Should prem babies die?

Tracey - posted on 03/07/2011 ( 81 moms have responded )

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Hi Ladies, due to a legal settlement between www.dailymail.co.uk and the doctor mentioned in this article, we have been asked to remove the article from our site. I apologize for the inconvenience.



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Catherine

Community Manager

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Mary - posted on 03/07/2011

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Wanda, I understand where you are coming from, but I also know there can be world of difference between 22 and 25 weeks. It's not that easy to sit back and watch a severely premature baby die....it's knowing, from years of experience, that the alternative can be much, much worse, especially for the baby.

On the flip side of this, I've watched parents insist that everything be done on a baby that was clearly not mature enough to survive...and watched that small little soul be tortured with numerous tubes and machinery for hours or days, only to succumb to the inevitable. I know that if I gave birth to a 22 weeker that was born alive, I would want whatever short lifetime they were granted to be spent in the love and warmth of my arms, and not in a plastic incubator with a tube down her throat.

Is that ever easy? No, but - to me- it is the more selfless parental act of love.

Mary - posted on 03/07/2011

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I don't think there should be an absolute, set-in-stone gestational age that is the sole determining factor of whether or not resuscitative measures are implemented. I do, however, think that resuscitation should not be implemented on all babies that fall into that gray area of 23-24 weeks. Even when the precise date of conception is known (such as with IVF), a due date does not definitively reflect the physical maturity of the specific baby in question. Just as some infants can roll over at two months and others don't until 5 months, a baby's intrauterine development and physical maturity is widely variable.

That being said, I do think we often go too far, and attempt extreme resuscitative measures on babies who should have been granted the peace of being left alone, rather than dying a slow torturous death hooked up to multiple machines and tubes. For every one miraculous story of a 23 weeker who defied the odds, there are many more tragic tales of those who didn't; the difference is that those stories do not make the headlines, or get retold in forums such as this.

When I was pregnant, I worked in L&D, in a hospital with a Level III NICU. I was quietly terrified of this exact scenario when I was 23-26 weeks pregnant. Like many nurses who have watched patients be needlessly tormented with desperate interventions, I firmly believe that hope drives us to go to far. Had I delivered in that gray area, I would have had the NICU team present at delivery, but would have trusted their judgement of my baby's physical maturity as to whether or not extreme resuscitative measures were reasonable.

[deleted account]

Karissa, sometimes allowing your child to die is the most compassionate thing to do. Just because someone chooses not to prolong suffering it does NOT make them a bad parent, it makes them a better parent than the one who is so absorbed in their own emotions they can't see what is in their child's best interests!

Carolyn - posted on 03/08/2011

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how is someone who is letting nature run its course playing god and those taking unnatural measures to revive a baby who would die not playing god ?

to me those taking extraordinary measures to prolong the agony of that baby are the one playing god... not the ones letting the babies go..

[deleted account]

Charity, there is a huge difference between terminating a life and allowing a life to end without interference! Nobody is suggesting murdering babies - whatever the age they are born at be it 22 weeks or 40 weeks, they are saying that if it is apparent a baby will NOT survive instead of forcing them to live in agony for a couple more hours or days why not show them the respect they deserve and allow them to pass away naturally.

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Merry - posted on 03/18/2011

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I think he gave us the will to survive, the intense feelings to procreate and the need to do our best for our loved ones.
He gave us the brains to learn and develop the medicine to help us live longer and healthier so I don't think he minds when we do our best medically to live.
But we also have compassion and realistic thoughts so I think we just have to make our decisions based on how we feel, and that's as good as it gets! It's a tough call with preemies, you just have to be able to live with your decision. So it's going to vary person to person

Mrs. - posted on 03/17/2011

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As painful as the decision is, I hope I never have to make it, I see where the doc is coming from. For me, on an individual basis, between the parents and docs - I would never blame someone for having the courage to not allow their child to suffer needlessly when they only have a very minimal chance of survival.

The God's Will thing....that always puzzles me. The thing is, if most of these babies were born without modern medical attention - they would not survive, period. I'm not so sure keeping them alive is so much God's will as it is man's will. Of course, I'm not real close with God, so I don't try to speak for him.

