February 08, 2010 12:00 PM

It was a longing so deep she could feel it in every part of her body. For six agonizing weeks, Michelle Duggar—who gave birth Dec. 10 to her 19th child at a frighteningly early 25 weeks—gazed at her tiny baby girl, hooked up to tubes and wires and fighting for her life, but was not allowed to hold her. She and her husband, Jim Bob, kept round-the-clock watch over daughter Josie Brooklyn’s incubator until the big moment finally came: Mother and baby had their first, long-overdue snuggle. “I told her, ‘I am Mommy, and I’m the one you were supposed to be with all this time,'” says Michelle, 43. “It was scary because she is so tiny, but it was wonderful to get a chance to be close.”

It was a tiny moment that caused huge celebration for the famously expansive Duggar family, stars of the hit TLC reality series, which, following Josie’s arrival, changes its name this week to 19 Kids and Counting. Born via emergency C-section at only 1 lb. 6 oz., the micro preemie has lived through a roller-coaster ride of survival that began when Michelle was helicoptered from Mercy Medical Center in Rogers, Ark., to University of Arkansas for Medical Sciences in Little Rock after a gallstone attack triggered contractions and then a dangerously high spike in blood pressure. As doctors prepared to cut her open, Michelle says, “I was saying to myself, ‘This baby is so small, I don’t think she can survive.'”

Over a month later, baby Josie remains in intensive care, now at Arkansas Children’s Hospital, recuperating from a bowel perforation. Says her physician Dr. Robert Arrington, codirector of the neonatal intensive care unit, “She responded to placement of an abdominal drain, plus antibiotics, and did not require an open operation.” At press time Josie was taking breast milk (pumped every few hours by Michelle) through a feeding tube and weighed in at 2 lbs., 3 oz. She will likely remain hospitalized until closer to Michelle’s original March 18 due date. “It is a miracle she is doing so well,” says Jim Bob, 44. “We feel like first-time parents all over again.”

Now living in a rented 8,115-sq.-ft. home less than a mile from the hospital, the 17 Duggar kids still at home are settling into their new environment away from Tontitown, Ark., with homeschooling, field trips around Little Rock and prayers for Josie. Every day Jim Bob puts his camera-phone into Josie’s incubator, filming video he shares every evening so her brothers and sisters can get to know her. “It’s the hardest thing we’ve ever had to go through,” says Jim Bob. “We told our kids to be thankful for her and to pray for her, and that every day is going to be a fight for her life.”

Three decades ago a baby born before 26 weeks had a poor chance of survival, according to experts, but today 8 out of 10 micro preemies make it. Josie’s doctors “do not know if there will be any developmental problems or not,” says Jim Bob. “We have no idea if she’s going to need therapies or how she will develop.”

Josie’s early arrival capped an emotional year for the family. In December 2008 Michelle delivered her 18th child, Jordyn-Grace; two months later Jim Bob’s father, Jimmy Lee, died of a brain tumor; and this past October the Duggars became grandparents when their eldest child, Josh, 21, and his wife, Anna, 21, had a baby girl. The devoutly Christian Duggars have been criticized for supersizing their family—Michelle went off birth control after a miscarriage in 1988 and since then has gotten pregnant about every 18 months. They say they consider each child a blessing from God. “This pregnancy was one of our closer-together ones,” says Michelle, who learned she was pregnant only 6 months after giving birth to Jordyn. “When I started having back pain, I thought it might be kidney stones that can act up with pregnancies close together.”

After the gallstone attack and elevated blood pressure, Michelle was diagnosed with preeclampsia, or pregnancy-induced hypertension, which can be fatal for both mother and fetus. Having many pregnancies isn’t a risk factor for preeclampsia, according to expert Dr. Jeannine Rahimian, chief of the Generalist Division of OB-GYN at UCLA Medical Center, but “being under 20 or over 40 is,” she says.

With her blood pressure climbing, Michelle and Jim Bob prayed and then watched as doctors delivered Josie, barely 12 inches long, “with a head the size of a billiard ball,” says Jim Bob. “She was tiny, but perfect.”

Five days later, when 10 of the Duggars children returned from an annual humanitarian trip to El Salvador, the entire clan gathered at the hospital and “had a family meeting,” says Jim Bob. “Then we went across the hallway into Josie’s room to see her. The little ones asked questions: ‘Why is she so small?’ Some of the children were crying.”

Michelle and Jim Bob take shifts at the hospital and at their temporary home (the thrifty couple live off real estate investments and the income from a book and their show on TLC, which will air 19 Kids and Counting: Special Duggar Delivery on Jan. 31; their insurance is covering Josie’s care). Crediting their faith and “prayers of people around the world” for strengthening them, Michelle sometimes relives the horror of Josie’s delivery. “The fear comes flooding back,” she says, “and the only peace I knew was talking to God through it all.” But Josie’s difficult birth has brought the Duggars closer together as a family—and, despite the uncertainty about her future, they won’t rule out having baby No. 20. Says Michelle: “We’ll just wait and see what God has in store.”

For now, Michelle is content to anticipate new milestones with Josie. “I want to be able to nurse her,” she says softly, “and for her daddy to get to hold her.” Jim Bob’s dreams are even bigger: “She’s 20, she’s wearing a big, white wedding dress. I’m walking her down the aisle, and I tell her she is a miracle,” he says. “It will be a beautiful day.”

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