Features

Abigail and Samuel

"Abigail and Samuel" Continued...

Issue: "Boy Scout dilemma," May 18, 2013

When parents, nurses, or fellow doctors begin worrying about “quality of life” for a particular baby, Sharp reminds them how hard it is to predict medical outcomes. “There are cases where I could say, ‘Wow, I remember worrying about this or that [condition] on this baby, but this child has grown up, graduated from high school. I attended the graduation, and now the child is getting married. … Some have gone to college. … It’s so hard for us to make the argument about quality of life when we don’t have a crystal ball to look down the road.”

Sharp sees his role as not merely helping preemies survive, but helping parents through one of the most difficult journeys of their lives. He wants them to be “joyful in hope, patient in affliction, faithful in prayer” (Romans 12:12).

Abigail, after a bout with a bladder infection, finally came home from the NICU when the Traffords reached Psalm 69: “You who seek God, let your hearts revive. For the LORD hears the needy.”

Today, at 1 year old, Abigail weighs 16 pounds, 10 ounces, takes medication to control her blood acid level, and is finishing up occupational therapy to improve her motor skills. She has almost learned to walk, says “dah-dah” and “bah-bah” (daddy and bottle), and barks at the family dog.

She’s busy, too. While Robin spends 15 minutes or so on the phone, Abigail crawls from the entertainment center to the dog kennel to the entertainment center and to the kennel again, where she repeatedly opens and closes the door. “She’s definitely tenacious and focused. And she has a temper. But she’s super loving,” says Robin.

“She very rarely meets a stranger—she’ll smile at anyone,” says Derrick, who bequeathed her his dark brown eyes.

The Traffords have more hard decisions ahead: They still have five embryos frozen. They plan to implant one this year but wonder if there’s another mountain climb ahead.

Robin says Abigail and Samuel taught them not to grasp anything in life too tightly: “God is faithful. He controls whether we live or die. … We know to raise her with very open hands, because she does not belong to us.”

On April 7, Abigail’s birthday, the Traffords returned to the NICU to visit other parents with premature babies. They handed out cards and pictures intended to give them hope for the journey: The pictures showed Abigail when she was born, when she left the NICU, and when she turned 1.

On the cards they wrote, “Just thinking of you. Love, the Traffords.”

Premature question

SURVIVING: The tiny foot of a patient in the neonatal intensive care unit at Holtz Children’s Hospital in Miami, Fla.
Marice Cohn Band/Miami Herald/MCT via Getty Images
SURVIVING: The tiny foot of a patient in the neonatal intensive care unit at Holtz Children’s Hospital in Miami, Fla.

Thanks to modern neonatal intensive care units, a preemie born at 24 weeks of gestation has more than a 50 percent chance of survival. Medical technology has bounded forward since the early 1950s, when doctors realized early oxygen chambers were causing 10,000 babies to go blind. In the 1980s doctors developed a heart-lung bypass procedure and began using surfactant to open air sacs in premature babies’ lungs. More recently, they learned nitric oxide could also improve lung function.

Currently, 23 weeks gestation seems to be a threshold for preemie survival. Below that, the baby’s organs simply aren’t developed enough to survive outside the womb, even with the aid of modern technology. According to the American Academy of Pediatrics, about a quarter of babies born at 23 weeks survive, in developed nations, and only about 5 percent of babies born at 22 weeks survive. The AAP recommends if a baby is born before 23 weeks or weighs under nine-tenths of a pound, doctors generally shouldn’t attempt resuscitation, since the process is painful for the baby and usually futile.

A so-called “gray zone,” from 23 to 25 weeks, creates a conundrum for neonatologists: Because of the uncertainty of pinpointing a baby’s date of conception (doctors normally estimate it from the mother’s last menstrual cycle), a baby may be more or less developed than its assigned gestational age would suggest. Whether a gray zone baby is likely to survive is a case-by-case judgment call.

Even outside the gray zone, preemies often have other medical problems in the womb, decreasing their chance of survival. The uncertainty leaves doctors and parents with hard decisions: If the baby is born and doesn’t look healthy or large enough to survive, should they attempt painful lifesaving measures that may or may not be successful, or simply make him comfortable as he dies? Pro-life doctors and parents wrestle with the question as much as anyone else.

Daniel James Devine
Daniel James Devine

Daniel is a reporter for WORLD who covers science, technology, and other topics in the Midwest from his home base in Indiana. Follow Daniel on Twitter @DanJamDevine.

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