'Doctors told me it was against the rules to save my premature baby' (UK)

[Craftsman]

Doctors left a premature baby to die because he was born two days too early, his devastated mother claimed yesterday.

Sarah Capewell begged them to save her tiny son, who was born just 21 weeks and five days into her pregnancy - almost four months early.

They ignored her pleas and allegedly told her they were following national guidelines that babies born before 22 weeks should not be given medical treatment.
Enlarge Sarah Capewell, mother of Jayden Capewell


Miss Capewell, 23, said doctors refused to even see her son Jayden, who lived for almost two hours without any medical support.


http://www.dailymail.co.uk/news/article-1211950/Premature-baby-left-die-doctors-mother-gives-birth-just-days-22-week-care-limit.html

[niyad]

1. how often is this bs going to be repeated?

[Rosa Luxemburg]

4. only to put the NHS in a bad light to Americans

[Craftsman]

7. This is from a London newspaper

[LeftyMom]

9. It's from the Daily Fail.

[Rosa Luxemburg]

16. but they are highlighting it here too

[blondeatlast]

26. Who is? Anonymous posters on political message boards?

And hey, wow, you're still here?

[blondeatlast]

24. In the UK, they call the Mail a "fishwrap" because that what it is most useful for.

It's a UK version of the National enquirer only with bigger boobs on page 2.

[redqueen]

73. If by "newspaper" you mean "disreputable tabloid", then sure...

:rofl:

FAIL!

[msanthrope]

10. As long as anti-choice trolls who can't understand medical

technology are allowed to post.

[stray cat]

2. Of course there are always some conditions that can't be treated

[Rosa Luxemburg]

3. doctors don't generally do that there

in the UK doctors don't have the follow the ruling strictly so I beleive this was a case of malpractice

[Craftsman]

5. I came with in a whisker of being in the same boat

My twin Daughter were almost in the same boat. My wife had complications and had to be put on bed rest after wards. We were at the TX Medical center and they were prepared to try to save them. But had the doctor said this to me under these circumstances he would have died as well if he did not reconsider his choices.

A kid this young has long odds and hard fight ahead, but with the right care they do have a chance. In the TX Medical Center they have helped load kids into car seats for the ride home with mom and dad after being released healthy that where born younger and with more issues. The rub is it costs.

[Contrary1]

39. How close to full term were your babies?

I noticed down thread that you took them home a month later. That would not have happened at 22 weeks.

[Craftsman]

44. She almost had then at 21 weeks and 3 days, the doctors were able to stop labor

She delivered at 35 weeks.

[Contrary1]

47. That's wonderful!

They were unable to stop my daughter's labor, even after they brought out the "big guns", which can have a negative effect on the mother. Her blood pressure shot way up, her breathing became labored. It was time to let nature take its course.

Enjoy your babies. They are grown and gone before you know it. :hi:

[Posteritatis]

6. Those docs failed hard at reading their own guidelines

The ones quoted in the article say that not carrying out resuscitation is "considered in the best interests of the baby" at that age.

That's a tiny bit different from not doing anything at all.

[enlightenment]

8. You do know that citing the Daily Mail is

a lot like citing the National Enquirer, right?

[msanthrope]

17. What, you don't read the "Femail" section daily? Today they

feature a story about having your rapist's baby....

http://www.dailymail.co.uk/femail/article-1212349/Having-rapists-baby-best-thing-I-did-After-date-raped-Miriam-horrified-fall-pregnant-little-girl-proof-good-come-evil.html

[enlightenment]

55. You bet.

Just like I loved to read about Batboy whilst whiling away my time in the check-out queue.

:)

[surrealAmerican]

11. That's a very slanted article.

The baby was 4 months premature. Had they done everything humanly possible, he would still have died.

[hedgehog]

19. They might have done everything humanly possible, but there was nothing

humanely possible to do. The choice is to keep the baby warm and cuddled as nature takes it course, or to hook the baby up to a machine to force him breathe, stick a tube down his throat to feed him, put him in a glass box and poke him with needles periodically until he dies.

[Hekate]

81. It's the brain bleeds that make me shudder, as well. They are just not ready to be born At All. nt

[Crunchy Frog]

51. Closer to 5 months premature actually.

Trying to save such an early baby amounts to pointless torture IMHO.

