Premature birth remains a significant concern in Northeast Ohio: 1,541 babies were born preterm in Cuyahoga County in 2024, or 12.4% of all live births. Against that backdrop, Cleveland-area mother Lindsey Freeman has turned her experience with two prolonged neonatal intensive care unit stays into a devotional for other parents.
Freeman self-published “For When: A Devotional for NICU Moms,” pairing Bible verses with essays about the emotions of parenting a baby in intensive care, according to Cleveland.com. She told the outlet that she wrote the book because it was the resource she wanted during her own hospital stays. Her first son was born prematurely in 2023 and spent 21 days in the NICU at University Hospitals Rainbow Babies & Children's Hospital.
Freeman's second son arrived at 30 weeks gestation in 2024 and spent 51 days in Rainbow's NICU, while she was also caring for a toddler at home. Infants born at that gestational age have an estimated 98 percent survival rate in modern neonatal intensive care units, according to the Better Health Channel. That statistic does not eliminate the extended feeding and respiratory support many premature infants need, or the strain on families during hospitalization.
A Devotional Built Around the Hardest Moments
Freeman told Cleveland.com that the book grew from the uncertainty she experienced during her sons' hospitalizations. Its entries are organized around situations parents may encounter in the NICU, with short readings and a table of contents designed to help readers find a relevant topic, according to the report.
The devotional includes entries titled “For When You Feel Hopeless” and “For When You Don't Feel in Control.” It also discusses Isaiah 40:30, which states that “those who hope in the Lord will renew their strength,” and invites readers to bring doubts, grief, trauma and anger to God. Freeman said she hopes the book directs mothers in difficult NICU situations toward Jesus and the Bible.
“For When” addresses experiences including a baby's first feeding, difficult medical decisions, loneliness and the strain of comparing one's experience with other families' births, according to Cleveland.com's report. Freeman said she wants parents to know that fear or anger does not mean they are alone or failing. The book is available on Amazon for $19.99.
Why the Stakes Are So High in Cuyahoga County
Freeman's experience comes amid elevated preterm-birth rates in Ohio. The March of Dimes report card says Ohio's preterm birth rate rose to 11.0 percent in 2024, earning the state a “D” grade and a ranking of 37th nationally in the organization's 2025 report card, with a statistically significant increase from 2023, according to March of Dimes.
The report card also shows a statewide racial disparity: Black mothers in Ohio had a 14.6 percent preterm-birth rate on average from 2022 through 2024, compared with 10.0 percent for White mothers. The cited county data establish Cuyahoga's overall rate but do not provide a separate racial breakdown in the figures presented here. Rainbow Babies & Children's Hospital, where both of Freeman's sons were treated, operates Cleveland's only comprehensive Level IV NICU, with an 82-bed capacity across its intensive care and transitional units, according to University Hospitals. The American Academy of Pediatrics defines Level IV NICUs as regional centers equipped to perform on-site surgical repair for complex congenital conditions alongside full pediatric subspecialty care, the highest tier in a four-level national framework.
Rainbow also runs the nation's first 44-bed Level IV Neonatal Transitional Care Center, a step-down unit where parents may stay with their babies 24/7, per University Hospitals.
The Emotional Weight NICU Families Carry Home
The psychological strain Freeman describes is also documented in research on NICU families. A systematic review and meta-analysis published in EClinicalMedicine found that 39.9 percent of parents with infants admitted to neonatal units experienced post-traumatic stress within the first month after birth, while 24.5 percent still had symptoms a year later. Separately, roughly 42 percent of NICU parents experience clinically significant anxiety in the first month, according to March of Dimes.
Support after a NICU admission
Mental-health concerns among NICU caregivers can overlap: an eClinicalMedicine systematic review and meta-analysis found that anxiety, depression and post-traumatic-stress symptoms were highly comorbid. A separate systematic review available through the National Library of Medicine found that screening caregivers during hospitalization may create opportunities for support and referrals both before discharge and afterward. Devotional support can complement, but should not replace, clinical mental-health care.
For families seeking help beyond the hospital, the Cuyahoga County Board of Health says its Maternal and Infant Vitality Initiative uses neighborhood navigators to connect pregnant women and families with clinical and community services, including mental-health and parenting resources.
There can also be a financial dimension to a prolonged hospitalization. Freeman's sons spent a combined 72 days in Rainbow's NICU. According to the Cuyahoga County Department of Health and Human Services, Medicaid can help eligible residents pay for doctor's visits, hospital expenses, long-term care and other covered services.
For Freeman, faith became one way to process the fear, waiting and powerlessness surrounding her sons' hospitalizations. She hopes “For When” gives other NICU parents a place to turn while they navigate those experiences.
