Korva is a scroll of the internet’s best ideas.
No clear rule at 23 weeks
The edges of the zone
A baby born before 22 weeks is generally considered a miscarriage, and pretty much no doctor will intervene. After 25 weeks, studies show that doctors feel morally obliged to save the life no matter what the parents say.
The hard questions
In between is a strange space between life and death where hard questions come up. Should this baby live? At what cost? Who gets to decide? Many parents who land there choose to let the baby show them whether it will stay or go.
Ethics and the law
Physicians weigh the Hippocratic oath of do no harm. Many legitimately believe that if a preterm infant is in serious peril of a life of suffering and pain, the way to do no harm is not to operate. Courts have seen very few disputes like this, and in every one so far, they have supported the person arguing to keep the child alive.
Why does care at 23 weeks vary by hospital?
National guidelines leave room for physician judgment and family preference at this stage, so each hospital sets its own policy. A 2015 study in the New England Journal of Medicine by Matthew Rysavy and colleagues compared U.S. hospitals and found that the share of 22-week babies given active treatment ranged from almost none to nearly all. Hospitals that treated more actively reported higher survival for babies born at that age.
Why did the Baby Doe case change U.S. law?
In 1982, an infant in Bloomington, Indiana, known publicly as Baby Doe, was born with Down syndrome and a blocked esophagus. His parents declined surgery, courts upheld their choice, and he died after six days. The public outcry led Congress to pass the Child Abuse Amendments of 1984, which require treatment of disabled newborns except in narrow circumstances such as when the baby is chronically and irreversibly comatose or treatment would be futile.
How do doctors know how many weeks pregnant she is?
Dating starts with the last menstrual period, which is often uncertain. An ultrasound in the first trimester measures the fetus from crown to rump, and the length tracks gestational age closely. The American College of Obstetricians and Gynecologists says first-trimester ultrasound dating is accurate to within about five to seven days.
More from Radiolab