[Howardx]

12. 23 years old, 5 year old daughter and 5 miscarriages

and im betting she could have gotten free contraception...

[hedgehog]

35. The question is, what did doctors tell her after the second miscarriage, or the third?

I'm betting that she was told to wait before attempting to get pregnant again. It's also possible that she was told it was very unlikely she would carry to term, but that she was determined to prove the doctors wrong.

[Howardx]

57. 23 years old pregnant 7 times already

i know what i would have told her.

[Hekate]

78. Exactly. Something is incomplete about this story. nt

[jobycom]

13. Good thing these types of situations never happen with the saintly American insurance companies.

That's the problem with socialized commie medicine. It puts life and death decisions in the hands of beauracrats and elected officials who have to answer to the people, instead of where such decisions belong, with the actuaries and accountants who have to decide whether their company makes a large enough profit to justify saving a customer's life.

Wealthcare: Because everybody deserves the right to die for money.

[librechik]

15. Yeah--I wonder how many times Insurance companies here refuse to pay

for 22 wk premature baby.

[Craftsman]

22. I do not know about other states but in TX once born you are a person

So if your folks have insurance you are covered. My wife and I had to have our premature twins in NICU for just under a month before we brought them home and we paid nothing out of pocket.

[librechik]

29. how many week s old were they? 36 wk preemies have an excellent chance of survival

can't say the same for 22 wks.

[sandnsea]

42. So completely untrue. Texas Has "Death Panels"

Texas is the only state where the hospital can disconnect people from life support. Google it up.

[Hekate]

76. "IF your folks have insurance." Big if. Glad your twins are okay, though. nt

[Lance_Boyle]

14. Yay! Let's demand an inalienable right to FUTILE TREATMENT!

:eyes:

[Craftsman]

18. Not always futile

A kid this young has long odds and hard fight ahead, but with the right care they do have a chance. In the TX Medical Center they have helped load kids into car seats for the ride home with mom and dad after being released healthy that where born younger and with more issues. The rub is it costs.

[hedgehog]

30. The odds are 99 to 1 against for a child this young.

the survivors tend to have disabilities. That's at the bottom of the article in the OP.

My nephew was born prematurely as were his two nephews. After a lot of worry, they're doing fine.

I had two sisters born prematurely, but they died. This was 50 years ago, babies born at the same age now need some extra care, but they are fine.

It can be a tough decision when a child is born too early. While there are exceptions, 22 weeks seems to be the limit.

[Posteritatis]

45. The odds were in that range when I was born too

(and I was born as a very premature surprise to Canadian parents visiting the US! Whoops!)

The lower limit's moved way down since then, and that's a good thing given what we're capable of, but I think we should be careful about writing someone off as a lost cause anywhere near as bluntly as they did (or, let's be fair, are claimed to have done) in the article. Some, yes; folks before even then, probably. Of course, I'm an historian and not a medical professional, so I have neither all the facts nor the training to understand them about this specific situation.

Who knows what'll be doable, say, fifty years from now?

[hedgehog]

67. Doing a quick search, it appears that 24 weeks is really pretty much the limit

until some new technology is developed. What we have now just doesn't work.

[Posteritatis]

68. Yeah, that's about what I'd heard

My point is that occasionally trying something that Just Doesn't Work Oh Wait It Did is the sort of thing that allowed me to survive being born as I was, and has also allowed people born much earlier than me to since then. I understand hopeless or near-hopeless situations, but I also hope they're judged one way or another on a case-by-case basis with as much information and knowledge on hand as can feasibly be brought to bear. If a situation is hopeless, some sort of palliative - for both the infant and the obviously-distressed parent! - should be happening in any case.

[hedgehog]

69. It might be better to do research into why babies are born prematurely -

anything we can do to allow the mother to carry to term is the best solution overall.

[Posteritatis]

71. Also definitely true! (nt)

[Maru Kitteh]

65. More like 9,999,999 to one. If it's even a real story, which I doubt.

[Lance_Boyle]

32. no offense, but you need to document that claim or quit spouting it

I believe it to be an outright lie that ANY medical center in the US (or anywhere else) has ever successfully treated and released a child born at fewer than 24 weeks gestation, much less "fewer than 21 weeks 5 days" as you claim.

