To want a clearer answer? Please be kind

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I have posted this here for traffic, I'm hoping someone with more knowledge may see and have a higher chance of reading.

I've had several miscarriages but two later ones. My DD was born in October as a late miscarriage. Since my losses seem to get later and later, it makes sense to think about what will happen and what are our rights if another baby is born early but next time is extremely prem but viable. I asked my consultant if this is possible and she said yes, it's sensible to perhaps prepare for a prem birth next time.

I am now pregnant again and the question I have is quite simple but not easy to answer, it seems - Can I refuse resuscitation for my baby if they're born not breathing just after the viability threshold? And, if they are born at 23/24 weeks and they are breathing on their own, can I refuse help for them?

I'm aware that these questions may seem so so cold to somz people Please know it is from a place of love and also practicality.

I do worry a lot that I'll end up going into labour so prematurely again, but this time a little later on. The list of complications for that little person for the rest of its life worry me.

I work alongside midwives and I'm friends with a few. None of them will give me a straight answer, none of them are clear. I usually get a response of '' You think about this in a lot of detail, don't you?'' or '' Why are you thinking so far ahead? '' when I've chosen to speak out to them.

I am seeing my consultant again in March who I hope will be clearer with me as she doesn't beat around the Bush.

We have a beautiful DS and if anything happens to this pregnancy then we promised ourselves we would be done.

Hi, my waters broke at 21 weeks and was told that before 24 weeks they wouldn’t be able to do anything for baby. Luckily I’m almost 26 weeks now and feeling positive. It was a huge shock to me that they wouldn’t help baby and i was absolutely devastated and terrified x

Sorry i actually read your post wrong so my answer isn’t very relevant xx

If they're born before 24 weeks you'd have to fight for intervention so def shouldn't have issues with your wishes. After 24 weeks I think you might have to ask very specific questions and decide at which gestation you would want them to do something.
I think pat 24 weeks you're going to struggle with them letting a breathing baby who needs help struggle. You need to think what that might look like too, if baby is breathing but say can't feed, how long the baby might be struggling for etc

As in, we always work towards life, so if the baby is viable, and alive, then we WILL work to save the babies life, no matter if there are some developmental delays etc because anything less is murder in law.

If baby cannot survive without intervention or would pass due to needed medical interventions then we would let baby pass away in peace.

But surely all babies born at the very line of viability need intervention, otherwise they can't survive?

Gestational ages of 23 to 24+0 can also be aborted but I suppose that's different as they'd be given feticide to ensure there's no possibility of them coming out alive if the woman opted for a late medical procedure.

Just seems off though that if my baby was born at 24+0 that they'd be rushed in for all the help in the world yet in another part of the country the sa'e gestation is being aborted. That's why I question so much how much quality of life my baby would Have if born at that stage.

That isn't a criticism by the way, I am pro choice and just thinking aloud.

My local hospital is the Luton and Dunstable who apparently take babies in from as tiny as 22 weeks

Recent changes in practice means that some babies at 22 weeks will be resuscitated. There are obviously different rules around this. After 23/24 weeks if your baby is showing signs of life they will be treated unless there are clear indications that this is futile. I don’t think that you will be able to dictate that based purely on your belief that early baby = major problems. Down the line, if the baby isn’t responding to interventions then you should be able to discuss treatment plans with your medical team

THE most important factor in this is that you deliver in a hospital with a level 3 Neonatal intensive care unit. If you are not currently under such a hospital you need to be as a matter of urgency. If your current consultant does not practice in such a unit you need all your care transferred so that you are under obstetricians and neonatologists who deal with the earliest and sickest babies

There is clear evidence that babies delivered in such units who are very prem (pre 28 weeks) have better outcomes than those who don’t. You do not want to be transferring a baby once it is born as this is much more risky.

Good luck

I’ve just seen you’re at the L&D

It’s an outstanding unit. I would ask to have an appointment with one of the neonatal consultants there, not with an obstretirican. They will talk you through everything but 24 weekers can be absolutely fine, they can have some minor problems or yes, they can have major probs. However once you get to 26 weeks the stats improve massively.

Neonatal medicine has improved so much and honestly, you are in excellent hands at L&D

How far along are you OP?

is viable is the key I thonk
So if 24 weeks and the oy issue is feeding, they wouldn't withhold feeding and let baby die. If baby had make brain bleeds and needed additional o2 etc then they could more resonably withdraw treatment

I'm not even due on yet Sleeping but got a positive test yesterday

OP -

I’ve not had your experiences, I’ve had x5 early IVF miscarriages before a successful pregnancy and I get the pragmatic thought process.
I opted for a hosp that was quite far on the basis of their NeoNatal provision (top class).

This is of no help but reading this has touched me. In line with a previous poster I spent each day with the mantra ‘today you are still with me’.

On second thoughts...
Does your hosp have a pre term birth clinic?

I was under such a team and found that they [midwives and consultants] didn’t shy away from such questions, I assume they had much experience of couples with a difficult history.
I didn’t get the well meaning but patronising ‘it should all be ok, be positive’ responses that I had received from the ‘normal’ team.

