But what about 28 weeks? 26? 24? 22? At what point would I allow the baby to pass on peacefully, rather than attempting heroic efforts at resuscitation with a small chance of survival and high likelihood of major disabilities if the baby were to live? My own gray area is between 24-28 weeks. By time a baby hits 26 weeks gestation, survival rates are between 80-90%, and about 15% of those surviving babies will have major disabilities as a result of prematurity. I think this would be the earliest point at which I would consider intervening.
General estimates of survival for live born infants who receive neonatal intensive care in the USA in the late 1990's are:
Completed Weeks of Gestation at Birth
|21 weeks and less ||0%|
A more accurate way of predicting survival is by birth weight, rather than gestation.
|Birth Weight||Survival (percent)|
| Pounds are approximate ||Vermont Oxford Network||NICHD|
|501-750g (1lb 2 oz - 1 lb 11 oz) ||58%||49%|
|751-1000g (1 lb 11 oz - 2 lb 3 oz) ||85%||85%|
|1001-1250g (2 lb 3 oz - 2 lb 12 oz) ||93%||93%|
|1251-1500g (2 lb 12 oz - 3 lb 5 oz) ||96%||96%|
Still, survival rates and even major disability rates are not the only practical or moral considerations that I would have to account for. Having a very premature baby, in my own family setting, would mean I would have to commute to a hospital with an advanced enough NICU: probably 40 minutes away and most likely an hour or more. The stresses on our family, the realities of trying to spend my time in a NICU while caring for a nursing toddler, and the emotional and financial drains that an extremely premature baby would entail are all things I'd have to carefully think about.
In addition, my own moral/religious understanding of our life on earth would influence my decisions as well. I strongly believe that life is sacred, but that it is not always appropriate to take heroic measures to prolong life. Death is something to embrace when it is the right time, since we understand it as a passage(and at times a welcome release) from one sphere of existence to another, just as our coming to earth was. It is a temporary separation, although still painful and difficult for those left behind missing their loved one. (For another LDS woman's perspective on this, read Descent's post.)
I hope I will never have to make this kind of decision. Have any of you ever been faced with such a dilemma? If not, have you thought about your own personal criteria for intervening versus letting the baby go?