[LeftyMom]

36. He can't.

The only 21 week, 5 day baby to survive (also the premature baby on record to survive, ever) was born in Ottawa in 1987.

[LeftyMom]

34. No, they haven't.

The youngest surviving premature baby in the world is was the same developmental age as this kid as this kid was. And that was in Canada, not in Texas. NO babies have survived after being born younger, at TX Medical Center or anyplace else.

Further, extremely premature babies almost invariably go home in specially designed car beds, not infant car seats, because their airways are so underdeveloped that sitting at an incline can kill them. Even at release they're also generally too small for infant car seats, which usually have a five pound minimum weight.

Please stop making things up.

[Crunchy Frog]

62. I know of one single documented case of a baby surviving

that was born at 21 wks 6 days. None earlier than that. If you can document a case of a younger baby surviving, I'd be interested in seeing it.

[LeftyMom]

20. No child has ever survived being born that early, in any country, ever.

The odds for micropreemies are extremely poor. At 23 weeks, which is more developed than this child was (and at this point, days matter and weeks even more so) only 1/4 of babies survive and 2/3 of those have serious health issues or cognitive disabilities. This kid was younger still, his odds of survival vanishingly small and his odds of being healthy if he had nearly nonexistent.

The guidelines are there for a reason. Sometimes the compassionate thing is to let go.

[Old Hob]

58. James Elgin Gill--21 weeks and 5 days

alive and quite healthy today... or so I read.

[LeftyMom]

59. I clarified that elsewhere on the thread.

But thanks for clearing it up here.

[The Magistrate]

21. Survival Rates At This Stage, Sir, Are Zero Under Present Medical Abilities

A sad story, certainly, but hardly an indictment of policy.

[Craftsman]

25. Tell that to TX Childrens Hospital, they have had it happen last year

[Lance_Boyle]

33. prove it. n/t

[The Magistrate]

37. You Are Going To Have To Back That Claim Up, Sir

And produce an account of the survival to discharge from that hospital of an infant born after less than twenty-two weeks gestation.

And even if you can find one, it still would not represent a significant chance of success in any specific instance, no more than purchasing lottery tickets constitutes a plan of saving for retirement.

[hedgehog]

48. I checked the Texas Children's Hospital site - there is no reference to a child

born before 22 weeks surviving. They do hi light the cases of a child born at 25 and another born at 27 weeks. In terms of development, these children were much more advanced than any infant born at 22 weeks, and these cases are presented as a remarkable achievement.

[The Magistrate]

49. And There Would Be, Ma'am: It Would Have Made National News, People Everywhere Would Recall It

[Kceres]

50. And how is that child now?

At 21 weeks of gestation the integrity of the skin is not reliable and it may slough off with touching. Think of the pain. Even if the newborn survives you're looking at months and months in the neonatal intensive care unit with an outcome of cerebral palsy, probable blindness, probable deafness (due to all of the ototoxic antibiotics the neonate received for infections due to an immature immune system), heart problems, not to mention lifelong pulmonary problems. So much suffering. It's a tragic event, but sometimes the kindest thing to do is to place the newborn in the mom's arms and let it go.

[Mariana]

64. That child never existed. The poster is misinformed. nt.

[sabrina 1]

23. The Daily Mail? A rightwing tabloid

that never misses a chance to help out their counterparts here on issues like this.

Every time I see them used on a site like this, I feel screaming.

You may as link to The Globe for all the credibility they have.

For the record, having lots of relatives in the UK, this is utter bullshit.

[Contrary1]

27. Some of the idiot comments to the article...

Are saying they had a baby prematurely at 30 weeks, and the child is just fine now, so this baby could have been saved. :eyes:

The difference in development between 22 and 30 weeks in the womb is monumental.

And yeah, I know what I am talking about. I held my twin granddaughters, born at 22 weeks for the short time they lived. Two minutes/2 hours. They looked perfect. 14 ounces/18 ounces.

The problem is what I could not see. Lung buds incapable of drawing even a single breath. One of the girls was already into heart failure when she was born. No chance at all for that little one.

