PURPOSE: To explore the influence of poverty on the parenting experience and maternal developmental trajectory of Lumbee mothers with medically fragile infants. DESIGN: A multiple-case study design using secondary data from a larger longitudinal study of parental role attainment with medically fragile infants. SAMPLE: Five cases involving mothers who were Lumbee Indians and who had medically fragile infants. RESULTS: The key features of the mothers' talk about their parenting experiences were organized into categories that fit into five inductively derived themes related to poverty. IMPLICATIONS: Health care professionals need to be aware of how the context of living in poverty affects mothers of high-risk infants who are hospitalized in tertiary care units. In particular, low-income mothers, especially American Indians living in high-poverty areas, urgently need improved community resources such as access to birth control; early prenatal care; programs to help reduce drug, alcohol, and tobacco use both during and following pregnancy; and follow-up health and developmental services for their infants.