The Viability of Pre-Mature Infants and the Disappearing of Motherhood


A SYTYCB entry

In a recent article over at the New York Times, Rahul K. Parikh discusses the difficulties that doctors face in determining the course of action for babies who are born at 23-26 weeks gestation, as many as 19 weeks pre-mature. The conversation is an important one; the idea that doctors have an emotional and ethical journey in their professions is, unfortunately, somewhat novel. But the piece is lacking something bigger than that – the voice and experience of mothers.

Parikh lays out the unfortunate reality that babies who are born “at the margin of life” – between 23 and 26 weeks gestation have an increased risk of developing conditions that will impact the quality of their lives, such as cerebral palsy, vision impairment, and problems with cognitive development that may impact their emotional and behavioral capacities. He notes that doctors have a responsibility to decide the course of treatment for each baby while keeping in mind the quality of life that zie may have. Should a doctor take extreme measures to save a baby who was born at 23 weeks and may live the rest of hir life with serious medical conditions?
This must be a precarious situation for any physician. There is a need to balance ableist prejudices about whose life is worth living with the high rate of lawsuits, all while juggling a physician’s own emotions and moral compass. However, in a piece about the difficulties of deciding whether to help a baby live, I’d expect to hear more from the mothers who birthed the babies.

This absence of mothers’ voices is not uncommon for conversation around motherhood and childbirth. Mothers are all but disappeared from the birthing process in a hospital setting, which experts in the midwifery model attribute to the medicalization of childbirth. The rise of the medicalization of labor and delivery removes the process of birth from the mother, strips mothers of their bodily power to birth, and turns it into a surgical procedure that is done to the mother, where zie is a passive object upon which to be operated.

Medicalization moves the human condition from the social realm to a plane where only those in the medical field have the tools and language necessary for discussion. We see in Parikh’s article, and countless others, that the medicalization of childbirth has created a dialogue in which only obstetricians and neonatologists can participate; the participants in discourse surrounding childbirth are no longer the mothers themselves. There is no space in the hospital context for mothers to speak or acknowledge the internalized wisdom that they possess to birth their children, and there is no mention of the power that these mothers own. There is no mention of the mothers as potential assets to doctors in making these difficult decisions about the viability of their infants. Instead, the author notes that doctors prefer to round on infants when their parents aren’t there, lest they allow their pesky emotional attachment to their children to interfere with the real work of doctors. The fact that the only mother interviewed for this piece is also a doctor highlights this unsettling reality.

Parikh’s article is an important piece of the conversation – we do need a space to honor and celebrate the emotions and ethics of doctors – but it is only a piece. We should never have a conversation about the viability of life outside of a womb without inviting mothers to join the conversation in a meaningful way.

Join the Conversation

  • Jamie Utt

    Powerful piece! Thank you so much for your perspective! I, personally, would love to see a series of posts from by mothers where they share their “internalized wisdom,” to use your words. Having testimony to the experience of carrying (or choosing not to carry) a child to term in one place would be a powerful testimony to the internalized wisdom of mothers. Perhaps that exists in one place elsewhere?

  • Melissa

    “medicine remains a fundamentally human — and therefore imperfect — endeavor” – This comes as a refreshing acknowledgement from the medical profession. Many professions are fundamentally and profoundly human, therefore, making them imperfect. This piece points to the fact that technology has once again outpaced human discourse. We have the tendency to medicalize most things when it comes to our bodies, particularly childbirth. I appreciate this piece calling out the almost complete absence of mothers and complete absence of fathers voices. It is frustrating to recognize that hospital births are the most common and accessible for most women, however, this is our reality in the U.S. With this in mind, I hope there is a stronger recognition of including those who are impacted most in the conversation before, during, and after the process of birthing a child.

  • hermeneut

    This is the kind of writing that I want to see at Feministing. Thanks for this interesting look at childbirth and the medical model.

  • Claire

    This is a thought-provoking and sensitive approach to a difficult subject that needs much more attention. The medicalization of childbirth is, I would argue, linked to the politicization of conception; if we, as a country, do not trust women to know when their child is alive, how can we trust them with the lives of their children?

  • Sadie

    Thanks for sharing this important view. I love description of mothers’ “internalized wisdom” and that they are important assets to the doctors in these situation. Thanks for humanizing this complicated issue and helping to amplify the voice of women!