Foresight in Prematurity           


Prematurity.  One in ten babies are born premature each year.  Worldwide, that accounts for over 15-million births.  In the United States, that number is over 400,000 infants ("Home | March of Dimes," 2015). 

Our prematurity journey started on a night so cold that it appeared sound and movement had frozen.  It was remarkably peaceful with only the lights of the ambulance outside of the window rushing us to a fixed-wing plane for critical transport.  The night of December 8th, 2009 was the coldest on record at 6-degrees Fahrenheit.  The night was so cold that helicopter transports were grounded and the 5500-foot elevation over a snowy pass closed.  Instinctually I knew this would be the outcome of my pregnancy.  To the bewilderment of my family, I asked that we have our baby shower at 24-weeks gestation.  I had my son’s nursery completed at 26-weeks gestation.  I had my hospital bag and birthing plan written up at 28-weeks gestation.  I purchased a special policy through Emergency Airlift in the event I needed to be critically airlifted by helicopter or fixed-wing plane to the regional Children’s Miracle Network Hospital with a Neonatal Intensive Care Unit.  This detailed planning ensured an inner response of peace and security through the critical days surrounding my son’s premature birth.     

According to Robert K. Greenleaf who first coined the term servant-leadership, “foresight is the central ethic of leadership” (pg. 14).  Greenleaf describes foresight as an ability to function at different levels of consciousness – one is real-world concerned, responsible, effective and value oriented; the other is able to see oneself deeply engaged in today’s events and project in to the indefinite future.  This allows us to foresee the unforeseeable.  Foresight allows us to act confidently from minute to minute on our deeply held values while also examining our lives as they unfold in action (Doss & Horsman, n.d.).  This essay will explore Greenleaf’s statement, “[foresight] enables the servant-leader to understand the lessons from the past, the realities of the present, and the likely consequences of a decision in the future” by applying personal, professional and societal lens to foresight in prematurity (Doss & Horsman, n.d.)

Foresight allowed me the advantage of knowing, a deep knowing that exceeds the ability of words, to prepare for my son in advance of his premature birth.  While I didn’t consciously know that I knew I would have a premature infant, a deeply led instinct told me to be prepared.  In the times I failed to listen to this knowing were the areas of unpreparedness. 

When I reflect on my prematurity experience, I liken it to the mythological story of the Phoenix.  The story that has been passed down through oral and now written tradition states that once every 500 years, the Phoenix builds it’s nest with tinder and lights itself on fire burning to ashes in it’s nest.  The Phoenix that emerges from the ashes has a beautiful plume of multicolor feathers and is extraordinary to witness.  The story of the Phoenix is a metaphor for the rebuilding of a new life by allowing one’s old life to pass while allowing a new self to emerge.   It has taken five years from the burning of my phoenix within to emerge with a plume more bright and beautiful that far exceeds my greatest imagination.   Three years ago I started my pursuit of graduate school with a mission to serve organizations that care for families impacted by prematurity or special needs.  On May 9th, 2015 I participated in the graduation ceremony at Gonzaga University wearing a symbolic phoenix around my neck celebrating my co-created plume.  I did not rebuild in a silo.  It took my beloved son who inspired me daily through his struggles; my husband to keep me focused on my mission; my family and friends to cheer me on when I felt discouraged or frazzled; my professors and the Gonzaga community through holistic engagement; and my work at Hand to Hold as an Organizational Development Consultant serving an organization that cares for families impacted by prematurity. 

As an Organizational Development Consultant for Hand to Hold I am privy to select information offered to me by our Executive Director and Staff.  Our Founder and Executive Director Kelli Kelley is a servant-leader committed to the mission, “to provide comprehensive navigation resources and support programs to parents of preemies, babies born with special healthcare needs and those who have experienced a loss due to these or other complications” ("Hand to Hold ," n.d.).  As the Organizational Development Consultant I am asked to provide thought leadership strategically as well as on projects that will move the organization forward.  I also lead a volunteer program that enables parents who have graduated from their NICU to return and serve using Hand to Hold products and services.   Scharmer & Kaufer write, “each initiative was started by a small core group of people who share a deep common intention to create a future that is different from the past” (Scharmer & Kaufer, 2013).  Like many 4.0 organizations, Hand to Hold started as a vision to provide professional quality resources and support on prematurity as a parent-led organization.  Previously, Neonatal Intensive Care Unit medical staff held a belief that only those with medical knowledge were valuable.  Throughout the last five years NICU’s nationwide are recognizing the exceptional value of a preemie parent’s insights and understanding. 

At Hand to Hold I have helped support a non-profit consultant in developing Hand to Hold’s strategic plan for the next three years.  As Hand to Hold approaches it’s fifth birthday, it is extraordinarily successful serving families in all fifty states and 45-countries providing relevant information for NICU families.  The strategic planning experience should be a source of disruption in preparation for co-creation of a new strategic plan, however, for Hand to Hold many of the results obtained through survey’s and interviews told us what we already know and many had absolutely nothing negative to say.  The critiques that Hand to Hold did receive were written constructively to help better the organization. 

