RONZONE: An obligation to stop premature births



Raquel Ronzone

Don’t bother with them. This was the message projected by Britain’s Nuffield Council on Bioethics in 2006. The organization declared that premature babies born before 22 weeks gestation should not be given intensive care treatment to keep them alive.

More surprising is the fact that news of it never reverberated shock waves across the sea to the United States, where debates on euthanasia, abortion and other right-to-live issues are as common as they are heated and divisive – and where prematurity is the leading cause of newborn death.

The Mayo Clinic defines premature or preterm births as those that occur before the due date, specifically three or more weeks less than the normal human gestational period of 40 weeks.

Prematurity affects about 12 percent of babies, and the complications of such births cause an estimated 30 percent of neonatal fatalities – deaths within the first 28 days of life – according to the March of Dimes.

The Mayo Clinic acknowledges that exact causes of premature births are unclear but lists common risk factors associated with it: pregnancy with multiples, smoking, alcohol or drug use, infections, high blood pressure, diabetes, underweight, overweight and obesity, domestic violence, stress and previous abortions. Pregnant women who are younger than 17 or older than 35 also face premature deliveries more frequently than women of other demographics do.

Since prematurity strikes pregnancy at the core, evicting babies from the best, most natural place of nourishment and development, its effects are diverse, with varying degrees of seriousness, and, according to recent research, potentially long-standing. Brain hemorrhages, intestinal and respiratory difficulties, anemia, hearing loss, asthma and infections can accompany premature births. Retinopathy of prematurity, an abnormal growth of blood vessels in the eye, can lead to permanent visual impairment or blindness altogether. Though sometimes treatable, developmental, behavioral, neurological and learning problems, such as cerebral palsy and statistically lower IQs, can affect premature babies throughout childhood and adulthood.

Unlike Britain’s Nuffield Council on Bioethics, medical or bioethical societies in the United States have yet to disclose formally a position on the care of premature babies. Given the severity and frequency of these births, however, one might suspect that preemies consistently receive intensive care to coax their frail one- or two-pound frames to a point of viability and thriving especially in the United States where prematurity runs rampant. A close look at the natal treatment administered by United States hospitals proves otherwise and shows indifference parallel to that of Britain.

An article by USA Today reported that only 23 percent of the babies born at 22 weeks received intensive care. But every moment in the womb makes a difference, in the health of the baby and the response of the medical team around him or her. The majority of babies – a more than generous 99 percent – born at 25 weeks received intensive care.

The desire to help the most vulnerable babies seems obvious, almost instinctive. But reluctance to treat extremely premature babies with such serious measures might stem from financial reasons and concerns of effectiveness.

U.S. News and World Report stated that medical costs for healthy, full-term babies during their first year total an estimated $4,500. Employer health insurance covers $3,800 of that. For preemies, though, the cost increases exponentially – to about $50,000 – and employer health insurance pays roughly $46,000.

The March of Dimes reported the survival rates for premature babies: about 20 percent to 35 percent for those born at 23 weeks, about 50 percent to 70 percent for those born at 24 to 25 weeks and more than 90 percent for those born at 26 to 27 weeks.

The United States, Britain and other developed countries have access to the treatments needed to try to save premature babies. Legitimate worries about costs and likely impracticably – given the high rates of mortality and health complications – have impeded these efforts.

But the United States, for one, has failed to raise substantial awareness of prematurity and the importance of prenatal care in precluding it. It has also failed to publicize the factors – the at times, controllable, changeable medical conditions, lifestyle factors and demographic aspects – that contribute to prematurity.

Since the United States is reluctant to treat aggressively its most desperate population, it should at least educate expecting parents as a way to prevent premature births from occurring in the first place. Otherwise, the simultaneous neglect in instructing and refusal to treat newborns will continue the needless dying and suffering of babies.


Raquel Ronzone is a sophomore communication major from Philadelphia. She can be reached at [email protected].