Charity - posted on 03/17/2011

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I don't believe it's God's will to bring a baby into this world just to let it die. That's where sin comes in. Sin brought death and sickness into this world. God works miracles everyday. Just because He doesn't save the life of a baby doesn't mean He doesn't love us. He allows things to happen for reasons that we may never know. If a baby is born too early people have the right to choose whether or not they want to fight to save their child. If a parent wants to take their child off of life support that's up to them. If they choose not to even try to help their child survive that's up to them also. It's such a touchy subject. I don't think there are any right or wrong answers. But I don't think pulling the plug is an option just because the baby won't have a good quality of life. If the child survives then it's for a reason. And we should trust God to help us stay strong and provide us with the things we need to take care of the child. When we leave God out of our lives, life is more difficult to handle and meaning becomes a depressing mystery. I'm sorry if you took offense to what I previously posted. I was under the impression that we write our opinions without being cursed at for it.

Carolyn - posted on 03/11/2011

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Mary i tried to go there, but all i got was " so the disabled dont deserve to live ?" " should fullterm babies with disabilities die ?" ect ect.

You said exactly what i was trying to get at, and you said it much better. :)

Mary - posted on 03/11/2011

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Another consideration that no one has touched on this debate is the reality that a large number of these micro-premies that we "saved" have some very significant disabilities that relegate them to a "life" that requires 24 hour nursing care. Some families are able to maintain them at home, and others live out their days in long-term care pediatric facilities. They spend their days hooked up to ventilaltors and/or tube feedings.

I vividly remember my rotation through one of those wards at AI Dupont Children's Hospital in Delaware. It was beyond depressing. Many of these children, who were now one to two years old, had days, and even weeks pass without a visit by a parent or family member. Their sole human contact was that which they received from the staff of the hospital. I remember one of the more seasoned nurses talking to us about trying not to judge these family too harshly. She spoke about the long-term emotional toll that seeing your child in this state took, as well as the enormous amount of guilt these parents struggled with. It was even more difficult for them to maintain daily contact when they had other children to care for.

I bring this up because I think a lot of you have a romanticized notion of the possible outcomes of resuscitating these extremely premature infants. I'm sure that many of the parents of these children were full of hope and love when they either consented or pleaded for the NICU staff to "do everything" to save their baby, while never fully comprehending what that salvation entailed.

[deleted account]

Casey if you had read the thread nobody here has said that just because a baby is under 24 weeks they should be left to die, in fact, pretty much everyone who agrees with the sentiment (to an extent) has stated several times that they don't think it should be based on gestational age because often they are wrong and unreliable, just because the doctors think a baby is 25 weeks it may only be 22 or vice versa - we have all said that it should be based on the individual baby and individual circumstances. It isn't the money that bothers anybody but the un-necessary suffering the baby will suffer.

Casey - posted on 03/10/2011

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I think it's ridiculous and i don't know how anyone can sit there and say that at 23 weeks gestation a life isn't worth saving but at 24 weeks we'll at least try, it's absolutely stupid and I'm sure Dr Daphane Austin would have a much more difficult time in making such a heartbreaking decision if she was ever put in this situation, I realise that it costs money to care for a prem baby but how can anyone put a price on a life. And besides no-one knows weather a prem baby is going to make it through or not yes I know alot of them don't but there is also alot out there who do and those little fighters should be given the chance.
As for abortions at 24 weeks I think thats disgusting and wrong!!!

Carolyn - posted on 03/10/2011

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Wanda, allthough you might not see this, I dont recall anyone saying babies should be left to die "just because tey have a disability"



I am really not sure where you are getting that from.



also this debate doesnt really pertain to this family, as their children were born at 25 weeks + 5 days gestation, beyond the proposed guideline in the article.

Sharon - posted on 03/10/2011

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They have my thanks for using my tax dollars. I'll be sure to tell the people here who were denied kidney transplants due to a bankrupt welfare system why they can't keep living.