Society is ready to embrace new ideas.  Through co-creation alongside organizations like Hand to Hold, NICU’s now recognize the value of a parent-professional’s viewpoint.  Hand to Hold’s Executive Director Kelli Kelley was one of six non-profits that serve families experiencing prematurity to collaborate together and build the Preemie Parent Alliance ("Preemie Parent Alliance," n.d.).  The world that used to be, that is dying, are preemie parents who feel alone as if nobody understands.  Replacing the old construct are organizations collaborating together to walk alongside families, build community and engage in meaningful relationships. 

With the emergence of preemie parent led non-profits helping meet the needs of families a socioeconomic change is beginning to develop.  Many of the organizations associated to the Preemie Parent Alliance offer high quality cardstock handouts with meaningful, applicable information.  The gifts offered are those that help lift families in a NICU out of despair and are often benchmarked to social and psychological research. 

I currently work as an independent contractor for Hand to Hold in an organizational development role.  It pays one-third what I could make in any other organization and the work is inconsistent therefore my one-third pay does not contribute to the needs of my family.  It’s acceptable while I am in graduate school as it’s offered me a strong title “Organizational Development Consultant” while giving work experience in my area of graduate study.  Yet, as I look forward to completing my graduate thesis titled “Exploring the role of a servant leadership paradigm in the neonatal intensive care unit” in December 2015 I am starting to think about next steps.  The staff at Hand to Hold in Austin, Texas are way overworked, over-burdened and under funded yet none are able to transfer to work to me who is under-employed and asking for opportunities to serve.  This is where my current disruption lies. 

My response to the current disruption is to engage in relational opportunities locally in San Luis Obispo County.  A proposed idea by Executive Director Kelli Kelley of Hand to Hold is to find a secure position elsewhere and serve Hand to Hold on the side.   The other avenue I am currently building is a small consultancy business called Courageous Steps Consulting.  The focus of this consultancy business would be to solely work with organizations associated to the Preemie Parent Alliance, including Hand to Hold, and providing organizational development and growth and help organizational leader’s better serve their unique mission based on a servant-leadership paradigm.

As I tie together the exploration of a personal, professional and societal world that is dying and waiting to be born, I will outline the ecological, socioeconomic and spiritual-cultural divide.  I will outline ways I approach moments of disruption and my inner response to these moments. 

A few days ago I represented Hand to Hold in a meeting with the Nurse Educator at Sierra Vista Regional Medical Center where I am an acting Liaison as one of the volunteers in the program I am building.  Hand to Hold does an exceptional job providing print materials to hand to families in the NICU that leads to searching our website for navigational resources.  In the meeting with Pam, the Nurse Educator, she asked that I do not provide any print material.  One of the perplexing challenges required I think creatively and identify how I can communicate what Hand to Hold offers without some tangible item.  She recommends that Liaison’s check out a hospital-issued iPad, ecologically avoid wasting paper and focus on relationships. 

This meeting led me to follow up by e-mail with Kelli, our Executive Director, and Jenn, our Family Support Navigator, recommending ways in which we explore non-print options.  One of the questions I fully expect to arise from the e-mail relates to socio-economic divides.  Many of the families we serve represent a wide variety of income levels and one of the concerns that I fully anticipate may come up relates to post-NICU access to our materials.  It is my understanding in California and Oregon that many on state assistance receive pre-paid smartphones and will be able to access the Internet.  I included this information in the e-mail anticipatorily. 

 Through the lens of a spiritual-cultural divide, I do not experience anything extraordinary.  While I am the only Catholic at Hand to Hold and in leadership at Preemie Parent Alliance, all are deeply led by a personal relationship with Christ.  Our materials do not specify a particular religion yet individual to individual we all celebrate an engaged and active faith.  An example includes referring the Director of Diversity and Inclusion at Whitworth University, Stephy Noble-Beans to our director at Preemie Parent Alliance as a prospective speaker on intercultural communication.  I had a follow-up conversation with our Preemie Parent Alliance director named Keira who said that she had an opportunity to pray with Stephy after their lengthy, inspiring conversation.  I often pray with my co-workers and our executive director and our team encourages my participation in such activities as attending a seminar-fellowship the Discovery Institute (2014) and spending a week at St. Andrews Abbey in California (2015).  They celebrate my faith as I celebrate their faith.

In closing, as a leader serving both Hand to Hold as an Organizational Development Consultant and the Preemie Parent Alliance as we prepare for our Annual Summit in Dallas this October, it is clearly essential how as once enters in to this field reflecting servant-leadership in prematurity the necessity of Otto Scharmer’s U Model (Scharmer, n.d.).  One must begin with an open mind to serve.  This requires the courage and strength of a core conviction that we must give back to the nurses and staff that gave us so much.  One must continue ongoing growth and development to continue the interpersonal movement towards an open heart to serve.  Lastly, one must develop an open will to serve.  In addition to engaging volunteers in the service of their NICU, we fully expect that through modeling servant-leadership such service will also further them in their healing journey from their own days, weeks or months in the NICU with their infant.





Doss, E., & Horsman, J. H., Ph.D. (n.d.). Foresight & strategy [Scholarly project]. In Blackboard. Retrieved May 19, 2015, from

              Home | March of Dimes. (2015). Retrieved June 5, 2015, from

Scharmer, O., & Kaufer, K. (2013). Leading from the emerging future [E-book]. Retrieved May 27, 2015, from

Scharmer, C. O. (n.d.). Addressing the blind spot of our time. The Social Technology of Presencing, 1-19. Retrieved June 14, 2015, from