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New Study: Prospects for Premature Babies Are Improving

Findings could impact debate on late-term abortions

BY GREG CHESMORE

June 14-20, 1998 Issue | Posted 6/14/98 at 1:00 PM

 

NEW ORLEANS—Babies born prematurely aren't necessarily destined for death or life with severe disabilities, according to a study released at this month's Pediatric Academic Society's annual conference in New Orleans. The study debunks the popular notion that many babies born prematurely will not survive or will suffer severe disabilities.

Dr. Douglas Derleth of the Mayo Clinic in Rochester, Minnesota, announced the results of a study of 10 infants born at the clinic in 1991 and 1992 at 23 to 24 weeks gestation. The infants were born at least four months prematurely. A normal pregnancy is about 40 weeks. Derleth's study focused on infants who were given at least one “aggressive treatment” to keep them alive.

Despite the odds, Derleth said his study proves that the common assumption that babies born this early have little or no hope for a life without disabilities is not necessarily accurate.

“Many feel that 23-24 week babies who need aggressive interventions will either die or have severe handicaps, so aggressive support is often withheld from such babies,” said Derleth. “This assumption is not true.”

The aggressive treatment mentioned by Derleth can take many forms. Some premature babies may require cardiopulmonary resuscitation (CPR) at birth, while others may require intensive ventilation due to lung immaturity. Other children need potent doses of certain medication to maintain an acceptable blood pressure.

In Derleth's study, only one of the infants died. One of the children is completely normal, two experience minor disabilities, and the remaining children are considered “moderately disabled.” All of the infants are talkative and interactive.

Derleth said it is difficult to predict how the babies will do once they grow up, but he reiterated that the future of severely premature children is not as dismal as some may think.

The results of Derleth's study, and others like it, have a direct implication on the debate over abortion—particularly late-term abortions. The Supreme Court's landmark Roe v. Wade abortion decision created a trimester framework to pregnancy and allowed states some leeway in restricting late-term abortions. However, Roe's companion case, Doe vs. Bolton, essentially sanctioned abortion for any reason, at any stage of pregnancy, by interpreting a woman's “health” to include virtually any reason a woman might seek an abortion. That liberal interpretation has allowed late-term abortions to be performed throughout the nation. This fact has led pro-lifers to introduce legislation at both the state and federal level seeking to restrict one particular type of late-term abortion, partial birth abortions.

The issues surrounding the humanity of premature infants have played a direct role in some state legislatures during the debate over partial-birth abortion. In New Hampshire, one state legislator shared her own compelling testimony of giving birth to her daughter at just 24 weeks in 1974. The experience, she told her colleagues on the floor of the New Hampshire House of Representatives, forced her to examine her beliefs on the humanity of unborn children and the morality of abortion.

State Rep. Mary Brown shared her personal testimony during the state's debate on a bill to restrict partial-birth abortions. The attending physician told Brown and her husband that the child's chances were “zero.” Yet her daughter Jessica was born kicking and flailing her arms, even though she was small enough to fit in the palm of the doctor's hand. The doctor's response was less than encouraging: “Her chances are slim, and even if she survives, she'll probably be physically and mentally handicapped, blind or worse. Do you want to try to save her?” The Browns' answer was an emphatic yes.

“I stood over her, feeling helpless,” Brown told the state legislature. “I began to wonder about abortions. Her features were perfectly formed. She had fingernails and toenails, eyes, nose and mouth. When I realized she was a second-trimester fetus and how many like her are aborted each year, I felt sick in the pit of my stomach.”

Twenty-three years later, Jessica graduated from the U.S. Coast Guard Academy, receiving her diploma from none other than President Clinton, an ardent supporter of keeping partial-birth abortions legal.

“Obviously the doctor's predictions did not come to pass,” said Brown. “Can you imagine if we had listened to him and discarded her? I can't imagine that. The doctor was wrong.”

Many babies born prematurely do face a tough road. Every baby is different and how the child responds to treatments after birth often dictates how successful full-recovery efforts will be. However, according to neonatologists, babies born at 24 weeks have a more than 57% chance at survival. Babies born just a week or two before the crucial 24-week mark, face much more difficult odds. The Journal of Pediatrics reports that 33% of babies born at 24-26 weeks suffer from a “major disability,” while 40%-50% will have a “minor disability.” The odds of escaping disability improve the longer the baby is able to stay in the womb.

As medical technology advances, physicians are discovering more effective treatments for premature infants—increasing the chance of both survival and good health. One new treatment, which appeared on the scene just a few years ago, assists premature babies in the breathing process and reduces the often-fatal effects of respiratory distress syndrome. Often the lungs of the premature baby have not developed enough to adequately receive and process oxygen. These babies lack a necessary substance, called surfactant, which opens the tiny air pockets in the lungs and transfers oxygen to the brain. However, today the premature infant's lungs can be filled with a steady stream of a new colorless, odorless liquid called perflubron, which breaks the surface tension of the air sacs in the lung and facilitates the baby's breathing. Studies have shown that the process of filling the lungs with perflubron, often referred to as “liquid breathing,” has been remarkably successful in improving the lung functioning of premature infants.

The rise of new medical technology has made the future brighter for premature babies, but some pro-life physicians warn against becoming too transfixed on the notion of “viability” as a litmus test for an unborn child's personhood.

Dr. Paul Byrne, a neonatologist who has cared for premature infants, is president of the Catholic Medical Association. Byrne said he's seen premature babies beat the odds before, even without today's technology. However, medical technology could continue to advance—saving more babies born prematurely.

“The limits of science and technology are not known,” said Byrne. “But no matter what the advances, the life of the new person begins at conception. We know that conception has occurred when the sperm and ovum come in contact. All we can do is verify the truth.”

As medical professionals learn more about how they can assist babies born prematurely, abortion advocates continue their crusade to defend the “right” of a mother to abort her child at any stage of pregnancy. According to the Alan Guttmacher Institute, the research arm of Planned Parenthood, approximately 600 third-trimester abortions are performed annually in the United States. Pro-life sources claim the number is likely higher since statistical reporting of abortion is not required in many states. However, one thing remains clear: As more premature babies survive, at younger ages, abortion advocates may have an increasingly difficult time defending the absolute right to abortion.

Greg Chesmore writes from Bloomington, Indiana.