Fetal viability - some reading for forum Participants.
https://en.wikipedia.org/wiki/Fetal_viability
Definitions
Viability, as the word has been used in United States constitutional law since
Roe v. Wade, is the potential of the fetus to survive outside the uterus after birth, natural or induced, when supported by up-to-date medicine. Fetal viability depends largely on the fetal organ maturity, and environmental conditions.
[2] Another definition for
viability, as used in the medical phrase
limit of viability, is the expectation that a fetus has an equal chance of surviving and not surviving outside his or her mother's womb.
According to Websters Encyclopedic Unabridged Dictionary of the English Language, viability of a fetus means having reached such a stage of development as to be capable of living, under normal conditions, outside the uterus. Viability exists as a function of biomedical and technological capacities, which are different in different parts of the world. As a consequence, there is, at the present time, no worldwide, uniform gestational age that defines viability.
[3]
Various jurisdictions have different legal definitions of viability. In
Ireland, under the
Health (Regulation of Termination of Pregnancy) Act 2018, fetal
viability is defined as "the point in a pregnancy at which, in the reasonable opinion of a medical practitioner, the foetus is capable of survival outside the uterus without extraordinary life-sustaining measures." [Definitions (Part 2)(8)]
[4]
Medical viability
There is no sharp limit of development,
gestational age, or weight at which a human fetus automatically becomes viable.
[1] According to studies between 2003 and 2005, 20 to 35 percent of babies born at 24
weeks of gestation survive, while 50 to 70 percent of babies born at 25 weeks, and more than 90 percent born at 26 to 27 weeks, survive.
[5] It is rare for a baby weighing less than 500 g (17.6 ounces) to survive.
[1] The chances of a fetus surviving increase 3-4% per day between 23 and 24 weeks of gestation and about 2-3% per day between 24 and 26 weeks of gestation. After 26 weeks the rate of survival increases at a much slower rate because survival is high already.
[6][7][8][9]
Stages in
prenatal development, showing
viability and point of 50% chance of survival (
limit of viability) at bottom. Weeks and months numbered
by gestation.
Completed weeks of gestation at birth 21 and less 22 23 24 25 26 27 30 34 Chance of survival
[6] 0% 0-3% 0-5% 40-70% 50-80% 80-90% >90% >95% >98%
Period of viability
The period of viability refers (traditionally) to the period after the twenty-eighth week,
[10] or more recently the twenty-fourth week, of
gestation when a
human fetus is capable of living outside of the
womb. Whether the fetus is in the period of viability has legal ramifications as far as the fetus' rights of protection are concerned.
[11]
It sometimes incorporates weight as well as gestational age.
[12][13][14]
United States Supreme Court
The
United States Supreme Court stated in
Roe v. Wade (1973) that viability (i.e., the "interim point at which the fetus becomes ... potentially able to live outside the mother's womb, albeit with artificial aid"
[15]) "is usually placed at about seven months (28 weeks) but may occur earlier, even at 24 weeks."
[15] The 28-week definition became part of the "trimester framework" marking the point at which the "compelling state interest" (under the doctrine of
strict scrutiny) in preserving potential life became possibly controlling, permitting states to freely regulate and even ban
abortion after the 28th week.
[15] The subsequent
Planned Parenthood v. Casey (1992) modified the "trimester framework," permitting the states to regulate abortion in ways not posing an "
undue burden" on the right of the mother to an abortion at any point before viability; on account of technological developments between 1973 and 1992, viability itself was legally dissociated from the hard line of 28 weeks, leaving the point at which "undue burdens" were permissible variable depending on the technology of the time and the judgment of the state legislatures.
Born-Alive Infants Protection Act of 2002
In 2002, the U.S. Government enacted the
Born-Alive Infants Protection Act. Whereas a fetus may be
viable or not
viable in utero, this law provides a legal definition for personal human life when not in utero. It defines "born alive" as "the complete expulsion or extraction from his or her mother of that member, at any stage of development, who after such expulsion or extraction breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles"
[16] and specifies that any of these is the action of a living human person. While the implications of this law for defining viability in medicine may not be fully explored,
[17] in practice doctors and nurses are advised not to resuscitate such persons with gestational age of 22 weeks or less, under 400 g weight, with anencephaly, or with a confirmed diagnosis of trisomy 13 or 18.
[18][19]
U.S. state laws
Forty-three states have laws restricting post-viability abortions. Some allow doctors to decide for themselves if the fetus is viable. Some require doctors to perform tests to prove a fetus is pre-viable and require multiple doctors to certify the findings. The procedure
intact dilation and extraction (IDX) became a focal point in the abortion debate,
[20] based on the belief that it is used mainly post-viability.
[21] IDX was made illegal in most circumstances by the
Partial-Birth Abortion Ban Act in 2003, which the U.S. Supreme Court upheld in the case of
Gonzales v. Carhart.
Limit of viability
The limit of viability is the
gestational age at which a
prematurely born fetus/
infant has a 50% chance of long-term survival outside its mother's womb. With the support of
neonatal intensive care units, the limit of viability in the developed world has declined since 50 years ago, but has remained unchanged since the late 90s.
[22][23]
Currently, the limit of viability is considered to be around 24 weeks, although the incidence of major disabilities remains high at this point.
[24][25] Neo-natologists generally would not provide intensive care at 23 weeks, but would from 26 weeks.
[26][27][28]
As of 2006, the
two youngest children to survive premature birth are thought to be
James Elgin Gill (born on 20 May 1987 in
Ottawa, Ontario, Canada, at 21 weeks and 5 days gestational age),
[29][30] and Amillia Taylor (an IVF pregnancy, born on 24 October 2006 in
Miami,
Florida, at 21 weeks and 6 days gestational age).
