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Success with prenatal surgery: Caring for the ‘patient within the patient’

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 Anna Reynolds [8]

A recent paper [9] published in the peer-reviewed journal Issues in Law and Medicine details lifesaving treatment and prenatal surgery being given to babies in the womb. The study, titled “Perinatal Revolution” affirms that the preborn child is a unique and separate patient from the mother. When doctors treat both the mother and the “patient within the patient,” successful treatment of conditions that might otherwise be severely life-limiting are possible, increasingly so as technology continues to advance.

The paper’s authors are Drs. Colleen Malloy, Monique Chireau Wubbenhourst, and Tara Sander Lee. Two of the study’s authors are associate scholars with The Charlotte Lozier Institute. The research is being publicized so that doctors and other health care professionals are made aware of these lifesaving procedures, so that they are less likely to recommend or coerce patients into aborting their children rather than carrying to term. The study notes that a doctor’s personal views about abortion and the availability of prenatal treatment can directly affect whether a mother decides to end her child’s life in an abortion or carry to term. The authors write, “In several studies of families receiving diagnoses of Trisomy 13 or 18, a majority of parents (61%) felt pressured to terminate the pregnancy.”

Doctors and other medical professionals are not the only ones who can benefit from this information about the emerging treatment for babies before birth. If parents are unaware of life-affirming treatment options, they are more likely to fall prey to coercion to terminate a child with a potential disability. However, knowing about the rapidly developing field of prenatal treatment and the dramatic increase in the successful treatment of premature babies [10] empowers families to make life-affirming decisions for their children.

READ: Abortion doesn’t help babies with spina bifida, but prenatal surgery does [11]

The paper details how advances in genetics and medical technology have made it possible for doctors to treat babies more effectively while still in the womb. Prenatal surgery has been available for decades [12], but with technological advances, treatment can be better and less invasive, and may be done at even performed at earlier gestational ages. Some of the conditions discussed in the paper that can now be treated or mitigated in the womb include cerebral palsy, fetal hypothyroidism and hyperthyroidism, spina bifida, and cystic fibrosis.

The authors write about these technological developments:

“With the ability to see the fetus in real time came the ability to diagnose problems and to consider how best to help the affected fetus, to follow affected fetuses and to monitor treated fetuses, over the course of pregnancy. This shifted the focus from the newborn, with a severe disorder that could not be corrected after birth, to the possibility of prenatal medical or surgical intervention that could help ameliorate the clinical manifestations of disease…These diagnostic capabilities led to further research and clinical trials and the realization that the fetus was, and is, a patient.”

Successes with these prenatal surgeries have far surpassed conventional treatments given to newborns with these conditions. Study author Tara Sander Lee wrote in another paper [13] about a peer-reviewed study of prenatal surgery for spina bifida published in the New England Journal of Medicine. The babies who received prenatal surgery fared so much better than babies who received the conventional surgery at birth that the study was halted before completion so that all babies would receive the superior prenatal surgery.

The most recent paper notes that the types of surgery and interventions available continue to evolve. The authors write that cellular therapy for babies before birth, tissue engineering, gene therapy, and the artificial womb may be available to treat babies soon, as these methods are rapidly developing. They note that these therapies are uniquely suited to treating preborn babies, writing, “Many of these cell-based techniques take advantage of the fact that the fetal environment is constantly remodeling and ideal for accepting stem cell therapies that facilitate regeneration.”

Despite these dramatic advances in lifesaving treatments for mothers and their preborn babies, many people, including doctors, are not aware of the potential. The more people know about these technologies, the more families may have the courage to give each child a chance at life. Not every child with a medical condition diagnosed prenatally will be cured through these emerging techniques, but the study notes that even in these cases abortion is not the only option. The rapid expansion of perinatal hospice [14], and the much better mental health outcomes for families [15], demonstrates that abortion is not a solution.

Finally, the study authors note that these emerging technologies have ethical implications that require oversight and ongoing engagement in public discourse. In this area, pro-lifers have contributions to make, as these emerging technologies reveal what pro-lifers have already recognized: the preborn child in a human being worthy of life, protection, and care.

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