Friday, December 12, 2008

Birth of a Child-II

Contd..from the last article

As I was stating earlier the time of 36 weeks inside the mother's womb is very crucial. As I experienced recently that even if the baby comes out after 34-35 weeks it is a considerably immature baby! These babies are very likely to have breathing troubles and in the baby that I am observing off-late he had to be put into an incubator in a ICU immediately after birth. Even after 34 to 35 weeks the lungs can be highly immature and unable to supply enough pure blood to the body. The alveoli in the lungs may simply be unable to expand enough and the baby might have to put into artificial breathing machines. Contrary to prevalent ideas and very surprisingly recent research has shown that these artificial breathing machines when used on new-born babies can affect brain development! So the situation is really complicated.

If the lungs seem to be maturing fast and the situation is not very bad then doctors can try to do some chemical treatment where they use chemicals called "surfactants" which little that I understand from the viewpoint of a physics student is that they reduce the surface tension of the alveolar bags and hence help them expand to full capacity.

The point is that birth just 2 weeks earlier than the typical 36 weeks can lead to pretty complicated situations. Over and above these lung problems another very common problem with pre-mature babies is that they may be born with holes in their heart! If the hole is large then chances of survival can be very slim given that already the lungs are under performing. If the hole is small then gradually the correct tissues grow and the holes get filled but if this does not happen then pretty complicated and risky operation might be required.

The baby I am observing now and whose situation has prompted this blog seems to have both the troubles of a under-developed lungs and has 2 holes in the heart!

Further if the premature baby is not of a good mass and is not physically very healthy then he/she might not be in a position to even survive these complicated medical treatments.
If the baby is very pre-mature then even after birth she/he needs to be kept in similar humidity and temperature conditions after birth like she/he was inside the womb. That is maintained these days by artificially creating such conditions inside glass chambers in which the baby is put.

Obviously these processes are very very expensive and not every family will be able to afford these treatments. And in these treatments there is no guarantee of success, further with things like late crying and convulsions the baby is likely to grow up to be a spastic child which no treatment can cure. Then why should the parents keep trying to save their child when it is sure that there is no cure and the fatal damage has been done within the first few minutes of birth!

Isn't it better for them and the world that in such a situation the parents decide to opt for mercy-killing of the baby?
Isn't euthanasia for the new born baby a much better thing in such situations than let her/him grow up to be a mentally handicapped person?
Shouldn't parents in such situations let hard sense of logic dominate human emotional instincts and take the bold step?

On the little brighter of my grandmother's elder brothers was born a very pre-mature baby and in those days about 75 years ago there was no such technology as talked of earlier. He was supposedly kept inside wet-cotton inside a shoe box and the room was covered with wet-clothes which were constantly kept wet! I feel a sense of extreme scientific thrill that they could save the baby in those days! Even one of my childhood friends was also born a very pre-mature baby. She is very much alive today and very much running around with her life.

And to top it all I had read that even Newton was born a pre-mature baby! I feel completely excited at the idea that in the early 17th century, some 300 years ago they could save a pre-mature baby!

In fact various research works have shown that pre-mature babies if are free from any other health complication at birth like lung dis-functioning etc then are likely to grow up to be very intelligent people!

The point of this article was to share from my almost non-technical viewpoint (that of a student of science with formal training in mathematics and physics but nothing formal in biology after class 10) some of the various non-preventable factors at birth that determine the health of the baby and have an irreversible effect on the person.

The point is that all these scary things can happen at birth and the couple has almost no control over it and can do nothing to prevent it. And if they can't go for hard options like euthanasia at birth then they have a very very painful life ahead, further society has collectively a terribly difficult task of bringing up a mentally handicapped child.

This reminds me of a Spartan custom. During the times of the roman empire the Spartans were supposed to be the most skilled warriors and probably the first civilization to have election and a democratic government and they supposedly had greater women-men equality in the society than it exists even today. Already in those days they supposedly had elected women representatives in the parliament! These Spartans had some specification about the minimum health standards of a child at birth and if the baby was below it then it was immediately killed.

What they did definitely does not seem appropriate today since today we need not have an entire society of warriors. I don't see why to do mathematics one needs to have a herculean figure. But the point is that given their needs Spartans did have the courage to overcome normal human instincts and use hard logic.

Given all this huge gamble that exists with the health and intelligence of the child, is this entire adventure of having a child worth it?

