How young is too young, and who is it that makes that decision? You are the person I want to talk with. You are the person who needs to meet James. Had the NICU team attending James’ delivery known his correct gestational age, they would have done nothing. The NICU team would not have been in the delivery room. My amazing little boy would not be alive because no one would have given him a chance. Just look at him. He is a curious, funny, smart little boy who is full of life. He makes every moment better just by being here. How dare someone say he’s not worth the committment financially or medically because he’ll have too many challenges. Look into his sweet face and tell me 22 weeks 6 days isn’t viable.
I started this post weeks ago. I look at it now and then, but that’s all. It’s a hard topic for me. It’s my soapbox, and the reason I put all this out there for people to see. Maybe someday James’ story, and stories of others like him, will help make a difference in the gestational age at which they attempt life-saving measures. I don’t get into politics or have lots of strong opinions I want to convince people of. I’m pretty easy-going about most things, but this is a topic I feel strongly about. This is something I will stand up and fight for.
I don’t know if you can fully understand until you’re faced with the possibility of something as small as one day meaning the difference between life and death. My understanding isn’t as strong as those who have been on the other side; those who have held their babies as they take their last breath because they were born too soon to even try. Those are the people I tell James’ story for.
23 weeks is commonly defined as the earliest gestation at which a baby is viable. Most NICU’s will attempt life saving measures on 23 weekers. Some look at weight instead, and will attempt to save babies over 500 grams. James was neither 23 weeks nor 500 grams. There is no test that James would have passed to make the doctors and nurses attending his delivery think he deserved a chance. His Apgar Scores were terrible, he wasn’t breathing, he didn’t make any sound. An error my doctor made the night I was admitted to the hospital helped to save his life. The NICU team discovered that error as they completed paperwork following James’ birth, but, thankfully, he was already on a ventilator.
One of his neonatologists recently told me about a meeting the doctors have every so often to look at how they are doing as a NICU. They look at their own statistics and percentages of survival at various gestational ages. Of course there is no identifying information presented, but she recognized James’ information right away. He was the only baby under 23 weeks gestation. How many others could have survived if they were given a chance?
The Edmonton Journal recently published an article discussing viability (you can find it here). It generated a lot of discussion in preemie groups on Monday about the limits of viability. The article starts with an amazing story of survival of a baby girl born in Florida at 21 weeks 6 days gestation, weighing just 283 grams. (James weighed 440 grams) She, like James, was saved due to an error. She’s now in kindergarten. Just astounding. The article states that in Canada they are starting to push the limits of viability back to 22 weeks gestation. When will hospitals here do the same?
The odds are stacked against 22 weekers surviving. I understand that. Even 23 weekers have tremendous odds to overcome, but many do just that. When it means a child might live, have the opportunity to be held by their mom and dad, feel love, learn to smile and laugh, experience the amazing gift of life, how do you not give them a chance? How do you say no to this?