It is that stage of fetal development when the baby is "potentially able to live outside the mother’s womb [that is, can survive], albeit with artificial help."

No! To do so is completely illogical. 50 years ago viability was at 30 weeks. 25 years ago it had dropped to 25 weeks. Today we have a survivor at 20 weeks and several at 21 weeks.

But the babies haven’t changed. Mothers are making the same kind of babies they always did. But they are surviving earlier.

Because of a vast increase in the sophistication of the external life support systems around the baby. Because of neonatal intensive care units. Because of greater knowledge and skill of the doctors and nurses.

From ancient times. Until the 19th century, it was assumed that the baby was not alive in the first half of pregnancy. It was also "known" that when the mother "felt life," when "the babe doth stir," that at that time the baby "came alive." Two examples show this:

Abortion was always a sin in the Christian Church. A penitent confessing this sin was given a penance to perform. The penance for the sin of a late abortion was always more severe than one for an early abortion. Why? Because in the late abortion she had killed a baby who was alive.

English Common Law succeeded ecclesiastic law and followed the same pattern. Abortion in the first half of pregnancy was a minor crime, a mis-demeanor. Abortion after she felt life, after "quickening," was a felony, a serious crime.

Has that law changed?

Yes. In the early 1900s it was discovered that the baby’s life began at conception, not at quickening (Karl Ernst Van Boar, 1827). Accordingly, in 1869 the British changed their law, dropped the felony punishment back to conception, and the two-tier punishment policy was eliminated.

Amazingly, yes. Any lawmaker today who supports protecting babies’ lives only after viability is still living in the middle ages, in pre-scientific times.

There is a variance, just as with children and adults, but a much narrower one. Dr. L. Lubchenco, University of Colorado, has been the recognized authority in preparing most of the charts used. Babies can be small for stated age or "runts," if malnourished. They can also be large for stated age, but still fall within the 90 percentile range on the charts.

It seems that we have probably reached the youngest age at which the baby’s lungs are well enough developed to exchange oxygen. One happy advance has been the use of surfactant in their lungs. This has meant babies under 1500 gm at birth are 30% less likely to die.

Effect of Surfactant . . . in newborn infants weighing 500-1500 gm,
Schwartz et al., N. Eng. J. Med., 1994; 330 (21): 1476-80

Decreasing Mortality with Surfactant . . .
J.Horbar et al., Pediatrics, Vol.92, No.2, Aug ’93, Pg. 191

A further advance may be using oxygen saturated liquid instead of air.

J.Greenspan et al., Liquid Ventilation of Preterm
Baby, Lancet, Nov 4, ’89, No. 8671,1095

It depends first upon the existence of a high-tech neonatal intensive care nursery. Almost all medical centers in the developed world have these.

The other factor is the baby. Some top notch medical centers just haven’t yet been blessed with the birth of a child so well developed at an unusually young age that he (or she) can survive at, say, 20 to 22 weeks.

Baby Kenya King born in Plantation, Florida, 21 weeks (4 1/2 months) from the first day of her mother’s last menstrual period; weighing 510 gm (18 oz) she was 10.5 inches (26.5 cm). She dropped to 370 gm (13 oz). She is shown at 2270 gm (5 lbs.) with her mother. (Miami Herald, Pam Smith photo)

But a major center such as Johns Hopkins reported the following survivors:

• at 25 weeks = 79%

Many assume this, and there was a problem with those saved 20 years ago, but "Preterm infants of less than 1,000 gm (2 lbs.,2 oz.) do not appear to have significantly higher incidence of severe developmental abnormalities in the first 18 months of life than do 1,000 to 1,750 gm babies."

In a study of 68 babies weighing 500-750 gms at Stanford University, the overall survival rate was 35%. Of these very tiny infants, 9% had severe handicaps, 36% remedial problems, and the rest were normal.

Limiting Treatment for Preme, low wt. Infants,
E.W.Young et al., Am. J. Dis. Ch, Vol. 144, May ’90, Pg 549

In your author’s files are 6 cases of 23 week (after LMP) survivors. Their weights ranged from 16 oz. (540 gm) to 24 oz. (810 gm).

We have 11 cases of survivors at 22 weeks (after LMP). These weights varied from 12 oz. (339 gm) to 22 oz. (663 gm).

We have 2 cases at 21 weeks (after LMP), including baby Kenya King above.