April - posted on 03/10/2011

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ah this thread just hits me hard with the emotions. most of the preemies I have had in my life have survived and none of them have been as severe as "not being able to wipe their own ass, choking on saliva". All were born between 22 and 25 weeks. Each one was no more than a pound or a few ounces over a pound. Each one fit into the palm of your hand. One has no permanent effects, one is deaf, another has CP. They are all adults and teenagers today, fully functioning in society. There's one more. The little girl I mentioned in my previous post that has never lived outside the hospital yet. Who is to say that she won't end up like my friends? (I am deaf, I have a lot of friends who were preemies. In fact, most of my friends were preemies). I guess in my experience, it hasn't been rare for a preemie as young as 22-25 weeks to survive with only mild disabilities. Yes, I know a PP was talking about having a bunch, and one girl does. She's a teenager now in high school with tons of friends and lives a normal, happy life. I have no doubt in my mind that the little girl who lives in the hospital will have a wonderful life, too. She is going to face many challenges, but I am certain she is going to grow up happy.

Alyssa - posted on 03/10/2011

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Sarah,

""Abortion is the end (termination) of a pregnancy. Most abortions occur during the first trimester of pregnancy (up to 12 weeks), although some may be carried out in the second trimester (12–24 weeks) or, in rare circumstances, in the third trimester (24–36 weeks). ""

http://www.betterhealth.vic.gov.au/bhcv2...

Merry - posted on 03/10/2011

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Carolyn, if the baby doesn't stand a chance at a 'normal' life. Normal including a few disabilities, then I said it's not worth it. There has to be hope for the baby to thrive. If the baby faces such brain damage it can't ever think, coupled with physical deformities etc then I definitely think it's cruel to keep it Alice for the emotional factors. Same with as I said about brain dead babies, or babies whose heart fails over and over, or babies who aren't growing or developing at all.
There has to be a good end in sight for me to think these measures are worth it to try to save the baby.
Obviously you won't know right away if each baby has a good possible outcome, so if the parent wants to try, try. But if time and time again the baby proves that it just wasn't ment to live, a hard call has to be made.

I *think* we are in agreement.
It's about the potential quality of life that needs to be considered in each case.

[deleted account]

OK... what about if we look at this in the context of the whole world and all the babies in the world, who presumably have the same "right" to live (if there is such a right)? Why should we spend hundreds of thousands of dollars keeping ONE baby alive when a simple course of vaccinations costing $5 can save ANOTHER baby (equally gorgeous, equally loved). Just that baby is in another country.

Doesn't that change the ethics of the issue when you look at it like that?

Sharon - posted on 03/09/2011

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Charity - if you believe that strongly in GODs will. Didn't God just will a baby to be born ridiculously early? Was it Gods will that the baby suffer before dying?

Stop laying bullshit on Gods' doorstep. God gave you free will. Make the choice to save the suffering another human being.

Just because its a baby doesn't make it more or less deserving of life saving efforts. But there comes a time when a judgement call has to be made. Combat triage nurses/doctors know this. This one can be saved if we act now, but it'll cost 3 hours of time and in that 3 hours we could have save those 8 people and all their limbs.

Its not pleasant or happy judgement call - but it has to be made. MOST babies born at 22 weeks do no survive. In order for them to survive they are put through hell. Only to face a degraded life? WTF? Really? OH and lets face it, at the cost of taxpayers. Even private insurance pays a pittance to the ultimate cost of the months/years of medical care a micro premie needs.

So, if you want to drag God into this, God had already decided you didn't need a child when he caused it to be born so early.

We all want our babies to live. We all want them to be perfect healthy and able. We would give ANYTHING to save our babies - no matter how early they had been born.

When I was pregnant with my first - all the docs had said I wouldn't be able to get pregnant and carrying a baby to term after that miracle would be an even greater miracle. I was waited daily for a miscarriage to occur. I thought about this stuff all the time. I asked EVERYONE about it. UGH it sucked.