[31][32] Both children were born just under 20 weeks from fertilization (or 22 weeks' gestation). At birth, Taylor was 9 inches (22.86 cm) long and weighed 10 ounces (283 grams).
[31] She suffered
digestive and
respiratory problems, together with a
brain hemorrhage. She was discharged from the Baptist Children's Hospital on 20 February 2007.
[31] As of 2013, Taylor was in kindergarten and at the small end of the normal
growth curve with some developmental delays.
[33]
A
preterm birth, also known as
premature birth, is defined as babies born alive before 37 weeks of pregnancy are completed.
[34] There are three types of preterm births: extremely preterm (less than 28 weeks), very preterm (28 to 32 weeks) and moderate to late preterm (32 to 37 weeks).
[34]
Factors that influence the chance of survival
There are several factors that affect the chance of survival of the baby. Two notable factors are age and weight. The baby's
gestational age (number of completed weeks of pregnancy) at the time of birth and the baby's weight (also a measure of growth) influence whether the baby will survive. Other major factors include race and gender. For a given weight, Black babies have a slightly better chance of survival than White, while most other races have a rate between the two. Male infants are slightly less mature and have a slightly higher risk of dying than female infants.
Several types of health problems also influence fetal viability. For example, breathing problems, congenital abnormalities or malformations, and the presence of other severe diseases, especially infection, threaten the survival of the neonate.
Other factors may influence survival by altering the rate of organ maturation or by changing the supply of oxygen to the developing fetus.
The mother's health plays a significant role in the child's viability. Diabetes in the mother, if not well controlled, slows organ maturation; infants of such mothers have a higher mortality. Severe high blood pressure before the 8th month of pregnancy may cause changes in the placenta, decreasing the delivery of nutrients and/or oxygen to the developing fetus and leading to problems before and after delivery.
Rupture of the fetal membranes before 24 weeks of gestation with loss of amniotic fluid markedly decreases the baby's chances of survival, even if the baby is delivered much later.
[6]
The quality of the facility- whether the hospital offers neonatal critical care services, whether it is a Level I pediatric trauma care facility, the availability of corticosteroids and other medications at the facility, the experience and number of physicians and nurses in neonatology and obstetrics and of the providers has a limited but still significant impact on fetal viability. Facilities that have obstetrical services and emergency rooms and operating facilities, even if smaller, can be used in areas where higher services are not available to stabilize the mother and fetus or neonate until they can be transferred to an appropriate facility.
[35][36][37][38]
Comments -
TxDot guy - Thank You for a reasoned post. Remember - Ignorance is only the lack of education.
What Europe does is information - but to me, not necessarily a model to follow.
Ireland is a very Catholic country ( excluding Northern Ireland) - and the anti-abortion stance of the Church was/is a major influence on the Abortion Argument.
Some of the argument focuses on length of pregnancy to allow abortion - 24 weeks is about 50 % survival outside the womb - for other wise healthy babies
700 grams in Preemies seems in neonatology practice a birth weight at which babies under that weight have a much lower survival.
Roe v Wade was 1973 - modern neonatology did not exist - it was spurred by the death of Patrrick Bouvier Kennedy - born prematurely and expired. Definitions of fetal viability have changed greatly since 1973.
Gnadfly - fetal heartbeat is detectable at about 6 weeks gestation - by ultrasound.
JBC- I respectfully differ on Planned Parenthood - they have been victimized as an organization by a planned fake smear. i disagree with most of your post.
PP provides far more than just abortion - it is a health care provider to millions of underserved women. Services not duplicated by other programs.
I agree with the possibility of individual misconduct in an organization - but please do not throw out the "baby with the bathwater", so to speak.
For those concerned about "partial birth abortion - please see above 2002 federal "Born Alive Protection Act. " Federal law supercedes State law in these matters.
Also, the
Partial-Birth Abortion Ban Act in 2003, which the U.S. Supreme Court upheld in the case of
Gonzales v. Carhart.
as far as required tests being "Harrassment" - I phrase that in terms of what is medically required for the procedure. That which is not medically required, may reasonably be termed unreasonable expense and a deterrent to the procedure - Exactly as intended by some laws and lawmakers. as each case is individual - I prefer not to try to define what is medically required - Medicine is to variable and each case is different and requires different management modalities.
I must state I agree with not using Taxpayer funds to pay for Abortions. Unfortunately, our taxes go to pay for many things which some of us as taxpayers would disagree with.
No easy answer. I would prefer to see abortion not funded by taxes - let the woman and physicians deal with it. Private donations are acceptable to me.
I hope most of Forum participants take the time to read - and regardless of opinion, recognize it is a difficult argument, and "compromises" are difficult for both sides.
Means We as a country should try harder to come to an acceptable compromise. I expect the extremists of both sides will not let that happen - the Argument will continue.
Bottom line - in most states - which have the right to regulate medical care and abortion - 24 weeks is the limit for abortion, except in cases of fetal death, rape, incest, or significant risk to the life and health of the Mother. Seems the most reasonable compromise at this time under established Law.
It has been pointed out that the SC is capable of reversing itself -When 5 judges concur that is a Truism.
I respectfully hope this is Helpful.
A Truism - "Education is the cure for Ignorance. Doing the same thing over and over again while expecting a different outcome can be termed Stupidity."
A Final Thought - Where is AE? This Forum Thread seems to be guys arguing about what is first and Foremost, an Issue of Women!
