Wow, i taped this and have just watched it back. My son was born at 24+1 in very bad condition, with bad for dates lungs and with a total body infection (sepsis). He needed (and got!) aggressive treatment including a special type of ventilator (oscillator) and nitric oxide to assist his gas transfer. That was despite the fact that noone thought he would survive.
He looked very like the babies in the program, it brought a lot back.
Well, we were very blessed and Nathan pulled through. 150 days as an inpatient and he came home on oxygen. He suffered two severe brain bleeds within his ventricles in his early life, but he shows little delay now he is 18 months corrected - although we have had physio, SALT, and still see a lot of consultants at the hospital. He would be counted as a medical miracle - and under rules about who to resuscitate he would have failed any test going because he initially seemed so weak.
I think we can all agree with 2 of the 3 conclusions of the program - that we should be doing more to prevent premature labour in the first place, and that we should be prepared to support the babies we do save for their entire lives. Care should not stop at 18, and we should not make any disabled person feel they are not wanted by society or are not worth supporting.
Whether we resuscitate 23 weekers on an outcome benefit / short term suffering / cost decision is tricky.... but we should be careful of the statistics. Bliss say the cost of resuscitating the 450 babies born in the uk every year is 0.009% of the NHS budget - a drop in the ocean. Many 23 weekers do not survive the birth or get as far as the NICU. Although this is very tragic, it means there is very little cost in attempting to save these babies - probably the worst we can say is that the mum and dad are not able to spent time with their baby in the last few minutes of life as the doctors are trying to save their lives. I know I would certainly give up the chance to hold my dying child for a 10% chance that they might live.
In some european countries the survival rates are much better because every 23 week birth is attended by a senior obstetrician and a senior neonatologist. This is internet rumour, but I heard a survival rate of 35% at 23 weeks, which rises to 65% of those babies that get to the NICU alive. That is a completely different outcome to the 9% quoted in the program. Even in the UK, the EPICure study implies a higher survival rate, although it may be that only the "stronger" babies were resuscitated in the first place.
Also, what do we mean by a disability for the 8 of 9 children who survive but are disabled? Well, as someone else said, being disabled includes needing to wear glasses! It may mean being partially deaf, or having minor coordination problems which prevent the child from hopping or riding a bike but where the child is able to walk, get dressed, and live a more or less normal life. We need to be careful not to lump all these children into the more difficult life Heather faces.
And if the objective is to prevent serious disability in 23 weekers, surely this would also mean we should force abortions for all children identified pre birth as suffering a serious disability (genetic problems - e.g. downs syndrome or growth abnormalities - e.g. lack of kidney formation). When you think about it, this is completely unacceptable to society, and infact noone is saying we should withdraw or never offer treatment to prevent all risk of disability at the cost of preventing all hope of a healthy life.
Its all so emotive, and noone is saying we should outright stop resuscitating 23 weekers - just that we should think about it and not allow this to be a taboo subject.
Put it another way - should we resuscitate a 20 weeker who has no hope of living? If not - where do you draw the line? At any hope of living? at a significant hope of living? a significant hope of escaping severe disability? Only if the disability can be moderated and improved by the lifelong care we are prepared to offer?
And once we have drawn that moral line, we can start discussing the relitive costs compared to other NHS services and whether the funding also makes sense.
My heart goes out to all the parents in the program, and to the medical staff who do this day in and day out to give our few miracles the chance to survive.