Couples unable to conceive naturally take all sorts of expensive and sophisticated help from medical professionals to be able to have a child.


What justifies all this effort and emotion and expenditure when on the bare minimum one can't ensure that the child will not be mentally handicapped?

(especially in India where the nation is already crippled by this luggage of 6 billion people!)

reminds me of the lines of a famous hindi song:

"...Tujhse naraz nahin zindagi se, Hairan hoon main..."


AnoNick said...

Where are the numbers, the statistics? People get scared of flying in a plane, because they fear the tremendous risks involved. But the number of deaths is far lower than road accidents. But which these people surely travel by road every day!

My point being, one can't take a reasonable decision without statistics. What is the risk my child will have complications from early birth? What is the risk my child will not cry? Is crying such a big factor? How big? Which study says that?

There surely are a lot of factors to worry about in childbirth. But where are the numbers?

I appreciate your post, it highlights some important issues. But you can't expect people to decide on risks without knowing how much of a risk it is, and whether there really is a risk. You mention in the earlier post that the diaper risk is mostly conjecture.

There is one point which goes against my analogy with most other risks in life: there is another life involved. Your coldly logical attitude towards that other life when it faces suffering, even though that goes against most arguments in your post, but it's valid. If the parents have no money to perform life-saving operations, or if the child has a disability which will rob it of all joy in life, euthanasia is an option to consider. But in less extreme cases, I feel we should not judge children on intelligence, or health, or anything else at all.

Anirbit said...

Let me say 3 things in response to what "AnoNick" has to say:

1. Many of the statements that you have made clearly demonstrate a gross ignorance on your part of the biological world. Neither am I professionally trained in the subject either but still having interacted with the medical world on a regular basis I have gained an understanding of what and how much the risk is.

2. In cases like this let us not invoke stupid statistics to judge matters, like government which go by numbers like "only 0.00000001% of India is affected by so and so" so it is not a big problem.

These are too important matters to be looked through mass averaging but need to be looked at an individual basis.

For the country as a whole it is 1 spastic child among millions of healthy children that is born..for that family it is their only child who is crippled for life.

It is an issue at an individual level and NOT a problem for the population ensemble.

Let us not get get philosophical about what parameters to use to judge a child but let us use the simple cold hard logic that no parent would want a spastic child and a society without any handicapped people is definitely a better society.

AnoNick said...

1. You say you have gained an understanding of how much the risk is. Will you please quantify it?

2. Stupid government statistics? I never said government. There are NGOs which collect these statistics, you know. And to continue my earlier analogy, if someone crosses a road, you have a chance of having an accident. For his/her family, it'll be their relative who is gone, for the government it's just another accident. But does that stop us from crossing roads?

3. You don't want people to have children at all! Is society without children a better society?

Your Nietzsche-ism is philosophy too. I do not think it right to kill a child unless it will really lead a wretched life. Even then, it needs some consideration.

Anirbit said...

A basic point:

Road accidents are preventable. and very much so.

The things I was talking about (factors that can go wrong at child birth) are anything but preventable!

Your comparison reminds me of a similar comparison made by one very brilliant student in Physics that I know..he said that in the Mumbai blasts some 170 people have died whereas recently in some building crash in Delhi more than 200 people died...then why is India making such a uproar about this Mumbai attack and not about that building crash.

Ridiculous I must say!

Radha Dilip said...

Comments against your idea "Let us not get get philosophical about what parameters to use to judge a child but let us use the simple cold hard logic that no parent would want a spastic child and a society without any handicapped people is definitely a better society."

It is such ideas that work behind ethnic cleansing. Entertaining an idea that a society without any handicapped people is definitely a better society" is equivalent to your being a mental terrorist.

Harsh words? but the idea is to awaken the sensitivity in your heart - it is not enough to be sensitive to issues; logic does not alone suffice; we are born to sample life and observe the world - but please beware and take no position where you proclaim what is order.
how do you know that parents will not need a spastic child?
Love, in its gentlest form lets us coexist with any kind of shortcomings in ourselves and in others. In learning to live with those who are not fit, we learn to gleam into so many unfit things in ourselves, and gently, ever so gently learn to accept it. Life gleams with beauty when it is touched by imperfections.
and why should each of us contribute to this world by being not handicapped or not? the world is a large place of coexistence of everything. Nature accommodates everything!