For the other, months of being poked, prodded, hooked up to every monitor available, and in unimaginable pain for less than a 10% chance of survival. While at the same time, better than a 50% chance of having severe disabilities had she lived. Sometimes, one has to think beyond their own desires.

I still weep when I think about them.

[kestrel91316]

28. 5 1/4 months gestation is not viable except perhaps with terribly expensive heroics.

Unfortunate, but until a few years ago this infant would not have survived more than a few hours, if that.

It's called triage. Unless that high level of care can be provided to everyone, it cannot and should not be provided to anyone.

If I delivered a baby THAT prematurely, I wouldn't be blaming doctors for its death. I'd be blaming God.

[Craftsman]

31. So when you can save the life even if in a rare instance do not try?

It is a human life.

[Barack_America]

38. How much are you, personally, willing to pay?

Be it through premiums or taxes or what have you, the money has to come from somewhere.

What proportion of your salary are you willing to pay to spare no treatment, no cost in saving every life, despite what the medical literature says about the chances and prognosis?

10%? 20%? 50%?

[The Magistrate]

40. That Has A Nice Ring To It, Sir, But It Is Utterly, Brutally Meaningless

Present health policy in this country consigns thousands to death yearly for reasons of profit and loss on company balance sheets.

What do you propose to do about these human lives?

[hedgehog]

41. I think it's wrong to put this into terms of the money to be spent or saved.

The problem is, babies born this young have problems we don't know how to treat. The techniques used on babies even a few days older just aren't enough. I looked into this yesterday when this story was posted in the Health forum. the guidelines aren't about saving money, they about sparing the child unnecessary pain.

[Craftsman]

52. There is no way you can defend not even trying to save this live

Yes the odds are long but you have to try.

[Kceres]

53. Even if it means a life of pain and suffering for the child?

Do you really mean that? Do you honestly think that a 21-weeker is just going to wake up one day and be fine? It will NEVER be fine. How much pain is OK with you for the sake of life?

[The Magistrate]

54. Nonesense, Sir

What cannot succeed is pointless to attempt.

Your entire effort here boils down to an appeal to emotion, which you hope will swamp reason, in the interest of preserving a system that at present consigns thousands each year to death, who could readily in most instances have been kept alive, on considerations of shareholder profit only.

[hedgehog]

66. Take this situation to the other end of life -

Say someone is 85 years old, in end stage Alzheimer's and can no longer swallow. This person is not awake but continuously sleeping.


Do you keep this person warm and dry and let them slip away, or do you insert a feeding tube?

Alternative scenario:

what if the person's heart stops, do you attempt to resuscitate?

[Arugula Latte]

70. No, you do not HAVE to try.

Sometimes babies are born way too early. That is the painful truth.

There has to be a cut off where people say, "Enough. This is ridiculous."

I would never have put my a baby through that if s/he had been born at 21 weeks. That is selfishness.

[hedgehog]

72. You're taking a lot of heat here, and I'd like you to know that I'm sympathetic

to your attitude, but I think I' seeing a larger picture. When a child is born this soon, the parents find themselves confronted hour by hour with the question of whether to go ahead with this procedure with all those possible side effects or whether it's time to let the baby go. Terminally ill patients and their families have the same questions.

Think of it this way - if you try to save every baby born this early, for every baby you save, 99 die after being put through the wringer. There is no way to tell ahead of time which baby will survive, so in effect you are torturing 99 babies and their parents for nothing. Even the one baby you do save is liable to have some kind of permanent disability.

No baby should ever die. Babies aren't supposed to die. I've been through miscarriage and it's a terrible thing. Sometimes, we have to stand back and admit that the best thing we can do is not make a bad situation worse.

[librechik]

43. Think about it--if she were getting an abortion, it wouldn't even be called late term

at 22 wks. This is a fetus.

[hedgehog]

74. Technically so, probably because it is so rare for survival if born this soon.

However, I suspect most people would be shocked at what a 22 week old fetus looks like.

[Crunchy Frog]

46. Babies that early are simply not viable.

To try to save them at that age is simply unnecessary cruelty IMHO. Sadly, I think the right call was made.

[truebrit71]

56. Stop using the Daily Fail as a news source...it is a right-wing rag..

...

