU). She describes what it feels like to be discharged without the baby to whom she’s been so intimately attached for the past many months. DiGregorio was not able to take her daughter home until Mira’s weight reached 4 pounds, which took 59 days in the hospital.

Early is more than just the story of one infant. Like many who face such challenges, DiGregorio set out to learn all there is to know about prematurity.

She found that it’s a common but invisible problem that costs $26 billion a year in the U.S. alone. The book examines prematurity from many different angles, including a history of the machines that have been used in caring for preemies, such as iron lungs and incubators.

Few Easy Answers

Preemies essentially need to complete the job of growing outside the womb, with the help of a skilled care staff that understands how best to support the process. However, it can be more complicated for very early babies.

A gestational age of 27 weeks is considered the “zone of viability,” but there is not a lot of consensus on what is best for these most premature babies, who may face serious development disabilities even if they survive. We often hear of the great success stories — hospitals saving babies who weigh less than a pound — but we rarely hear about their later quality of life, or the cost to their families.

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Another dark side is that some babies are born prematurely because of an unknown problem, and continue to experience development delays even with extensive support.

DiGregorio examines difficult questions, such as the choice parents might need to make for a tiny preterm infant when the chances of survival are slim and odds of disability high. There are no easy answers.

While DiGregorio has done her homework, personally, I’d find all of this frightening to read if I were pregnant or considering having a child. My own daughter recently had a baby at 35 weeks, and I could see how difficult it was for her when her son didn’t meet the milestones her friends’ children passed with no trouble.

We know so much more now than we did 10 to 20 years ago about caring for preemies, but Early drives home the fact that much of life is really just a roll of the dice.

Early: An Intimate History of Premature Birth and What it Teaches Us About Being Human by Sarah DiGregorio (HarperCollins, 2022)

CHRISTINE CONTILLO, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.

In this Article: Pregnancy and Childbirth