![]() ![]() Others are diagnosed with cerebral palsy, developmental delays and hearing or vision loss by the time they’re toddlers.īirth before 25 weeks forces an excruciating choice on parents: Let the baby die and live with the knowledge your child might have been saved, or ask for intensive care and risk taking home a child whose medical needs exceed your family’s capabilities.ĭoctors, nurses, and other neonatal intensive care workers are caught up in this ethical dilemma as well, wondering where to draw the line in offering active care to babies at ever earlier gestational ages. ![]() Some survivors emerge from the neonatal intensive care unit practically unscathed. The hardest cases involve babies born in the grey zone between 22 and 24 weeks, when it is possible to save a baby’s life, but impossible to predict its quality. The story of the Nadarajah twins puts an unusually sharp line under the medical and moral challenges that arise when women go into labour dangerously early. He was part of the team that cared for the Nadarajah twins during their 5½-month stay at the hospital. Prakesh Shah, Mount Sinai’s pediatrician-in-chief, takes part in morning rounds in the NICU. “He said, ‘If you have the babies even a few minutes before 22 weeks, it’s going to be a death sentence for them.’” Rajendram in a way that is seared in her memory. If she delivered afterwards, two resuscitation teams would try to save their lives.Ī doctor explained the plan to Ms. Rajendram delivered before midnight, Mount Sinai staff would ensure the twins died comfortably. ![]() Rajendram reached 21 weeks and six days, Mount Sinai agreed to admit her. It also has a standard, however, mutually agreed upon by the neonatology staff, that it will not provide intensive care to babies born earlier than 22 weeks. It has a track record of saving infants born at the precipice of viability. Mount Sinai Hospital, located in downtown Toronto, is home to one of the most sophisticated neonatal intensive care units in the country. Push for a transfer to Mount Sinai, she texted. Nadarajah reached out to the group’s Canadian co-founder for advice on what to do next. Nadarajah to the Instagram account of TwentyTwo Matters, a group that advocates for babies born in the 21st, 22nd and 23rd week of pregnancy – infants so small and fragile that, until the last decade, most Canadian hospitals offered them nothing more than a comfortable death in their parents’ arms. Kevin Nadarajah and Shakina Rajendram, seen here with their dog, Eden, were thrilled when they learned Ms. She and her husband, both devout Christians, prayed that her labour would slow down enough to give the twins a chance. There were her babies, safe inside her, their hearts thumping away. “The doctor kept asking us: Do you understand you’ve lost the babies?” Ms. Death is inevitable if the baby isn’t put on a ventilator right after birth, and even then, the odds of survival are so slim that few hospitals in the world are willing to try. The babies are coming too early, he said, and nothing can be done to save them.Īt 21 weeks and five days, a fetus’s skin is like tissue paper, its lungs too immature to draw breath. Rajendram and confirmed she was in labour. The couple drove to the emergency department of their local hospital, where a doctor examined Ms. Nadarajah said, “everything was kind of a blur.” Rajendram called for her husband, who was sipping coffee on the couch next to the couple’s Bernese-poodle mix, Eden. She was 21 weeks and five days into her pregnancy, barely halfway to the ideal finish line of 40 weeks.ĭistraught, Ms. Rajendram, then 34, woke to discover she was bleeding.
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