It's So Personal: What Do You Mean, Viable?

A reader writes:

My twins were delivered at 29 weeks and 3 days because I had severe pre-eclampsia.  If I had continued to carry them I was at risk for seizures, kidney failure, and a ruptured liver.  My blood pressure was so Davinci high that there was a risk the boys’ oxygen supply would be cut off, leading to brain damage. 

So I had a C-section.  The boys were in the NICU for 9 weeks. Owen in particular had a hard time; he was on oxygen and IV for a long while, had a heart murmur, and aspirated his milk.  Retinopathy  affected both boys, so they both wear glasses and always will.  Oliver had surgery for a couple of hernias.  They are now three and speech delayed, so we're going through testing to determine if they're autistic.
 
The reason I give you a brief outline of my boys' birth and development is because they were born nearly six weeks after a fetus is considered “viable”.  To be perfectly honest, I don’t view my children as having been viable when they were born; I couldn’t feed them by mouth (the suck/swallow reflex doesn’t develop until at least 35 weeks), they couldn’t breathe on their own, their digestive systems didn't work properly, they couldn't regulate their body temperature (having no body fat), etc, etc.

In the abstract, I would say I am pro-choice, but an abortion was not something I could personally choose. I certainly treasure my children regardless of the challenges they continue to face.  But as your readers have demonstrated, abstract concepts become difficult to apply in the face of deeply personal circumstances.  One of the abstract concepts that is too often bandied about is the idea that at a certain number of weeks a fetus is suddenly viable. But my 29-week babies were not viable at all without massive medical intervention.  Regardless of its gestational age, a fetus that is faceless or only has a brain stem is clearly not capable of sustaining life.  So why do the number of weeks that have passed since conception determine whether the pregnancy can be terminated or not?
 
There are no legal limits on abortion in Canada.  The law that governed abortion was overturned by the Supreme Court of Canada in 1988 and nothing has taken its place.  I personally think that’s a shame, because I’d like to see a public discussion of what we as a nation think is appropriate with respect to abortion and I’d like to see some guidelines in place.  Having said that, abortion rates have been steadily declining in Canada and are now lower than the U.S. (97,254 abortions in 2005 compared with births of 364,085), so maybe we are doing something right. 

It seems to me that rigid formulas determining what options are available based solely on gestational age totally miss the point – you can’t just plug the data into a flowchart and ascertain the appropriate outcome.  This is personal, and the best system is one that assists mothers in coming to the decision that’s right for them.

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