I think - that if you put it out there 'yes we will try to save your baby but you will have to pay back every dime without government aid beyond the cost of a normal newborn" you'd see people NOT saving their babies. right now its easy to say "oh yeah, it won't cost me anything - the government will pay for it"

Every life touches another. The baby was a live and now its not. would umpteen months hooked up to a billion monitors, leads, oxygen tubes with tearing skin, swelling brain etc make a difference to the baby? Or are you still worried about yourself?

Charity - posted on 03/09/2011

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I believe it's not up to anyone to terminate a life just because the odds are against it. I believe in the God of creation. The God of life. He knew each one of us before we were ever thought of. He has a plan for each life. If a baby is brought into this world, I believe God has a purpose for that life. Even if it's only for a few minutes or a few years. Every life touches the life of another and we have no right to interfere with that. I think if more people would hold onto this concept we would not have to have discussions like this. God works miracles everyday. If we destroy a life we are taking away a chance for a miracle. We are ALL children of God. We have no right to take the life of another child of God.

Carolyn - posted on 03/09/2011

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we can talk about full term babies being born with disabilities, but that isnt what this debate is about,



its about putting an under 22 week premature baby through physical hell and pain on the rare chance that it might survive with an ever rarer chance at leading a relatively normal infancy and life at the parents desire regardless of medical advice and prognosis, and absorbing an astronomical cost to simply prolong the suffering of these poor babies before an inevitable death.



Should everyone else have to support and go along with someones desire because they dont want to let go and accept circumstances as they are ?



noone is saying to let babies with a chance die, but those without one who were born before 22 weeks development ( since EDD can often be wrong) should be spared the pain and agony and made comfortable as they pass on instead of endlessly resuscitating them, increasing the odds of brain damage and further negative health outcomes.



there wil always be grey area and i am sure discretion for each case, most times these are never blanket statements and have exceptions to the rule.

[deleted account]

I know peemie parents whose babies suffer from some disabilities that keep getting talked about - vision loss, hearing loss, CP and CF. They'd all be really offended if someone told them that their children didn't deserve a chance.

And just because a child is born at 22, 28, 32 or 40 weeks, there's no guarantee that they won't suffer the same issues. Yes, the odds a preemie will are greater but if a full term baby is born severly disabled should they be left to die as well?

Carolyn - posted on 03/09/2011

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laura i guess you missed the part where i said " blind, deaf, AND a host of other ailments"



plenty of people lead fullfilling lives blind, or deaf, or with mild disability. I never said one or the other, i clearly said AND. Would i suggest allowing a baby to die simply because it would be blind, absolutely not...



the level of disablity i am referring too, they would not be able to express wether or not they want to die because they cant move, wipe their own ass, or communicate let alone swallow their own saliva or make eye contact with you when you ask.

[deleted account]

Hm. I do think that humans try to defy nature a little too often sometimes. It would break my heart as a mother if I ever had to see my child on too many machines with pipes on every angle attached to him/her. Sometimes creatures are just not meant to remain on the earth and we need to accept that. Where people make idiot rules, for example a dog is so old that it can't walk. It is sick and miserable. It is "wrong" to try to keep it alive and "in its best interests" to put it down. Try that with a person? You have now been labelled a "murderer".

Babies shouldn't have a definite date that they cannot be born before, but seriously now, if a child is born too soon and not developed properly, even if you resuscitate or incubate or whatever, it usually comes with a price later on.

This being said, if my child was premature I am sure that I would fight to keep him/her but still being reasonable about it. I would rather see the child pass quickly, than have to see them suffer for hours if not days before they finally decide that nothing more can be done.

Merry - posted on 03/09/2011

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So it's either force a baby to live without sight or sound, or deciding it doesn't deserve to live at all?
Personally if I had to choose to either live blind and deaf or to die, I'd choose to live. Maybe everyone doesn't feel that way?

Merry - posted on 03/09/2011

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I don't think there's too many disabled people who wish they were dead.....
Accepting assistance, meaning the heart is beating the brain is functioning, the baby is growing and developing.
Brain dead babies, babies whose hearts won't beat without help, or babies who aren't growing or maturing I would say are not accepting the assistance well. They are just being sustained for irrational reasons. There has to be hope that the baby will develop into a child. If it's just prolonging death, then it should not be allowed for the baby to suffer.

