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A Risky Combination

“In a country well governed, poverty is something to be ashamed of.” Confucius

Once again, this week’s ABC Four Corners program has opened up avenues for discussion around the implications on society of poverty, this time in relation to premature birth.  BBC documentary, “23weekbabies: The Price of Life” discussed the ethics of keeping premature babies alive.

Whilst this ethical argument may seem on the surface to be unrelated to child protection, one of the issues raised was that premature births are often directly attributed to conditions of maternal poverty.  Living in poverty is now understood to be a major factor in putting a woman at risk of premature birth.

Studies such as Preterm Birth: Causes, Consequences, and Prevention  discuss the effects of poor socioeconomic conditions in relation to premature birth.

There are many factors related to an increased likelihood of premature birth.  Some examples are:  giving birth under the age of 16 years or over the age of 35 years, cigarette smoking, substance use and abuse, sexually transmitted disease and poor nutrition.

Some of these risk factors are more commonly seen in women living in poverty.  Aadequate prenatal care is often inaccessible as free Bulk Billing medical surgeries and outpatients clinics are stretched beyond their means.  Nutritious foods are generally more expensive and often beyond the means of the socioeconomically disadvantaged.

Poverty and pregnancy is a risky combination and the consequences of these pregnancies are often devastating.

Born under 25 weeks gestation a baby has a greater than 90% chance of living with a lifelong physical or intellectual disability.  Here we find serious implications for the under resourced child protection sector.  These disabled children often exhibit extremely challenging behaviours and therefore are more likely to end up in foster care in either a full time or shared care placement.  This places more pressure on struggling child protection and not for profit organizations.

The ethical debate around providing massive medical interventions to keep these babies alive is not one for me to solve.  I can see no answers.  The chances of a 23 week gestation baby surviving and having a normal life are extremely slim but parents of these babies, faced with the decision to resuscitate or not overwhelming choose to give life a chance and no one can judge that as wrong.

Should we be focussing on prevention rather than a cure?

Perhaps our Governments should channel more money into avoiding these tiny people being born too early by providing funding towards appropriate prenatal medical care and nutritional supplements to economically disadvantaged expectant mothers.

We may just save on both the financial and emotional costs of these babies born too young.

Tess Vincent.  PeakCare Queensland.

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