Aaron Lewis: In the Grey Zone

“If they’re less than 25 weeks we really don’t bother doing anything for them… it’s unlikely they will survive anyway.” That’s what a doctor friend of mine told me recently when discussing his recent work at Woman and Infants Hospital in Providence. I was shocked. Did my friend just tell me that neonatal doctors will not try to save the life of a baby born alive simply because they believe the chances of survival are low?

Woman and Infants does not make their standard operating procedures readily available, but I was able to do some research into this idea and what I found was disturbing and downright criminal, in my opinion. Doctors who deliver babies in what is known as “The Grey Zone,” will routinely withhold life-saving measures, even if it is against the wishes of the parents. A baby who is born in the Grey Zone is typically a baby born anywhere from 22-24 weeks of gestation.

A study published in 2007 by the Department of Pediatrics at the University of Chicago found that just 4% of doctors surveyed would provide full resuscitation of a baby born alive at 23 weeks or earlier. This study also found that just 33% of doctors said that parental preference would determine whether they resuscitated an infant born at 23 or 24 weeks. Imagine for a moment being the parent of a child born at this stage and wanting the doctors to do everything possible to save your child’s life, only to find out that nearly seven in 10 doctors would totally disregard your wishes and would simply let your baby die.

Of course, it is true that babies born in the Grey Zone have a nearly zero percent chance of survival without some kind of post-natal care; however, that rate can climb to as high at 25% for babies born at 22 and 23 weeks who are given active post-natal care. So why are doctors choosing to let these babies die, especially in scenarios where the parents are adamant that their babies be saved? Are these Grey Zone decisions being practiced at our local hospitals and birthing centers?

Let me leave you with the story of baby Lyla, who was born in 2014 at just 21.5 weeks, weighting only 14.5 ounces. Lyla’s doctors told her mother that there was very little chance the baby would survive, but despite the prognosis, Lyla’s mother had a feeling that her daughter would live. In this case, the doctors did what all doctors should do in this situation: they tried to save the baby’s life… and they did. Lyla lived and suffered no major disabilities from her premature birth. Those doctors are heroes.

At the top of this post are pictures that her mother provided to Today of Lyla at three weeks old (24 weeks gestation) and at four years old in 2018.