Saturday, 30 July 2011

23 Week Babies - Revisited

I have blogged about this before, after the screening of Adam Wishart's documentary "The Price of Life - 23 Week Babies". If you missed it, you can view it on YouTube. However after some flutters on Twitter this week, I wanted to revisit this topic and clarify the situation in the UK.

In the press this week, there has been an article about baby Jacob McMahon a little boy born at 23 weeks, sadly his sister passed away several days before, however after a 5 month stay in hospital, Jack is now home. This story has been picked up by the US Right to Life movement, and been interpreted in somewhat interesting ways, an example is this article tweeted by a fellow preemie mum today.

As in the US, in the UK babies born before 23 weeks are assessed on a case by case basis. Jacob is undoubtedly a special little boy he is not unique, many babies have been saved below the "threshold" of 24 weeks. I can understand the Right to Life movements desire to utilise these stories, as the current abortion limit is 24 weeks in the UK, so there argument is surely that if babies can survive if born before this threshold then termination is wrong.

I dislike the linking of the premature baby debate to the termination debate and I see them as two very seperate issues. Just to clarify, I have a completely on the fence attitude to termination. In a perfect world, all terminations would be banned, babies would be born to happy parents, who want and are ready for a baby, and no baby would be poorly in the womb. But life isn't like that. I would never judge anyone for having a termination, each of us has to do what our own heart and conscience tell us to do.

So to clarify, babies born before 24 weeks can be saved in the UK. It is, somewhat, a lottery, in this case a term I also dislike. It is a lottery because it depends on what sort of hospital you present to. If you present to a hospital without a level 3 NICU then its unlikely that they will be able to save your baby born before 24 weeks, it doesn't mean they won't try, but they may not do if they feel that treatment will be futile.

There is more debate about this in the UK than in the US, and that is for one very good reason. We all pay for the treatment of these tiny babies, our medical system is public, its not down to individual insurance companies or hospitals, its down to the NHS to determine what level of support they are prepared to provide. 

I feel that the Right to Life people, at times, miss the point. Treatment is not without cost. Doctors are not cruel, making arbitrary rules. They are governed by a number of factors, but first and foremost "first do no harm".  There is a reason they give babies morphine, treatment is painful. And sometimes, its futile. Babies can be born in horrendous circumstances, already having infections, or having underlying medical conditions that have not yet been diagnosed. I am not ashamed to say that I asked whether we should let Joseph slip away. I was concerned about the cost to him personally of undergoing treatment. In our case it was clear cut, delivery had been done in a timely way, and he needed some interventions, however they were minimal compared to other babies. Am I sorry I asked that question, no I am  not, because I felt, as his mother, I had to consider his needs, all I wanted was my baby to be well, and to not suffer.

I do think it is healthy and right that we debate these issues. However as well as love and compassion, we need to debate with truth and with integrity.