Newborn baby is borderline; should the doctor resuscitate?

Washington Post ^ | Gautham K. Suresh

[Morgana]

The newborn resuscitation room was uncomfortably hot — the thermostat was set high to prevent a just-born baby’s body temperature from dropping rapidly. Our neonatology team was finishing up paperwork on a baby we had just resuscitated and stabilized when a nurse from obstetrics popped her head in: “Don’t leave yet! A 23-weeker just rolled in; she might deliver soon!”

The nurse practitioner on the team groaned. There was no need for him to say anything more. All of us in the room felt exactly the same. A baby born before 37 weeks of pregnancy is considered premature and has a greater chance of complications and death than a baby born full term, between 37 and 41 weeks. Babies born at only 23 weeks are so premature that — when they survive — many end up with severe handicaps, including mental retardation, cerebral palsy, blindness and deafness.

Because of this, those of us who work in neonatal intensive care units (NICUs) often face an impossible decision: to provide intensive care to such babies when they are born or to step back and not intervene.

A birth and a debate

In this case, I had an ominous feeling. Under ideal circumstances, the obstetricians would use medications to try to stop preterm uterine contractions. This would give me, the neonatologist, time to talk to the woman in labor and her husband or partner and explain the risks, complications and treatment choices for a preterm baby. I would try to allay the anxiety and shock that almost all of them felt.

[jsanders2001]

I’m sure Team 0 would make that determination based on color, race, paren’ts political party (voting usefulness), potential earning capability, and whether they are a member of the elite clique or not.)

[Twotone]

We’ve been working on a petition to stop state dollars from being used for abortions. All too often people won’t sign because they’d rather the abortion take place than that another mouth end up on the public teat. It’s a sad, sad world we live in today.

[Usagi_yo]

Well, if I ruled the world — Put all the effort they can into the preemee, without putting other more viable babies at risk.

Continue to evaluate and adjust based on the realistic guesses on the survival and problem severity, as they emerge.

Standard triage rules right? Do I work on a patient with 50% survival rate with or without care or work on the patient who’ll die 90% of the time without but only 10% of the time if cared for?

[tnlibertarian]

I'm working out of town and I just got off the phone with my former 28-weeker. I told him goodnight and to be a good boy for Mommy. He's now 5 1/2 years. Thanks in no small part to the prayers by Freepers, he is perfectly healthy, if a bit of a handful at times.

So, I'm a bit biased.

[Nifster]

There is no such thing as a ‘borderline’ baby. Once that child is delivered it is incumbent on ALL medical personnel present to do everything possible to make sure this child lives.

The very idea that a doctor (or any other medical person) would suggest anything less is evil

[Guenevere]

My granddaughter was born at barely 28 weeks-(2-1/2 lbs.) and she is the brightest student in her 3rd grade class (& yes, I am bragging!)....but it's true.

She reads on a 6th grade level and makes straight A's.....she excels in everything!

She's smart, creative, articulate and I thank God always for His mercy and the NICU personnel!.....

[Captain7seas]

Well Gautham, lemme ask you...if that “borderline” baby was YOU, what would YOU tell the Dr? Hmmmmm

[kcvl]

First of all this nasty looking thing wouldn't be my doctor. And I have a wonderful, caring, compassionate, clean Indian oncologist that I wouldn't trade for the world!

[freerepublicchat]

I believe this much: if the mother and her family can't financially support the effort, then it probably wasn't meant to be.

[Marie]

Why in the hell would you say that? He went to heroic measures to save the baby and wrote this entire article about how doctors shouldn’t give up too soon.

[faucetman]

you said “I believe this much: if the mother and her family can’t financially support the effort, then it probably wasn’t meant to be.”

I can’t believe anyone could say such a thing. It’s about MONEY? I hope it never comes to pass that YOU need care you can’t afford to pay for and they say “it probably wasn’t meant to be.”