Oh and I think if you ask a person who has a disability, they would be offended if you referred to their life as 'horrible'

Carolyn - posted on 03/09/2011

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"But if they want to try, and the baby seems to be accepting assistance, then it's no ones job to harp on them about the money"

so how do you measure if a baby is " accepting assistance" and who decide's what an acceptable rate of "acceptance" is the parents emtionally invested who will think that little twitched is a sign from god that baby is "accepting" treatments, or the medical experts who know that twitch was just a twitch, or a nervous response to being pokes with needles, and tubed, etc.

with cancer patients etc, usually there comes to a point where they are told nothing is going to help and they will die, and they are just made comfortable. Family members cant walk in and force the doctors to do more surgeries, and continue to take life saving measures. These people can also speak for themselves. They have a choice if they want to prolong their agony and pain and endure painful treatments and shitty quality of life. A premie baby doesnt.

hmm i just thought, how is forcing doctors to keep a baby alive who will surely suffer brain damage, blindness, deafness and a host of other problems ( and i mean these babies who will forsure with out a doubt suffer these ailements) any different then lopping of a peice of forskin at birth ? instead of nerve endings, you are forcing a baby to live with out sight, sound, and the more extreme effects of being born at 20 weeks . god forbid you circumsize your kid but save that premie so he can "live" a horrible life.

Merry - posted on 03/09/2011

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To clarify, I'm not talking about euthanasia of the elderly, I'm talking about resuscitating old people who are on the way out regardless. Just to have a bit more time together etc.

Merry - posted on 03/09/2011

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First of all, I have to say I'm really happy I'm already 32 weeks! Lol, preemie stuff is scary.

I think that medicine is improving all the time, odds of a 28 weaker surviving was bad at one time, and we are always getting better and better at keeping babies alive earlier and earlier. Who knows, ten years from now the odds for a 22 weaker could be much better! We can't put alimit of age on who gets help because you never know how old each baby is anyways, and even then some are going to do better then others.

It's got to be up to the parents, it's their choice for their baby. If they just want to hold their baby until it passes then they should be able to in those micro preemie cases. But if they want to try, and the baby seems to be accepting assistance, then it's no ones job to harp on them about the money. We put soooooooo much money into terminally I'll people, and extremely old people, and disabled people. I mean why is a preemie any less important then a cancer patient with two years left to live trying every chemotherapy and surgery to extend their life a bit more. And yes, it is sort of cruel to have those babies all hooked up and wired and poked etc. But that is on the parents to decide if it's worth it to them or not.

Idk what I'd do, by 18 weeks I know my baby's sex, and have them named so by 22 weeks I'm very tightly bonded to my child! But idk, I haven't been there.



Honestly I think it's a bit more of a waste of money to try to resuscitate the extremely old people. They lived their lives, they are going to die in a short time regardless of interventions, why spend so much time money and equipment trying to restart a 87 year olds heart!

At least the preemie babies *could* have a whole lifetime ahead of them......

Audrey - posted on 03/09/2011

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ALL babies should be given the chance and resources to live!! i dont care what the situation is. how could any decent mother say otherwise?!

Karissa - posted on 03/09/2011

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This study pretty much negates the need for all doctors all together. Everyone is going to be dead eventually, so putting any money into anything to keep us healthy and alive is complete waste. From the beginning of conception life should be protected. I'm sure any mother who has a premie baby would be ok with doing anything necessary to keep their child alive. Doing nothing and letting your child die would be the definition of a bad parent. A doctors job is to protect life no matter what, and letting babies die, no matter how old they are, is wrong.

[deleted account]

A few people have said "every baby deserves a chance to live"... but if tons of money is spent on each tiny little 22-weeker, there'll be nothing left to spend on health prevention programs that could save a large number of OTHER babies.

As a society we have to face up to the fact that there is a limited amount of money to spend on health, and it should be spent in the most efficient way, not just at the way that tugs at our heart strings the most.

