Hot Topic (11/10): Should premature babies be treated or allowed to die?
'Doctors told me it was against the rules to save my premature baby'
By Vanessa Allen and Andrew Levy
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.
Miss Capewell, 23, said doctors refused to even see her son Jayden, who lived for almost two hours without any medical support. She said he was breathing unaided, had a strong heartbeat and was even moving his arms and legs, but medics refused to admit him to a special care baby unit.
Miss Capewell is now fighting for a review of the medical guidelines.
Medics allegedly told her that they would have tried to save the baby if he had been born two days later, at 22 weeks.
In fact, the medical guidelines for Health Service hospitals state that babies should not be given intensive care if they are born at less than 23 weeks. The guidance, drawn up by the Nuffield Council, is not compulsory but advises doctors that medical intervention for very premature children is not in the best interests of the baby, and is not 'standard practice'.
James Paget Hospital in Norfolk refused to comment on the case but said it was not responsible for setting the guidelines relating to premature births.
A trust spokesman said: 'Like other acute hospitals, we follow national guidance from the British Association of Perinatal Medicine regarding premature births.' Miss Capewell, who has had five miscarriages, said the guidelines had robbed her son of a chance of life.
She said: 'When he was born, he put out his arms and legs and pushed himself over.
A midwife said he was breathing and had a strong heartbeat, and described him as a "little fighter".
I kept asking for the doctors but the midwife said, "They won't come and help, sweetie. Make the best of the time you have with him".' She cuddled her child and took precious photos of him, but he died in her arms less than two hours after his birth.
Miss Capewell, who has a five-year-old daughter Jodie, went into labour in October last year at 21 weeks and four days after suffering problems during her pregnancy. She said she was told that because she had not reached 22 weeks, she was not allowed injections to try to stop the labour, or a steroid injection to help to strengthen her baby's lungs.
Instead, doctors told her to treat the labour as a miscarriage, not a birth, and to expect her baby to be born with serious deformities or even to be still-born. She told how she begged one paediatrician, 'You have got to help', only for the man to respond: 'No we don't.'
As her contractions continued, a chaplain arrived at her bedside to discuss bereavement and planning a funeral, she claims. She said: 'I was sitting there, reading this leaflet about planning a funeral and thinking, this is my baby, he isn't even born yet, let alone dead.'
After his death she even had to argue with hospital officials for her right to receive birth and death certificates, which meant she could give her son a proper funeral.
She was shocked to discover that another child, born in the U.S. at 21 weeks and six days into her mother's pregnancy, had survived. Amillia Taylor was born in Florida in 2006 and celebrated her second birthday last October. She is the youngest premature baby to survive.
Miss Capewell said: 'I could not believe that one little girl, Amillia Taylor, is perfectly healthy after being born in Florida in 2006 at 21 weeks and six days.
'Thousands of women have experienced this. The doctors say the babies won't survive but how do they know if they are not giving them a chance?' Miss Capewell has won the support of Labour MP Tony Wright, who has backed her call for a review of the medical guidelines. He said: 'When a woman wants to give the best chance to her baby, they should surely be afforded that opportunity.'
What the medical guidelines say...Guidance limiting care of the most premature babies provoked outrage when it was published three years ago. Experts on medical ethics advised doctors not to resuscitate babies born before 23 weeks in the womb, stating that it was not in the child's 'best interests'. The guidelines said: 'If gestational age is certain and less than 23+0 (i.e at 22 weeks) it would be considered in the best interests of the baby, and standard practice, for resuscitation not to be carried out.'
Medical intervention would be given for a child born between 22 and 23 weeks only if the parents requested it and only after discussion about likely outcomes. The rules were endorsed by the British Association of Perinatal Medicine and are followed by NHS hospitals.
The association said they were not meant to be a 'set of instructions', but doctors regard them as the best available advice on the treatment of premature babies.
More than 80,000 babies are born prematurely in Britain every year, and of those some 40,000 need to be treated in intensive care. The NHS spends an estimated £1 billion a year on their care.
But while survival rates for those born after 24 weeks in the womb have risen significantly, the rates for those born earlier have barely changed, despite advances in medicine and technology. Medical experts say babies born before 23 weeks are simply too under-developed to survive, and that to use aggressive treatment methods would only prolong their suffering, or inflict pain.
The guidelines were drawn up by the Nuffield Council on Bioethics after a two-year inquiry which took evidence from doctors, nurses and religious leaders. But weeks before they were published in 2006, a child was born in the U.S. which proved a baby could survive at earlier than 22 weeks if it was given medical treatment.
