For Janaya, Makoa's delivery was the easy part; it was more painful to watch through the window as the NICU team worked on her son.
A neonatologist quickly wrapped Makoa up to his chest in a plastic bag, dampened with a warm saline solution to protect his exposed intestines - all four feet of them.
Team members cleaned him off, then threaded a thin tube down his throat into his stomach, which had partially come out of his abdomen during the birth. The tube would suction bile to prevent any waste from getting into his already stressed intestinal tract.
At 11:02 they placed an oxygen mask over his nose to help him breathe.
John continued to take pictures, watching the nurses and doctors for any sign of surprise. Since they acted as if everything was normal - at least for a gastroschisis patient - he was able to keep his parental panic in check.
At 11:11 a nurse finally got an IV into Makoa's left arm to keep him hydrated and maintain his blood sugar level. It would likely be weeks before his intestines recovered enough for him to eat anything.
Makoa's breathing had improved, and they reduced the oxygen mix. By 11:30 he was getting regular room air pumped through his mask.
A few minutes later they rolled his warmer out the door and into the delivery room to see his mother.
Janaya stretched her hand slowly, tentatively, toward her newborn son.
She brushed her baby's arm and then rested two fingers gently on his forehead. She was not allowed, of course, to pick him up.
She felt the cataclysmic pull of new parenthood: instant love, and terror.
But this wasn't the time for bonding. Janaya just wanted her baby put right.
After a few minutes, the doctors took Makoa away, down to the second-floor NICU.
It was 11:35 a.m. on Monday, Feb. 2.
Makoa, born a month prematurely, was the 111th baby delivered at CHOP and the 12th with gastroschisis.
The Special Delivery Unit - the only one of its kind in the world when it opened last summer - was built for babies like Makoa.
It would speed the start of treatment and allow mothers and their newborns to stay together.
Makoa had arrived in the NICU within an hour of his birth.
That was faster than would have been possible had he been born next door, at the Hospital of the University of Pennsylvania. It was hours sooner than if he'd come from any other hospital.
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