I’m so sorry about your losses OP. I can’t answer you, but I don’t think you’re being cold, I think you’re being pragmatic.

It's a huge thing you are having to consider.

I completely respect your thoughts on this, but would caution you that if that happens, any plans or decisions you make now might mean nothing to you at delivery, as you could very easily want them to do anything and everything at that point - you could then have to deal with torturing yourself about whether you had made the right choice in saying 'no' in advance.

I think that a sensible approach could be to say you believe you would follow the advice of the doctors at the time.

Despite always thinking that they were right, I didn't - couldn't - agree with a DNR (for an older relative) until I had sat there and asked the doctors outright exactly what the situation was. In my case, what I asked was 'will he have capacity?' because they were trying to be gentle and, for me, they weren't being 'blunt' or 'matter of fact' enough. The doctor paused and said softly 'No. He won't have capacity.'. My reply was 'I understand now.' - I needed to be there to hear those words to know it was the right thing to do, that although there was life, there really was no hope.

I truly hope that you never have to make that decision. But it is sensible (and brave) and realistic to think about it in advance. I just don't think it's ever possible to know 100% until the moment you have to say 'do everything' or 'No. Stop', whether you'd made similar before or it's the first time.

OP Im so sorry for your losses but with all kindness this is a question only you and your health professionals can answer. My friends son was born a 23weeks and although small for his age is fully fighting fit at ten years old now so its hard to say. As far ad I am aware they will make a decision based of clinical risk. My friends son was not deemed to be "compatible wih life" and they wouldn't resuscitate him. He tool a huge gulp of air and fought for his life.
I wish you all the best whatever you decide to do as a family.

Once the baby is born they will be considered a separate person, so you will not be able to decline treatment for them. The doctor will decide in the patient's best interests, but will take into account your perspective as next of kin. I think it would be very unlikely they would agree to deny lifesaving treatment to viable baby due to concerns about disabilities, though.

I am sorry you are in this situation!

I was just coming on to say the same as some previous posters. Once a viable baby has been born they are a separate person and will be medically treated as such, I don't think you'd have a massive input into their life saving care straight after delivery. If it was days/weeks down the line then you obviously don't have to consent to surgeries and the like but the consultants would've already balanced the risks to even suggest it.

I know a 23 weeker who fine. Slight sight issues due to underdeveloped in womb.
Also know many many slightly prem and term babies with severe disabilities.

There is no guarantee . 23-24 weeks they'll intervene dependent on babies condition and hospital policy. What they don't always tell you is that a birth of a baby before 24 weeks naturally can cause horric injury to the baby (basically decapitation).
I've told you that because you seem like someone who wants the truth and can handle facts.

I agree to talk to the consultant and midwife. Be frank. Ask hospital policy and if needs be seek a different hospital if you want a second opinion.

Like you OP I had two late miscarriages, one at twenty two weeks. One of my beautiful babies lived for a little while but eventually died in my arms without intervention or resuscitation. Of course I was completely devastated but knew in my heart that it was right to happen this way.

No one knew why I couldn't carry my babies, so I was given the cervical stitch for my later pregnancies. It was the answer for me as I went on to have 2DC, both full term.

I feel your pain and worry, that was me, and I hope your pregnancy goes well.

My nephew was born at 23 weeks and us now a mouthy 11 year old.
I genuinely think that in the moment you will let them do anything to save your baby. I’m so sorry for your losses.

What they don't always tell you is that a birth of a baby before 24 weeks naturally can cause horric injury to the baby (basically decapitation).

Where did you find this information from? I'm just trying to do a bit of research on it but can't really find anything

There's a paper written in 2014 about decision making in premature birth which might be useful for you. Obviously it was 6 years ago so some things have changed, and it is written in very technically language and not everything will be relevant to your situation, but it is a start if you're looking for information. www.rcog.org.uk/en/news/managing-the-birth-of-extremely-premature-babies-is-complex-and-requires-shared-decision-making/ (this is the link to a summary and you can click through to the full paper if you want)

I can completely understand the need for clarity, but that can be hard to get as circumstances can vary so much and often you don't have all the facts about a situation until you are in the middle of it. Ultimately the best person to talk to about this is your consultant, so I'm glad you feel she'll be honest with you, that's so important.

I guess it wasn't meant to be

Moderate bleeding started this afternoon. It's coupled with mild cramping so a definite chemical pregnancy. I know the ins and outs of it all by now.

I don't think it's meant to be. I want to just stick with my beautiful boy and be done with'it all. Why isn't that enough for me? Why am I so selfish, using up all of this emotion on another potential baby? I already have my baby

I'm sorry refreshed.
It isn't selfish to want the love you imagined. I hope you find peace x

It's not selfish to want another baby, OP.

But it is sensible to have some discussions - not right now, obviously - about what the best thing to do going forward will be. Take a break for a while, perhaps, give yourself and your body a chance to rest, focus on enjoying your little boy, and then, maybe in a year or so, see whether you want to try again.

Sorry to hear that OP. 💐
Look after yourself.