Amillia Taylor was born in Florida on October 24, 2006, after just 21 weeks and six days in the womb. She celebrated her second birthday last year. Doctors believed she was a week older and so gave her intensive care, but later admitted she would not have received treatment if they had known her true age.
Her birth also coincided with the debate in Britain over whether the abortion limit should be reduced. Some argued that if a baby could survive at 22 weeks then the time limit on abortions should be reduced. The argument, which was lost in Parliament, followed a cut to the time limit in 1990 when politicians reduced it from 28 weeks to 24 weeks, in line with scientific evidence that foetuses could survive outside the womb at a younger age.
However, experts say cases like Amillia Taylor's are rare, and can raise false expectations about survival rates. Studies show that only 1 per cent of babies born before 23 weeks survive, and many suffer serious disabilities.
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Should babies born before 22 weeks gestation be given intensive care or allowed to die?
In this particular case, do you think the doctors ought to have followed the wishes of the baby's mother and attempted to save the baby's life?
Would you want your premature baby to be given intensive treatment if he/she was born before 28 weeks? 26 weeks? 24 weeks? 22 weeks? Where do you draw the line?
wow i think that they should at least try to save the baby ..if it died at least they tried it disgusts me
i was born in 1984 and i was born at 24 weeks weighed only 1lb and was 11 inches long at the time i was not conciderd viable
and my mom was told that i had no chance of survival atall
my mother insisted on keeping me going because she felt i was a fighter i had made it that far ..
my mum worked in the hospital i was born in and she even worked in the nicu and they let her have her way im now im 25 with no problems and a baby boy of my own so i say give preemies a chance b/c miracles do happen if you allow them
heres a pic i was almost 9 weeks and they had just taken my vent off 
heres me about 1 month old still on vent
this is disgusting. it almost makes me want to cry. they shouldve helped that baby!
preemie babies should be treated sorry they are humans who deserve to live like any other baby born full term
stephanie/cloth diapering/full term bfing/extended harnessing mama
I think those are messed up guidelines! If the baby was live and breathing when born they should have tried to save him. I would have gone looney on the doctors. If the baby would have been born not breathing or moving I would understand why they would not do anything , but a baby that is obviously alive?! That is just wrong and inhumane. I really feel for that momma, I can not even imagine what she went through in those 2 hours and after.
Your mom was right! 
Quoting babie113:wow i think that they should at least try to save the baby ..if it died at least they tried it disgusts me
i was born in 1984 and i was born at 24 weeks weighed only 1lb and was 11 inches long at the time i was not conciderd viable
and my mom was told that i had no chance of survival atall
my mother insisted on keeping me going because she felt i was a fighter i had made it that far ..
my mum worked in the hospital i was born in and she even worked in the nicu and they let her have her way im now im 25 with no problems and a baby boy of my own so i say give preemies a chance b/c miracles do happen if you allow them
heres a pic i was almost 9 weeks and they had just taken my vent off
heres me about 1 month old still on vent
I say 3 minutes of resuscitation or any sign of life they get to be treated as any other baby.Any doctor not willing is playing executioner
This is horrible. I think if it is possible to save the life of the baby no matter what age then they should try. Always try. This is horrible. How can the Dr. see a baby breathing on her own, and acting completely viable, and just let her die. This is just awful. These Drs were worried about their paychecks, not the life of that baby.
Heather
The Witchy Momma
Rise up this morning, smile at the rising sun; Three little birds, pitch by my doorstep; Singing sweet songs, a melody pure and true; Singing, this is my message to you-ou-ou; Singing Don't worry, about a thing; Cause every little thing is gonna be alright.
This really upsets me. The fact that he was strong enough to live all by himself for 2 HOURS means to me that he had a pretty good chance of living if they would have helped him. What kind of animals were these doctors!? I didn't read the whole artical but I saw where they wouldn't even give her steroids for his lungs or a shot to stop labor! WTF!? I had the steriod for my girls lungs and it helped them SO much.. so this little boy was that strong without them he really was fighting to live.. It makes me want to cry. I had my twins at 28 weeks and they were in the NICU for 7 weeks. Of course I think that preemies should get medical attention.. Anyone who doesn't obviously hasn't had a preemie!
Another thought I just had.. How do they REALLY REALLY know 100% the exact time of conception? Obviously they don't and this proves it ....Amillia Taylor was born in Florida on October 24, 2006, after just 21 weeks and six days in the womb. She celebrated her second birthday last year. Doctors believed she was a week older and so gave her intensive care, but later admitted she would not have received treatment if they had known her true age.
So who are they to not save someone's baby.. especially someone who is begging for help. I bet if it were THEIR baby it would be in intensive care..
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on Nov. 10, 2009 at 2:41 AM