Paul marked each hour.
The neonatologist at Abington Hospital-Jefferson Health said that every day the twins remained in utero strengthened their chances of survival. Martha had been there since the start of her 23d week, when her pregnancy suddenly took a turn for the scary.
"I called my doctor and said, 'Something doesn't feel right. I'm not feeling the babies move quite as much,' " she recalls. She was diagnosed with an incompetent cervix and placed on strict bed rest. It was early November; the twins weren't due until March.
In her hospital room, she and Paul gave their daughters names - Claire Josephine for Twin A, Mary Gladys for Twin B. They listened to the neonatologists' grim scenarios. They walked the gossamer line between pragmatism and hope.
Paul told his wife, "We're going to leave here with two babies, one baby, or no babies, and we're going to be OK no matter which direction our life path is going. We're going to take each day as it comes."
He had just written "Day 5½" on the hospital room whiteboard when Martha's water broke. Two words punched through her mind: Too soon. Minutes whipped by: an emergency cesarean; Paul praying on his knees in an empty hallway as doctors delivered two infants, each weighing barely more than a pound.
"A nurse came out and said, 'You can come see the babies,' " Paul recalled. "They were basically translucent. The medical team was feverishly working to intubate them, to get their body temperatures up, to help them survive. I was able, with my finger, to touch each of their hands."
By the time Martha awoke from anesthesia, the twins were sequestered in a warm, darkened corner of the NICU, their eyes covered, their bodies wired to monitors and ventilators.
"They were so sweet, but not the way you think of a baby born full-term," Martha says. "They didn't have cartilage in their ears. There was no fat on their bodies. It was disturbing to look at."
The news grew worse: Though Mary seemed to be stronger - she had taken nutrients from her sister in a twin-to-twin transfusion in the womb - Claire was diagnosed with two brain bleeds and meningitis. If she lived, doctors said, she might never walk, talk, or feed herself.
Martha and Paul took the only path available: They inched forward, step by nerve-racking step.
They were the pair, after all, who met during their senior year at Pennsylvania State University and became engaged on Mount Nittany after five years of courtship. That day, they'd gone for a long hike around the mountain, stopping to overlook the campus.
"We've been hiking in this relationship for a pretty long time," Paul said then. "Would you like to keep moving forward? Would you marry me?" Their wedding blended the ebullient - Penn State cheerleaders, karaoke at the reception - and contemplative, with readings from the Beatitudes, a Gospel portion they chose because, Paul says, "it recognizes that we're part of something bigger than ourselves."
Despite Mary's more robust start, she turned out to be the more fragile twin; she died after just two weeks. Shortly afterward, they were able to hold Claire for the first time, nestling her tiny body skin-to-skin on Martha's chest.
"It was incredibly devastating to lose Mary, but we had to compartmentalize because," Paul said, "we still had a child in the NICU who needed our love, our support, our time, and our energy."
Before Mary's funeral, each parent slipped a letter into her casket. She was no longer in pain, they wrote, and they were grateful for that. Paul added, "Say hi to all the family that's up there already, and keep an eye on all of us, but especially Claire."
The days crawled by. Claire came off the ventilator. She gained weight. "I was scared to be hopeful," said Martha, who felt so anxious she hesitated to unroll an area rug she had bought for the nursery. Every so often, she asked the neonatologist, "Can I put down the rug?" Finally, in early February, he said yes. Unroll the carpet. Claire came home two weeks later.
It wasn't the life they'd imagined - two healthy infants cooing in twin cribs - but it was a life they embraced: a jubilant dinner when Claire no longer needed an apnea monitor; physical therapy to help her learn to crawl and walk.
Last year, the couple created Today Is a Good Day, a nonprofit that provides care packages and support for parents who have lost a baby or who have one in the NICU. The packages contain bracelets with the "One Day at a Time" slogan, a water bottle, and a journal to chart the lurch of emotions and events, its opening page inscribed with a single word: Congratulations.
"When you have a premature baby, people say, 'We're so sorry,' or 'How are you handling this?' " Paul said. He remembers his boss arriving at the hospital with a huge bottle of champagne shortly after the twins were born. "He said a birth, no matter the circumstances, should be celebrated."
Claire thrived. And then, after nearly four years, Martha was pregnant again. This time was a smooth ride to a scheduled 37-week cesarean. They were startled by the normalcy of a full-term birth: No one whisked Martha Rose to the NICU, and they brought the baby home after just four days.
Martha and Paul honor all their children - with the shadowboxes in Claire's room containing newborn handprints from her and her twin; with occasional visits to Mary's grave at Holy Sepulchre Cemetery. They mark every milestone: Claire's participation in an Irish dance class or a quiet moment when she's singing to her baby sister.
On Claire's fifth birthday, just before she blew out the candles on her mermaid cake, Martha asked what she was thankful for. She nuzzled toward her mother and said softly, "I'm thankful for Mary."