During a severe snowstorm, a 25-year-old Caucasian woman named Linda arrives at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, after giving birth for more than thirty hours at home. Being only 28 weeks pregnant, she hoped her contractions could be stopped. Unfortunately, the labor could not be terminated and she delivered a premature baby boy named David at 28 weeks' gestation; weighing only 1400 grams. Due to the difficult labor and the fact that baby David was in Frank breech, David was delivered by cesarean section. At delivery, David was evaluated and had no respiratory effort, no limb movement, a cyanotic appearance, and was covered in meconium-stained amniotic fluid. Tactile stimulation was applied, but baby David still showed no breathing effort and had a heart rate of only seventy-five beats per minute. The APGAR score for his heart rate was one and for respiratory effort, muscle tone, reflexes/irritability and color it was zero (APGAR). David got a score of one out of ten possible points. Baby David had to be resuscitated while still in the delivery room. Premature infants, those less than thirty-seven weeks gestation, make up the largest proportion of newborns who will require some degree of resuscitation. Being less than thirty-two weeks gestation and weighing less than 1500 grams only increases the chances that resuscitation will be necessary (Wiswell 289). Baby David has many factors that are not in his favor. Being born by cesarean section, through meconium-stained amniotic fluid, having a heart rate less than one hundred beats per minute, low muscle tone and no respiratory effort required intubation or suctioning. This, as well as middle of paper ......edia. " United States National Library of Medicine. United States National Library of Medicine, nd Web. February 28, 2014. Firdaus, Uzma, , S. Manazir Ali, and Sandeep Sachdeva. “Maternal and neonatal factors associated with stained amniotic fluid meconium.” Current Pediatric Research 17.1 (2013): 37-40 Web, March 1, 2014. “Meconium Aspiration Syndrome: MedlinePlus Medical Encyclopedia.” United States National Library of Medicine. US National Library of Medicine, nd Web. March 2, 2014. Venes, Donald, ed. Taber's Cyclopedic Medical Dictionary. 21st ed. Philadelphia: FA Davis, 2009. Print. Walsh, Brian K., Michael P. Czervinske, and Robert M. DiBlasi. “Meconium aspiration syndrome”. Perinatal and Pediatric Respiratory Care, 3rd ed. St. Louis, MO: Saunders/Elsevier, 2010. 470-72. “Neonatal resuscitation”. Respiratory care 48.3 (2003): 288-95..