Mainstream media in Nebraska and neighboring Iowa have used one heart-wrenching story as a way to try to pour cold water on the success of a Nebraska law that prohibits abortions after 20 weeks of pregnancy.
Danielle and Robb Deaver shared their story of how they were denied an abortion under the new Nebraska law, even though pregnancy complications reportedly made it unlikely their child would be able to breathe on his own. The couple ironically asked for an abortion to kill their baby as opposed to supposedly letting the child suffer.
But Sean Kenney, M.D., a maternal-fetal specialist from Lincoln, responded to the story with an opinion column the Omaha World-Herald newspaper printed.
Although my heart goes out to the Deavers, as a maternal-fetal medicine specialist who has cared for several patients in similar situations and who testified on behalf of the Pain-Capable Unborn Child Protection Act, I think it is imperative to make clear that their understanding of the facts is wrong.
Danielle Deaver was diagnosed with pre-viable premature rupture of the membranes (Pre-viable PPROM) at 22 4/7 weeks. When I was a resident at the University of Nebraska Medical Center, patients with Pre-viable PPROM could not be aborted because it was not considered to be a lethal condition and, without clinical infection, was not considered a significant risk to the mother.
An abortion that late in pregnancy, without a significant maternal health risk, would have been against Nebraska law, regardless of whether the Pain-Capable Unborn Child Protection Act had been passed.
While the World-Herald article said there was a less than 10 percent chance of the baby’s survival, over the years of my practicing I have seen the edge of viability drop from 24-25 weeks to 22-23 weeks. Survival at 24 weeks is fairly typical. The baby weighed 1 pound, 10 ounces, about 740 grams. The edge of viability is usually thought to be around 400 to 500 grams.
Based on an estimated gestational age of 23 weeks, a female infant and 740 grams, the National Institute of Child Health and Development-National Research Network would quote Mrs. Deaver a 37 percent chance of survival without profound neurodevelopmental impairment, based on data prior to 2003.
What most specialists try to do in these situations is maintain the pregnancy for as long as possible. If Mrs. Deaver had delivered two days later at 24 weeks, the baby’s chance of survival without profound neurodevelopmental impairment would have increased to 50 percent, 65 percent if she had received steroids.
The major long-term complication of Pre-viable PPROM, pulmonary hypoplasia, varies from less than 1 percent to 27 percent of cases and is rarely encountered after 24 weeks, which was only 10 days after Mrs. Deaver was diagnosed. The American Academy of Pediatricians in its Neonatal Resuscitation Program recommends resuscitation of all neonates after 24 weeks (barring known lethal conditions), regardless of parental wishes.
Tragic as the outcome was, the pessimism that predicted inevitable death for the baby was certainly unwarranted. One of my greatest success stories is a 22 6/7-week infant whom I wasn’t planning on resuscitating, but at delivery I heard him cry and ran him to the neonatal intensive care unit. Several years later, he was helping to translate for his mother, looking very neurologically intact.
Again, my heart goes out to the Deavers, and any information presented in this essay is not intended to criticize them. As I read between the lines, I think they would have liked to hear that there were better odds of survival.
They are obviously still grieving with their loss, and I hope their suffering eases. However, their situation provides no basis to challenge a law that was based on science and basic principles of human rights.
Julie Schmit-Albin, the president of Nebraska Right to Life, who led the fight for the law and has been following the case of the Deavers closely, commented to LifeNews.conm on Dr. Kenney’s response.
“Dr. Kenney is a maternal-fetal specialist in Lincoln, Nebraska who testified for the Pain Capable Unborn Child Protection Act at its 2010 legislative hearing,” she said. “Dr. Kenney told us he was disturbed to read the accounts of the Deavers losing their baby to the PPROM condition after the success he has had in helping both babies and moms through this condition.”