No treatment for a baby born at 21+5

[Katz]

Very emotive topic but interested to know what others think,

baby

Not 30 years ago it wasn't.

When it looked like ds2 was going to be born at 23 weeks the paeds came to ask me what I wanted them to do. They said if he looked strong and like he would make it then they'd fight, if he was very weak/blue/still then they wouldn't - but if he was in between then they wanted me to have made the decision. Did I want to sit and cuddle him for a few hours, or have them fight for his life?

That was a horrendous moment. But he was 23 weeks - past the cut-off I guess.

(and he didn't actually arrive till 33 weeks in the end)

i am glad your brother made it . no-one is saying that no baby is worth trying to save , but in this instance, based on the gestation and the knowledge/research, this baby was not given aggressive treatment.

And what's with all the US comments ? I'll bet none of them would have been in the slightest bit interested a few months ago.

'29 weeks is massively different to 21/22 weeks in terms of viability '

I agree with that, even accounting for 30 years advancement of medical technology.

Quite simply it would have been cruel to put this baby through aggressive, painful treatment when there was no chance of survival, and it would have given the parents false hope.

Medical science cannot save every baby, and it's very sad that the doctors are being blamed for this baby's death. Doctors do actually want to save babies, no-one in the medical and health care profession wants to see a baby die.

It is a heart breaking story and I am surprised they did not try to halt the labour.

However the nhs does not have finite resources. It is also terrible when elderly people are left in their poo on hospital trollys or cancer patients do not get the latest drugs.

Also there is the quality of life to consider and the fact that the child would probably be severely disabled. How can it be justifed aborting a child with Downs in late pregnancy, but keeping alive a very premature baby.

i wonder how long 28 weeks has been the designated standard for viability?

People on this and the other thread have referred to the baby that did survive when born at just under 22 weeks old. The reason why that baby was given treatment, and why the mother was given drugs to delay labour was because the mother had lied about her dates apparently, to ensure her baby got medical treatment.

This little girl did survive, but sadly at this age most simply do not. And medical intervention on a baby this small must be traumatic and painful for them. Look at the picture of baby Jayden, how fragile he looks, how thin his skin is. The medical intervention that would have been required would undoubtedly hurt him, and hurt him a lot, and not for a short period of time. He'd have needed that intervention for a long time.

As a parent you want your baby to be well and to survive. Of course you do. It is tragic if a baby dies, and so very unfair.

But I guess this is why we have other people to make the difficult decision for us. The use their knowledge and understanding to decide what is best both in the short term and long term for the baby.

I don't know whether this baby could have survived and been ok. Less than 1% of babies born before 23 weeks survive and most have severe medical difficulties. If he had been mine I'd have wanted to fight for him, but in reality....

I do hope in time the mother can begin to cherish the time she did have with her baby.

Viability is 23 weeks in the US I think.

Those anti-Obama Americans posting didn't all turn up by chance, did they?

"They should have tried to do something, that poor poor woman, heartbreaking." I think that this is where the issue becomes emotive though, because in reality a lot of people seem to be saying that the dr's should have tried to treat the baby because of the pain not treating him has caused his mother.

If the baby were treated, then it should be because there was a chance for that baby to survive, for that reason, and that reason only. As harsh as it sounds, the feelings of the mother cannot and should not be taken into account. Because a mother is too close to think objectively - a mother just wants her child to survive, and sadly, in this instance, that was just not possible.

There was a study done in Sweden and there out of 51 babies born at 22 weeks 10% survived past first year, only one without a major illness.
Now, it depends how you look at it. Out of those babies there very well could have been some 21+5,some 22+5 etc. You could argue that 10% chance is a lot. They didn't specify whether those illnesses were something the babies got through their first year or a major handicaps they were left with.
They are apparently much more aggressive with treatment in Sweden.
Also I read on BBC that there are huge differences across UK in how they treat premature babies, with some hospitals treating 22 weeks ones as born and offering intensive care and others not even bothering to try.
So, if there is this few % chance and parents expressly state their wish for the doctors to try, IMO the doctors should at least attempt to do something, not just give up on the basis of the presumed age of the newborn.

The baby born in America was an IVF baby, so it was just under 22 weeks from the embryo being transferred, not from LMP.

'As harsh as it sounds, the feelings of the mother cannot and should not be taken into account. Because a mother is too close to think objectively - a mother just wants her child to survive, and sadly, in this instance, that was just not possible.'

that is very harsh. I'm pretty lucky in that dd was saved because I asked for her to be saved! Despite the prospect of serious impairments.

I was listening to someone talking about this today, I believe that the major fault here is that the communication skills of the hospitals did not clearly convey that this little one could not survive.

It is heart breaking for the family, just as heartbreaking as it would have been if the lady had been 20 weeks pregnant or 24 weeks pregnant and the baby had been born, given assistance and died.

The lady needs lots of support and help to deal with the tragic loss of her baby, but the death of her baby is not the fault of the hospital.

If they won't help babies born before 22 weeks then how did that premature baby born at 21+6 manage to survive?

It does make me wonder whether the issuer here is more to do with the lack of support aftyer something traumatic like this happens. You seem to just get sent away without any explanation. Maybe if they sat down and explained to the Mother properly she would feel less angry with time (and I can understand that anger)

Ah I've now read the link. So Amillia Taylor's mum lied about her gestation. Wouldn't it have have been in her notes that she wasn't really 23 weeks?

nappyaddict The baby in America was 21+6 gestation. That is not the same as the woman being 21+6 after her last period.

So actually she was more like 23+6 (if you work on the average 28 day cycle and conceiving on day 14?)

Possibly - I dont know exactly how it works with IVF - apparently the embryos are cultured for a few days before they are transferred back? So it could be even more than that?

i agree with wannabe.. attempting to save the baby might well have given the mother less emotional pain,but the baby would have surely experienced physical pain as a result, which can't have been better than him dying peacefully in her arms?

also agree it sounds as though lack ofinformation and compassion have made the mother extremely angry., understandably

I don't know, it's ahrd. It seems that teh decision should be based on gestation AND develoment. gestation is often wrong anyway. OTOH I can see the point about holding teh child to the end, and possibly would choose that myself. OTOH again my nephew was apaprenlty unable to survice at his birth and the aprents took him elsewhere and he lived until 13 (and then went through hospital acquired MRSA).

I wuld think ewach case needs to be addresed on a case by case basis.

RIP little one. God Bless tothe poor Mum, a horrid thing to come to terms with.

I agree Fio; the key issue here, I think, is the cmmunication between medical staff and the parents of the baby, and the support (or lack of?) before, during and after such a traumatic experience.