"Viability is usually placed at about seven months (28 weeks) but may occur earlier, even at 24 weeks." ~Roe v. Wade
In 1973 with the passage of Roe v. Wade, the point of viability became central to the abortion debate. The courts created the "trimester framework" to determine when abortion regulations were permissible. This resulted in 1970s scientific knowledge being codified into Constitutional law. It wasn't until the Casey decision in 1992 that additional flexibility was given to adjust the moment of viability based on scientific advances.
As science continues to progress, so does the point of viability for babies to survive outside the womb. A recent study in the New England Journal of Medicine details groundbreaking research. Almost 5,000 babies born before 27 weeks gestation, born in 24 different hospitals, were tracked to analyze viability.
Time Magazine reported that the study is "shaking the preemie community with the surprising findings that in a small but significant number of cases, the 22-week limit may be no limit at all." The study also raises important questions about how agressively to treat premature babies, and how a lower age of viability might affect the abortion debate.
The study found that virtually every child born after 23 weeks received full-team medical care in a NICU. However, depending on the hospital, children born at 23 weeks had a 52.5%-96.5% chance of receiving care, while at 22 weeks the chances ranged from 7.7% to 100%. Those that did not receive medical care in a NICU simply received comfort care.
In the study, the survival rates for 22 week babies were just 2% and 9% for those who received resuscitation. While this is a small percentage, it is an increase from the previously thought 0%.
The study's key conclusion is that "differences in hospital practices regarding the initiation of active treatment in infants born at 22, 23, or 24 weeks of gestation" explain the varying survival rates. While the survival rates for babies at 22 weeks is incredibly low, it appears to be artificially low due to the assumption that they won't survive.
Time quoted Dr. Michael Uhing, the medical director of the NICU at the Children’s Hospital of Wisconsin as saying, "When outcomes are with babies hospitals never resuscitated, the results may have been falsely low."
The magazine's own analysis was that, "The mere decision not to resuscitate—often made to spare the baby the pain of a slow and all-but inevitable death —may have helped drive overall numbers down. In other words, provide the care that’s often withheld as an ostensible act of mercy, and improved survival rates may follow."
It appears that standards of viability reduce the use of medical care, and inhibit the advance of life-saving medical care. While premature babies are incredibly vulnerable, that should increase not decrease our efforts to protect them. As science progresses, it is clear that we will have to further rethink viability, which, for many "in the middle" on the abortion issue, is the determining factor in whether or not they support abortion.
This movement in public opinion could also affect public policy and legislation. If enough people understand that babies that can survive outside the womb are being routinely aborted, legislation will likely follow to make those abortions harder to get.
This seems like a viable departure from an abortion-on-demand culture that continues to devalue the most precious and vulnerable human lives.