Sorry if I sound brutal, but it makes sense...

Ez - posted on 03/09/2011

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My feeling is that it needs to be a judgement call based on each individual case. As has already been addressed, EDDs are notoriously inaccurate. So a 23 weeker may actually be a 25 weeker, with greatly improved chances of survival. That's why the decision to intervene needs to be based on the development of the baby, not the gestational age.

Sharon - posted on 03/08/2011

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That is the bereaved mothers' interpretation of things.

If she's telling the flat out truth my fucking ass would move out there the day after my baby was buried or flushed, whatever those fucksticks do, and get as far away as possible.

[deleted account]

I just don't understand why people like that want to make choices for the parents and then get paid ..... I have 2 babies that are preemies my one baby was 5 lbs 15 ozs which at the time I thought was tiny cause my other child was ( have 4 kids ) 7 lbs 11ozs. but then 10 months later I had my daughter she was so tiny 6 weeks early she weight in at 3lbs 10 ozs and after almost a month in the nicu she came home at 3lbs 10oz talk about scary. But for some to say babies that are early should be left to die who are they to play god..... I am so greatful for the drs and the nurses at the hospital that were there that saved my baby ... with out them my daughter would not be here. Yes there are risks but there are risks in life and we take them everyday by waking up and living our lives and well it doesn;t stop us does it?

Sarah - posted on 03/08/2011

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The link Kelly posted http://www.circleofmoms.com/moms-of-ange...

I'm only going to comment on this one because i don't know enough about premi babies to contribute to the discussion :)
This woman BEGGED the doctors to treat her daughter who was born at 22+5 and they refused, despite the fact that she was born breathing and her heart was beating strongly. That baby was alive for hours suffering while the doctors did nothing. Even if she was only alive a few extra hours the mother would have had the chance to say goodbye :(

Same thing with Poppi's rule in Australia. If the baby is born alive, they should have a chance. Even if it's only long enough to say goodbye.

And abortion legal to 24 weeks? that's DISGUSTING! :(
i think it's 16 weeks in Australia but most places don't do them after 12.

Sharon - posted on 03/08/2011

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She's never lived outside that hospital? How sad? And who is paying the bills? And how do her parents tear themselves away to go to work?

Kelly - You said that insurance companies should pay to save the preemies. That sounds like the should carry the bill in full. But I can agree with your revised statement.

If I were to sicken or be terribly injured I too would bankrupt myself and my husband to live.

Mary - posted on 03/08/2011

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April, if you went back and read all of my posts in this thread, I think you would find that I clearly made the point that an EDC is not a completely reliable indicator of true gestational age.

Perhaps, in an attempt at brevity, in the post you took that quote from, I did not specify clearly enough that I was referring to the actual level of physical/neurological maturity of the baby, and not just the gestational age based on dates.

April - posted on 03/08/2011

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I know someone whose baby was born at 25 weeks, but even if gestational age was accurate, she was small for even a 25 weeker.



The placenta was also taking up so much room that her daughter had little room to grow. Based on her size, she was LIKE a 22 weeker even though she was actually 25 weeks.



As due date is ESTIMATED, she could have been a 22 weeker that was like a 20 weeker! She is hooked up to machines and has been in the hospital for almost 6 months now (she's never lived outside the hospital yet), but she is wonderful.



She is beautiful and has a lot of personality! She makes funny faces and plays with her parents. I love her so much! I couldn't imagine her parents deciding to refuse medical interventions at birth.



No one knows yet what her life will be like, but right now she is happy! She has pain and her life is difficult, but she still enjoys life. I don't think it is right to decide for the child that they have no chance. If it was, this little girl wouldn't be here today.



Poor quality of life cannot be assumed. Each little person makes up his or her own quality of life. This little girl is happy and loving towards her parents because it is in her character to make the best of her situation. She wants to live and I believe that will was present at birth.

[deleted account]

Sharon & Carolyn, I understand what you are saying, but you completely missed the point of my post. Yes, the NICU care for a 22 week baby would probably bankrupt a family, BUT it is still the families decision whether they want to bankrupt themselves and get the care, or let the child go.

