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.