[muriel_volestrangler]

60. World record: 21 weeks, 6 days

Amillia Taylor shouldn't be alive. She was born at less than 22 weeks - in the US, where babies aren't considered 'viable' until 23 weeks. But her desperate mother lied to doctors about how far gone she was, and Amillia is now the most premature baby to have ever survived. Aida Edemariam reports on her extraordinary story and asks: should we be saving such tiny babies?

There is something otherworldly about the picture that appeared around the world yesterday: two tiny brown-pink feet, almost translucent, poking through an adult's fingers. You had to look twice to be sure that they were indeed feet.

They belong to Amillia Taylor, who was born in Miami last October, 21 weeks and six days after conception. She weighed less than 10oz at birth - not even as much as two ordinary bars of soap - and she was just 9½ inches long. Amillia, who is expected to be discharged from hospital in the next couple of days, is officially the most premature baby ever to have survived.
...
To put Amillia's achievement into perspective: babies who go to full term are born at 37 to 40 weeks. According to the American Association of Pediatrics, babies born at less than 23 weeks are not considered "viable". According to a landmark report published by the Nuffield Council on Bioethics late last year, which provides guidelines that all British neonatologists and paediatricians are asked to consider, babies born before 22 weeks and six days gestation should not generally be resuscitated. Below 22 weeks, no baby should be resuscitated. "For this age group, we consider current attempts to resuscitate a baby to be experimental," the report said. Even between 23 weeks and 23 weeks and six days, there is no legal obligation on doctors to try to save a baby if they judge it to be against the child's best interests.

http://www.guardian.co.uk/society/2007/feb/21/health.lifeandhealth

How strange that a story about a British 21 week 5 day baby turns up, but the 21 week, 6 day American baby, for whom the mother had to lie to get treatment, becase the American limit is more than the British one, doesn't. :shrug:

[LeftyMom]

61. Actually there's one who was born earlier than her

http://www.canada.com/topics/bodyandhealth/story.html?id=db8f33ab-33e9-429f-bedc-b6ca80f61bdc

Though I'm not sure if the gestation ages were based on LMP or ovulation date or femoral length determined by ultrasound or what, depending on what the basis of the date is those gestational ages might be a bit wobbly.

[kath]

83. Exactly -- good point --abovearticle gives the time SINCE CONCEPTION, not the Gestational Age, which

is the time elapsed since 1st day of LMP (last menstrual period) and is 2 WEEKS greater (22 wks post-conception = 24 wks gestational age (dated from LMP).

Two more weeks inside the uterus makes a VERY big difference in this age range. 24 weeks (since LMP) is pretty much at the margin of viability (perhaps half-a-week or so less). At 24 weeks, the eyelids are still fused (like a newborn kitten) and the skin is gelatinous and therefore VERY prone to breakdown and infection.
22 weeks is pre-viable.

Also, as LeftyMom said, often the dates (of conception or LMP) are pretty shaky.

[muriel_volestrangler]

63. This also shows us where the 22 weeks guideline comes from: the Nuffield Council on Bioethics

ie not the British government or National Health Service, at all.

The Nuffield Council on Bioethics was established by the Trustees of the Nuffield Foundation in 1991 to identify, examine and report on the ethical questions raised by recent advances in biological and medical research. Since 1994, it has been funded jointly by The Nuffield Foundation, the Medical Research Council and The Wellcome Trust.

New developments in medicine and biology raise important ethical issues. The Nuffield Council on Bioethics is required, in its terms of reference, to consider these issues. The Council has achieved an international reputation, providing advice that assists policy-making, addresses public concerns and stimulates debate in bioethics.

...

Membership of the Council includes clinicians, lawyers, philosophers, scientists and theologians.

