Duggar Family Together for Christmas

Dec. 25, 2009— -- Two-week-old Josie Duggar will be surrounded by her family for Christmas.

The baby's father, Jim Bob Duggar, tells People magazine that the "entire family is planning to relocate to Little Rock, Ark., temporarily to be close to Josie."

Josie Duggar was born Dec. 10 by emergency C-section. The 19th child of the couple was born prematurely because mom, Michele, was suffering from pre-eclamsia. Josie, who weighed 1 pound, 6 ounces at birth, remains in the neonatal intensive care unit at a Little Rock Hospital.

Jim Bob told People that "a close friend in Little Rock has opened up their home to us for the holidays." Some of the older members of the reality TV clan have just returned from a church mission to El Salvador, "so the whole family will be together and close to Josie for Christmas," said Jim Bob. "We're so thankful for everyone's thoughts and prayers."

Last week the Duggar family received some good news about Josie Brooklyn, who was born nearly three months premature: She's taking breast milk.

Freda Ruark, sister of mom Michelle Duggar, said that after three breast milk feedings, Josie Brooklyn was able to keep down two.

"The baby is doing great," said Ruark, who has spoken to Jim Bob, every day since her niece was born.

"Josie is holding her own. As long as she can get some of that breast milk, that will help build up her immune system."

Jim Bob Duggar sent an e-mail to ABCNews.com a week after Josie's birth about his wife's and daughter's condition. "Hello from the Duggar Family," he wrote. "We are so grateful for all of the prayers and e-mails of support for our family since Josie Brooklyn Duggar was born 12-10-09. Michelle is [recovering] from the emergency c-section and is doing [a lot] better. Josie is beautiful and in stable condition."

The other 18 children were "doing quite well" with the help of their grandmother, Jim Bob's mother, Mary, who lives with them. "They have lots of help," Ruark said, "and a big circle of friends.

Now they all await the day their new sister can come home. Until then, however, they can keep a watch on Josie Brooklyn through the hospital's high-tech monitoring system.

Each bassinet in the neonatal intensive care unit of the University of Arkansas for Medical Sciences hospital is equipped with "angel-eye cameras," according to the hospital spokeswoman, which allows family, via a password, to view the baby from their home computers.

Each room is also private and equipped with a pull-out sofa to encourage parents to visit and stay with their babies.

Ruark said there have been round-the-clock prayers worldwide and the family is focused on Josie Brooklyn getting stronger and not on why and how this happened. "Really, it is God's will," Ruark said. "There is no second-guessing."

For now all eyes are on "micro-preemie" Josie Brooklyn but doctors point out that the Duggar family tradition of back-to-back pregnancies may be slowly adding to the health risks for Michelle and future Duggars.

"I am not aware of this couple's reasoning on the matter of contraception," said Dr. John B. Coppes of the Austin Medical Center-Mayo Health System in Austin, Minn. "However, I hope they are aware of the risks for Down syndrome, uterine rupture, future C-sections, pre-eclampsia."

TLC continues to report that mother and baby are doing fine at the University of Arkansas for Medical Sciences in Little Rock.

All pregnancy carries risk, but some doctors say any woman, even with Duggar's stamina, increases her chances for health problems with numerous pregnancies.

A Uterus in (Too Much?) Use

Dr. Katharine Wenstrom, director of Maternal Fetal Medicine at Vanderbilt Children's Hospital in Nashville, Tenn., rattled off a list of complications, including life-threatening bleeding during birth, risk of heart attack or stroke -- all exacerbated by multiple pregnancies.

"She has an increased risk of uterine atony, or failure, of the uterus to contract after delivery, which can cause life-threatening blood loss and may require hysterectomy," said Wenstrom, who added that women who have multiple pregnancies are at risk for a condition called placenta previa. In such cases, she said, "the placenta implants over the cervix -- also associated with life threatening bleeding."

Although it seems only time is limiting the number of children that families like the Duggars can have, doctors say each pregnancy actually scars the walls of the womb, leaving limited real estate for a new pregnancy.

"Every time you have a pregnancy, the placenta implants in the uterus and that implantation site cannot be used again because it's scarred," said Dr. Diane Harper of the University of Missouri in Kansas City.

Pregnancies Can Get Complicated after Double-Digit Births

The more children you have, the more likely the placenta will implant in an inopportune place such as over the cervix (placenta previa). "You run the risk of developing problems with the placenta attachment," Harper said.

Going through 19 labors also stretches the mother's pelvic muscles and ligaments, sometimes to the point of causing uncomfortable or embarrassing problems.

Many Pregnancies Cause Incontinence?

Moms who've had multiple pregnancies usually have short labors and they're usually able to push the baby out with relatively little effort, according to Harper. But the elasticity of their pelvic floor can cause other problems.

If a baby starts to come prematurely, doctors have greater difficulty keeping the woman from delivering, Harper said. If the muscles around the uterus are sufficiently weakened, the result may be a condition called uterine prolapse, in which the uterus drops partway into the vagina.

The weakened muscles can also leave a woman incontinent, Harper said.

"The abdominal wall will lose all tone, causing intestinal hernias as well as putting intestines at risk for volvulus [a bowel twisted in a loop]," said Harper.

Other doctors say it is not so much the number of pregnancies that put the average women at risk as her age.

Older Mothers

"From an obstetric point of view, the number of children is less important than the maternal age at time of birth, history of obstetric complications, and general maternal health," said Dr. Lauren Streicher, assistant professor of obstetrics and gynecology at the Feinberg School of Medicine in Chicago.

For example, older parents are more likely to have children with genetic abnormalities such as Down syndrome. The Mayo Clinic also points out that older woman are also more likely to develop pre-eclampsia -- the condition that sent Michelle Duggar in for an emergency C-section Thursday.

Despite all the risks, Duggar has shown the human body is capable of reproducing successfully for decades.