I'm not going to judge another parents decision either way, I don't know how I would react. I do know that I racked up over $80,000 (it was over $140,000, but I cut a deal with the hospital) in medical bills to save my own life, and that was after insurance paid 80% until they cancelled my policy. It was MY decision, and it bankrupted me....not that I had much to loose. I paid it back, to me, it was worth it. between the insurance company, the family, and the hospital's profit margin, funds for the babies are not limited in most situations.

I understand that money from everyone's premiums pay for the care, just like money from everyone's taxes pay for the care in other countries, but right now, in the US, you are not forced to pay insurance (of course that is changing), so people are not being forced to pay for a child they don't think will be worth saving.

To me, the parent should have the final say about whether to intervene or not, not the government.

April - posted on 03/08/2011

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"There is a world of a difference between 22 and 25 weeks." There MIGHT NOT be. It's called estimated due date for a reason...it's just an educated guess! My son was born "full term". I put this in quotes because I believe he was actually 3 weeks early! I had no signs of labor, cervix fully intact, but the Dr, wanted to deliver as the due date was close to Christmas. He was taken via c-section for "failure to progress". I had no contractions, no signs of labor at all. When he was born, he couldn't even open his eyes yet!! Plus he was hairy and just looked damn tiny (5 pounds, 9 ounces) **I did keep track of when we had sex...according to MY calendar, the due date would have been early January. He was forced to be born on Dec. 22. Anyway, this is just an example of how off due date can be!!

Christina - posted on 03/08/2011

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I'm a nurse, and I'm big on "comfort care" only. If I had a baby born before 23wks gestation, I wouldn't even allow them to attempt to save my child. It wouldn't be fair to my baby. I have given birth to a preemie and know what that road is like. I know what it is like to stand there and be told that they are doing everything but there is no guarantee; that my daughter might not make it through the night. As a mother, I love my children ENOUGH to let them go. However, I do feel that every state has the right to dictate their own judgement on when viability is (whether it is 22wks or 24wks.) I have two nieces and two nephews (a singleton and triplets) all born at 24wks gestation. All four of them have health problems, the severity ranges. All four are completely deaf, the two boys have CP, one severe, one mild, ect. One has epileptic seizures. I love them so much and am so glad they made it. But there has to be a level of cut off where we just don't try to save these babies that really don't have a chance. We have to be kind enough to just say goodbye and I love you.

[deleted account]

@Kelly - that sounds like the same post. I'm not a member of that community so I can't be entirely sure.

@Mary - I understand what you are saying about about being mature enough to survive. In my mind I totally agee with you but this is a cause that is near and dear to my heart and my heart says to at least try.

I understand the odds are greatly stacked against a 22 weeker. I understand that they are often too immature to survive but if it had been my child I would at least want an attempt made.

% chance of preemie survival - 22 weeks 10% survive
23 weeks 50-66%
24 weeks 66-80%
25 weeks 75-88%
26 weeks over 90%

I got those statisics from the hospital that my son was born at. For the 10% that survive I would want an attempt made.

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Although I find this horrific, it really does has to be on a case by case basis, I think Mary puts a really good perspective on this issue. I agree that sometimes it is just more compassionate to allow the child to pass away rather than forcing treatments on them to delay their death which ultimately will happen - in the same way I think it is more compassionate to allow people who we know are dying to pass away without forcing treatment on them to prolong their lives. So if we allow adults to refuse treatment, should we not give babies the same respect (sort of).

Katherine - posted on 03/08/2011

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That's a really good point Tracey. They do do the APGAR and that should be a huge deciding factor. I'm still not for this cut off thing though.

Mary - posted on 03/08/2011

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Tracey - there is both the Dubowitz Score and the Ballard Score which are used to assess gestational age at birth. The problem is that with these severely premature infants, a decision about whether or not to initiate a resusc (particularly intubation) must be made immediately at birth in order to maximize outcomes and preserve brain function, so they really cannot do a very thorough assessment in first minute or so. What most NICU's have found is that their initial assessment at birth is usually on the generous side....a Dubowitz score performed at 30 hours of life tends to be lower (meaning younger) than the inital finding.

