IT'S the dilemma no would-be parent wants to face.
Mum-of-three Rosie Bull has suffered from kidney disease for several years.
But when she fell pregnant with her fourth child, it was eight years since her last baby. Her kidney condition had worsened and she was told by her doctor that having the baby could seriously affect her health.
The doctor told her that in order to save her own life, she would need to have the baby very prematurely.
A termination was an option that Rosie, 39, and her architect husband Andrew, of First Avenue, Carlton, were forced to consider.
Rosie, a Christian, was faced with a difficult decision, but in the end she said her faith helped her come to an answer.
She said: "Yes, I was scared; after that initial conversation with the consultant I just burst into tears.
"There was a lot of things to weigh up – I have three other children who need a mum."
But in the end the couple decided they would go ahead with the risk of having their baby daughter induced prematurely.
And so, at just 28 weeks, Lois was born at Nottingham City Hospital's neonatal unit – weighing 2lb 1oz.
Babies born after a typical 36-week gestation period weigh around three times that of Lois.
Such are the advances in neonatal medicine that had Lois been born as little as three years ago the chances of her survival would have been considerably lower.
But despite the chances of survival being better than they were, Lois's road to recovery was a difficult one.
After 14 days she picked up an infection and had to be transferred back to the high dependency unit in the neonatal department.
She was taken off milk for 48 hours, because doctors feared she had an infection in her stomach, which had swollen.
"It was at that point that it just hit me how fragile the situation was," said Rosie, who works for a family support charity.
"I was devastated and I did think for a second I might lose her."
Last weekend Lois finally left hospital after more than two months, and this Thursday Rosie will celebrate her 40th birthday with all her family.
She said: "I think the consultants are amazing. They had to balance the risk to my own health against when it was safe to deliver Lois – and they've pulled it off.
"I cannot believe we are all home together as a family. I wasn't sure if this day would ever come.
"This is the best 40th birthday present I could have ever wished for.
"But I won't be having another child again."
Rosie also has three other children Hattie,13, Emily, 11, and Jacob, 8.
Dr Craig Smith, a consultant for the neonatal department who helped save Lois, said: "This case was a little unusual in that the reason we had to deliver the baby premature was for the mother's own safety; normally it is the other way round.
"At 28 weeks we can now fairly confidently say that we will have a good chance of survival, and I'm happy that is the case with Lois."
Between 2009 and 2011 there has been an 20 per cent increase in the number of babies born prematurely at the QMC and City Hospital. In 2009 there were 530 premature admissions and this increased to 636 premature births by 2011.
However, more of them are being saved because of better equipment and advances in science. Since 2006 medics in Nottingham hospitals have cut the fatality rate for premature babies by a massive 35 per cent. In 2006, the hospital trust recorded 93 deaths, in 2009 it was 62 deaths and in 2011 only 40 premature babies died.
The Neonatal Survey for 2011, comparing trusts in the East Midlands and Yorkshire, found Nottingham's hospitals to be the best for saving premature babies' lives in relation to admissions.
Dr Stephen Wardle said: "We are doing something right, we are one of the biggest trust's in the region but statistically premature babies are more likely to survive here in Nottingham than any other hospital in the region.
"The main reasons for this is because we have improved communication links with our obstetricians [who look after both mother and baby], plus we have better staffing levels; if a child is in intensive care we try and get one nurse to every baby. There are also other factors, like we are able to take more accurate scans."
Ventilators are also more advanced than they were.
Lois will have to attend regular check-ups for the next two years to check that she is developing correctly as some premature babies can have problems with learning in later life.
The neonatal departments at both the Queen's Medical Centre and the City Hospital are a centre for regional excellence and as a consequence takes the sickest children from across East Midlands.
