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Early: An Intimate History of Premature Birth and What It Teaches Us About Being Human

Sarah DiGregorio

Why we're reading this: -All things NICU and premature birth.
[close] -All things NICU and premature birth.

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Oct 30, 2020 Nic rated it it was amazing

Shelves: nonfiction, medical, hospice-end-of-life, nicu-care

I do enjoy reading medical nonfiction books, but they're not typically page turners, until now. I couldn't set this one down, it intrigued me from page 1. It's a partial medical memoir as Sarah DiGregorio shares her own premature birth experience. However, it's also so much more: the history of NICU care and technology; the possible future of NICU technology (Womb bags! Literally, babies gestating in fluid filled bags); the potential affect of viability on abortion law; knowing when to let go - I do enjoy reading medical nonfiction books, but they're not typically page turners, until now. I couldn't set this one down, it intrigued me from page 1. It's a partial medical memoir as Sarah DiGregorio shares her own premature birth experience. However, it's also so much more: the history of NICU care and technology; the possible future of NICU technology (Womb bags! Literally, babies gestating in fluid filled bags); the potential affect of viability on abortion law; knowing when to let go - stopping life support; and current statistics on preterm births and inequities. DiGregorio is a journalist which shows in her thorough and neutral investigating. A unifying strong point is DiGregorio's ability to capture and maintain the inherent dignity of these tiniest patients for whom she continuously advocates.

We don't even really have a word for them, these children, these tiniest of people, who are not fetuses but are not quite babies yet. Being born didn't really make Mira into a newborn. I loved her, and she was my child, but she wasn't quite a baby, or at least not like any baby I had ever imagined. Her brain, if I could have seen it, looked like an almost-smooth lima bean, with only a few ridges and gyrations. 17

I was allowed to do kangaroo care once a day, for up to three hours. Those were the only times I could hold her....I looked forward to those hours so much that it felt like a bad case of nerves before a date. And I started to lose my mind. 19

...her birth and her struggle feel fundamental: at the intersections of birth and loss, science and humanity. 27

When scientists come up with new ways of treating, say, cancer, the conversations don't seem to be so fraught. But treating premature babies brings up unique, fundamental questions about existence...I admit, though, amid all that complexity, what I see most in the biobag is an attempt to prevent suffering--a wish that the smallest babies (or fetuses, or gestatelings) can keep dreaming their unknowable liquid dreams. 96

The history of the American NICU is fascinating. The 1st USA NICU, run by Martin Couney in 1903, was a sideshow at Coney Island!!! It was surprisingly well run and well staffed with professional nurses. The success rate was remarkably high, Of the 8,000 babies he cared for, reportedly about 6,500 survived. 71 No fees were charged to the families of the babies, but an admittance fee, which would be the equivalent of $7.00, today, was charged for gawkers. Even more incredible, Couney was not a physician, though he pretended to be one, and everyone believed him. He did genuinely care for his charges, and I couldn't help thinking that maybe not being a physician, at this point in time, led to his unique and better care of these preemies.

Interestingly, while he emphasized strict hygiene, Couney also encouraged the nurses to hug and cuddle the babies as they cared for them, which was forward thinking for the era. 68

The history which led up to the modern day positive pressure preemie ventilators was equally engrossing. The first ventilator use attempted on a premature infant was an iron lung (which uses negative pressure) relic, leftover from treating polio patients, and drug up from the basement of a hospital.

It was the traumatic and public death of Jackie Kennedy's premature baby, Patrick, which led to the difficult process of obtaining surfactant. It's still a labor intensive process. ...the surfactants that are most effective even now are pulled directly from the lungs of pigs and cows and purified, an expensive, difficult process...The biomedical companies that make surfactant actually employ people to go to slaughterhouses, insert tubes into just-killed cow's tracheas, and painstakingly extract the surfactant from one animal at a time. One set of lungs equals enough surfactant for two babies. 130

Premature birth among African American mothers is exceedingly high and DiGregorio demonstrates this is due to the constant, daily stress of racism. She also reports on the amazing success of group prenatal care, which helps women to support each other and, in the process, buffers them from daily stress. This particular hospital, Bronx-Lebanon (now called BronxCare), generally has a 12 percent prematurity rate. Among group prenatal care participants in 2018, that rate was 4 percent. That is better than the premature birth rate in Scandinavia, which has the lowest rates in the world. 272

Well, this review is getting lengthy, but as you can see, it's packed throughout with important information on helping premature infants and limiting premature birth. If you work with premature babies, this is the book to read. ...more

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Mar 31, 2024 Kendra added it

Shelves: audible, kindle

Jan 29, 2022 Billie Dion marked it as to-read

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