Melissa - I don't think you understand that initiating treatment is actually more painful and stressful than allowing that baby to simply be held in his or her parent's arms. Withholding interventions is actually the kinder, more compassionate route to take with these babies who are not mature enough to survive.

Sneaky - posted on 03/08/2011

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I don't agree with a gestation age being the deciding factor - they do APGER (I know I messed that up) tests when a bub is born and repeat it a few minutes later (at least they do in Aus), why can 'they' not design a set of minimal functions that a premmie baby must have before medical intervention is given? And large doses of pain killers for the ones that are born with out being developed enough to be saved :o(

Mel - posted on 03/08/2011

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those stories I read or hear about babies being alive for hourd with doctors refusing to help breaks my heart. Those bubs have a chance. Dont let them die in pain. Its just cruel. Every baby deserves a chance. What about the ones who do make it

Carolyn - posted on 03/07/2011

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Kelly the other thing about insurance companies is they raise premiums based on the $$ amount of claims made by their customers. So when those premiums go up , every client with that provider is footing the bill, and then shit gets so expensive, employers cant afford to pay their share and offer these benefits, and you cant afford to by them privately etc...

its not the insurance companie paying out a million bucks for life saving measures on baby who, in the medical opinion of trained medicals will not survive, its every person on that provider as well.

no different than a universal health care system.

So many people cant get treatments they need because they have capped out their insurance, or the insurance says " nope we are paying for that" and these are people who have children to care and provide for and people depending on them.

I think each case should be decided on its merits, and not just a blanket policy to take extraordinary measures on all premature ( 20ish weeks) deliveries. There is a reason we entrust our care to these specialists and there recommendations should have a majority percentage in what measures are taken.

Sharon - posted on 03/07/2011

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PFT! Kelly are you insane? insurance companies have enough to pay for the extreme attempts at saving EVERY preemies life?? I'm sorry, but are you insane? yes they may have the money - but do you forget that they exist to make a profit? Have you lost of the fact that there are other humans that need that company to pay for THEIR life saving treatments? And those same insurance companies have rules similar to the laws/rule of Aus.



Not to mention - these are not WHOLE insurance. That is, they don't pay for everything in full. They cover up to a certain amount or percentage and then the rest falls on the parent. And trust me. VERY few Americans have the money to cover the remaining portion. When I think of Americans who can pay the remaining costs EASILY, Donald Trump and Bill Gates are the only ones with recognizable names that come to mind.



When my son was in NICU for 7 days - at $1K+ - $3K a day, Our insurance paid for his birth and 3 days of NICU. WTF? yeah - thats what they paid. We bargained with the hospital and got it knocked it down some and then applied for medical assistance from the state. If I hadn't been fired for being pregnant (don't tell me its against the law, it isn't) We wouldn't have qualified for that aid and I figure we probably would pay off his birth when he was around 30 (provided we still purchased this house) if he had required additional care & surgeries.



(edited to finish the paragraph below and fix some typos and lacking information above)

Putting a dollar amount on your childs life SUCKS. But its a fact. Do you sacrifice your financial wealth for one child who may not have any quality of life, who may require HUGE investments of money & time in the future and short the children you have or want to have?



UGH - i dunno if its COMS or my laptop (or just me being tired) but I really screwed this up.

Alyssa - posted on 03/07/2011

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Sorry Katherine, I didn't see the comment in the OP. I do get what your saying, I think. Just because the limit for abortion is 24 weeks shouldn't mean babies born before this shouldn't be resuscitated? Is that what your getting at?

[deleted account]

That is not what I meant (I do see how it read that way). I meant I felt like the child's life is worth the $$ because big insurance companies have enough to pay for it without even blinking, so they should be required to.

In companies with universal healthcare (which I do still think is a better option that what we have here) the citizens are footing the bill for healthcare and often feel that resources should be spent on cases where people have better chances at survival.

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