Zoe Reighard was only 23 months old when she was rushed off the hospital emergency room in July with Kawasaki disease, a rare condition that can lead to aneurysms or even a heart attack.
But in the midst of fear about whether their daughter would live, the couple had to race around and quickly draw up power-of- attorney papers, giving her mother the right to make medical decisions and stay with her in the hospital.
Zoe's parents are lesbians and because they live in North Carolina where same-sex, second-parent adoptions are banned, only Carrie Reighard is a legal parent. Her other mother, Lisa Roldan, is not.
"Zoe was two weeks in the ICU and it was hit or miss," said Reighard, a 29-year-old CPA. "It was very frustrating at the time. Our daughter was lying there almost dying and we had to get the paperwork for Lisa to see her."
According to the 2010 Census, two million children in the United States are being raised by lesbian, bisexual, gay and transgender parents (LGBT), the majority of them in southern states.
Same-sex couples living in Mississippi are the most likely to be raising children, followed by Louisiana and Texas.
And now a new study, "All Children Matter," concludes that these children have become the "collateral damage" of laws and policies that discriminate against LGBT Americans.
The report comes just as the Senate Judiciary Committee is set to begin debate Nov. 3 on the repeal of the Defense of Marriage Act, a 1996 law that defines marriage as between a man and a woman and prohibits the federal government from providing benefits to same-sex couples.
The study was conducted by a coalition of advocacy groups, including the Family Equality Council, the Movement Advancement Project, the Center for American Progress, the National Association of Social Workers, the Evan B. Donaldson Adoption Institute, and COLAGE, with a foreword by the Child Welfare League of America.
Laws like those in North Carolina deny legal ties to the non-biological parent, having an effect on custody arrangements, inheritance and Social Security survivor benefits in the event of a death of the parent who is a "legal stranger."
They also make adoption impossible for children awaiting homes in those states.
Despite these laws, a growing number of LGBT couples are adopting in the U.S., according to a new study by the Evan B. Donaldson Adoption Institute. At least half of them are providing families for children in foster care and 60 percent are adopting transracially.
"Even if you are an opponent of gay and lesbian parents, the fact is, they are already raising kids and these are policies that leave them economically destitute or undermine their family stability," said Ineke Mushovic, one of the study authors from the Movement Advancement Project.
"It's just wrong, and I don't think the majority of Americans and policy makers really understand the lack of recognition for these families has this kind of impact and harms kids," she said.
North Carolina is among the top 12 states where LGBT couples are raising children, but also among those with the least gay-friendly laws.
Last December, a a state judge invalidated all second-parent adoptions by same-sex couples. It is also expressly banned in four other states, Arkansas, Florida, Mississippi and Utah, according to the Family Equality Council.
Second-parent adoption is only allowed for same-sex couples in 10 states and the District of Columbia, as well as in 16 other states in some jurisdictions.
Just last month, the state legislature narrowly approved putting the question of whether to impose a constitutional ban on gay marriage to voters.
The Rev. Patrick Wooden of the Upper Room Church of God in Christ in Raleigh, who has fought against gay rights, called homosexuality a "deathstyle" and told the New York Times that the ballot measure was "a great day for the citizens of this great state."
The nature of the American family -- once a married man and woman -- is changing.
In addition to two million children of LGBT parents, there are an estimated 21.8 million children being raised by single parents -- about 26 percent of all children, according to the "Custodial Mothers and Father and Their Child Support: 2007," which was released by the U.S. Census Bureau in 2009.
Studies Show Kids 'Develop Well'
Studies here and abroad have shown that children can be raised in a healthy environment, regardless of the composition of their family.
Children of same-sex couples "grow in similar ways" as those of heterosexual parents, according to Charlotte J. Patterson, a professor of psychology at University of Virginia and director of women and gender studies.
She studied pre-school children living in states where their same-sex parents were legally recognized by the law and found "overall, they are developing very well as a group and not different in their adjustment, whether their parents were gay or straight."
When Roldan met Reighard they knew they wanted children. Roldan, 45 and a bank manager, had two now-grown children from a previous marriage. They said it made sense for Reighard to get pregnant.
The North Carolina health clinic where they went for artificial insemination would only do it for same-sex couples within a 150-mile radius and also required them to go to counseling, something not required of heterosexual couples.
Their lawyer told them they could try to get a second parent adoption, which would have cost $5,000 to $7,000, but then the state invalidated adoptions for gay couples.
When Zoe was sick, their lawyer managed to fax the required legal paper to the hospital several hours later. "We are blessed we can afford this -- it cost several thousand dollars," said Reighard. "Others can't."
"It frightens me," she said. "If Lisa couldn't be there, it would have impacted Zoe's recovery if she didn't have familiar faces in the hospital. It was scary for her to begin with and not to have her mom there would be worse."
Since then, the couple has had to arrange for more legal papers so Roldan can pick Zoe up at school and take her to doctor's appointments and to provide for protections in their wills, parenting agreements and health care directives.
Reighard's parents live nearby and help with the child care and are supportive of the relationship. Should she die, Reighard said they would honor her partner's parenting rights.
But, they worry that if Roldan were to take Zoe to Pennsylvania to see her other grandparents, they would have to make sure to bring along the child's papers, "just in case something happens," said Reighard.
"There are so many children in the South because of such an emphasis on family values," said Reighard. "They get married young."
But attitudes toward gay couples are conservative and sometimes hurtful and Reighard worries about when Zoe will go to school.
"It is not uncommon here for people to say 'You are so gay' or outright 'fag,'" she said. "It makes me fear for Zoe. "Kids are cruel to begin with and if there is any otherness about you, they magnify it."
"I would like to think things are changing, but because Southerners see some of these changes in the North, they are almost digging their heels in even more," said Reighard "These are not just old, antiquated laws. They are creating new ones."