http://www.nuffieldbioethics.org/go/aboutus/page_2.html

Guidelines on giving intensive care to extremely premature babies
 At 25 weeks and above
Intensive care should be initiated and the baby admitted to a neonatal intensive care unit, unless
he or she is known to be affected by some severe abnormality incompatible with any significant
period of survival.
 Between 24 weeks, 0 days and 24 weeks, 6 days
Normal practice should be that a baby will be offered full invasive intensive care and support
from birth and admitted to a neonatal intensive care unit, unless the parents and the clinicians
are agreed that in the light of the baby’s condition it is not in his or her best interests to start
intensive care.
 Between 23 weeks, 0 days and 23 weeks, 6 days
It is very difficult to predict the future outcome for an individual baby. Precedence should be
given to the wishes of the parents. However, where the condition of the baby indicates that he
or she will not survive for long, clinicians should not be obliged to proceed with treatment
wholly contrary to their clinical judgement, if they judge that treatment would be futile.
 Between 22 weeks, 0 days and 22 weeks, 6 days
Standard practice should be not to resuscitate the baby. Resuscitation should only be attempted
and intensive care offered if parents request resuscitation, and reiterate this request, after
thorough discussion with an experienced paediatrician about the risks and long-term outcomes,
and if the clinicians agree that it is in the baby’s best interests.
 Before 22 weeks
Any intervention at this stage is experimental. Attempts to resuscitate should only take place
within a clinical research study that has been assessed and approved by a research ethics
committee and with informed parental consent.

http://www.nuffieldbioethics.org/fileLibrary/pdf/CCD_Short_Version_FINAL.pdf

So the guidelines are set by a council of medical professionals, with inputs from ethics professionals. They regard those born before 22 weeks as experimental, and thus needing to be in a study that has been approved for experiment (it is a baby whose life they'd be experimenting with, after all).

[kath]

84. Thanks for this - these guidelines are deliberated upon w/ great care, considering medical

capabilities and ethical principles. They did not come out of thin air...

[LeftishBrit]

75. Two points here

(1) There is no properly documented case anywhere of long-term survival of a baby born before 22 weeks. It is unlikely that doctors or hospitals in ANY country would even try to save a baby born that early. At least in the present state of medical knowledge, it simply isn't possible. All you could do would be to prolong the baby's suffering.

(2) The Daily Mail (sometimes known as Daily Hate, or Hate-Mail) is a vile, RW rag, totally unreliable on anything. It's basically the British answer to Rush Limbaugh's talk-show.

[Hekate]

77. I would bet there's a whole lot more to this story. Five 1/4 months is extremely unready...

... to be born.

The mother has a terrible record of bringing babies to term -- five miscarriages puts her far into the high-risk category. She miscarries about the same time each time? (or at least the last two) Something is very wrong with her genes or her eggs or her health or her uterus or whatever she's putting into her body.

Emotionally this has got to be devastating for her -- but at the same time I really have to say she is behaving stupidly and actively reducing her chances of ever having a second living child.

Sympathy -- very mixed.

Hekate

[holiday]

79. I just had a 24 weeker.

A 21 weeker is not viable. The lungs just haven't grown at that point. My 24 weeker had a 10% chance at the hospital we gave birth at. She made it, I'm holding her right now.

The earliest I have ever heard is 23 weeks and that is rare.

And here in America many hospitals do not try and save babies born before 24 weeks. I read that when finding info after I delivered my baby.

[Barack_America]

80. Thank goodness your little one made it.

:hug:

[SoCalDem]

82. not all miscarriages occur in the first trimester n/t

[Quantess]

85. So, the motivation for highlighting this event so many times is to make people say,

"oh, the British health care has death panels"
"I guess the US health care system isn't so bad after all"
"we should be grateful that we live in the USA and not in the UK"

[gleaner]

86. Read the post ..

and the article. Sorry, whatever it is selling, I'm not buying. Is this one of those deals like the Freepers saying that Stephen Hawking would have died of his ALS if he had been treated under the British National Health system?

As almost everyone who is educated knows Stephen Hawking is British and has survived long past the estimated lifespan for people with ALS. When he read what had been said, he told the press that he had received excellent care under UK's National Health. They kept him alive, as well as he could be, and provided him with equipment to function with his disability that he would not otherwise have had access to.

So, are you simply a person who believes everything they read without independent verification, or do you work for a health insurance company which is paying you to post stuff like that here, or do you truly not know the difference between the U.S. and the U.K. It's true both countries have a "U" in their names, but the UK is way, way across the ocean from us, and even though their health care system is basically government run, it is still a good system.

Bear in mind that here if the parents of the premature baby weren't insured or loaded no one would have moved very fast to save it either. Profit is the bottom line here. As long as no one forgets that when they get sick, they might actually survive the experience if they have the means.