This question is for a novel I’m writing, which is set in a society that does not have access to modern medical services. One of the characters reveals that he was born prematurely - many people didn’t expect him to live, but his mother took special care of him and carried him kangaroo-style inside her clothes for the first few months, and he survived without any major complications.
My question is, how early could he have been born without this seeming like a wild exagerration? How early is it possible for a baby to survive outside the womb without incubators and all the other modern equipment used to help preemies today?
No actual data to add, just another authors’ use of the same premise.
I have seen this device used in Katharine Kerr’s books. One character (named Perrin) was born a couple of months prematurely, and survived due to being cared for by a wet nurse who kept him under her dress and basically sat by the fire for a couple of months.
With modern techniques, premature infants can survive if born as early as 23 weeks or so (that’s only just over halfway through normal gestation), but they are very likely to experience health defects such as respiratory or visual problems, if they survive at all, which is quite unlikely).
According to this medical paper dating from 1902, premature infants could be viable when born at seven months (approx 30 weeks or two-thirds of the way through normal gestation)
I have a sister who was born at seven months. She was held in an incubator, mainly for warmth and observation, for a few days, but required no other care. Presumably, the same effect could be achieved by the “kangaroo” method described in the OP.
However, other babies born at seven months do require more intervention - so the idea that it is a very precarious situation is quite accurate as well.
My husband’s aunt was born in the late '20s and was a 7-month baby. She was born at home, not in a hospital. They kept her in a shoebox next to the woodstove – sort of a homemade incubator – for a couple of months. According to Aunt Hiya, this was unusual but not unheard of. The terms “shoebox baby” and “7-month baby” were recognizable. And it was a dangerous situation – many (maybe even most) shoebox babys died.
Now, my own daughter was born at 27 weeks and needed major medical intervention to stay alive. She was intubated in order to breath, for instance, and had a major septic infection that required antibiotics to resolve. Not all 27-week preemies are as ill as Doe was, but most of them are. And the ones without the lung problems tend to be babies who the doctors knew were coming early and they were able to give the mother a drug (Doe’s birth was an emergency and I didn’t have time to take this stuff and don’t remember what it’s called) to quick-mature their lungs. And that drug wouldn’t be available in the society of your novel.
So I think you’d be safe enough using a 30-week or 7-month preemie in your story.
I was born three monthe premature–and apparently leeded a lot of intervention, an incubator for three months, etc, and even then I almost died. Or so Mom said. I suspect that in a low-tech society I wouldn’t have made it.
Well, there was a study published recently that showed “kangaroo care” to be as effective, if not more, than incubators. None of the articles seem to mention limits but the article I linked mentions a baby that was two months premature thriving with the technique.
Aaaand it looks like it’s unanimous - about two months premature appears to be the limit at which this story would sound reasonable. Thanks all! I’m going to stick with months, because “weeks” just sounds too specific for the situation - a peasant woman with three other small children and her share of the farm work isn’t likely to be counting exactly how many weeks along she is.
My grandfather was born 8 weeks early in Germany 1898, he was wrapped in cotton wool in a shoe box and they fed him with a fountain pen (the old fashioned kind that suck and squirt ink).
He grew up to be perfectly healthy (apart from allergies, but his brothers and my mother have them too, so more likely they’re genetic) and died in his late 70s.
It sounds like a great story flodnak, hope the rest of it goes well!
Bear_Nenno, no I have never had asthma or respiratory problems.
I was not athletic in school, but that was more due to being forced ahead a grade and always being at a competitive disadvantage, than being particularly weak. Being ostracised because of being ‘different’, and lerarning to be ashamed of my body, did not help either. I seem to remember taking a long time to learn to do things like tying my shoes though.
I am nearsighted, if that has anything to do with it.
Apparently I was right close to the borderline where more serious problems occur.
A friend of mine was born six or seven weeks early in 1962 or 63 and all her mom did was bring her home and put her in a dresser drawer. I think her parents actually left it open too.
Other than allergies and mild asthma, she is one of the best human beings I have ever come across.
Well, I was born late by about three weeks and I’ve got “allergies and mild asthma”, so go figger. Prematurity ain’t the only cause of that, nor does prematurity guarantee it.
My son was born at the end of 23 weeks, not quite 24. He stayed 4 months and cost about $740,000 (of which I only had to pay a small portion) over the course of 2 years. He’s just turned 7. He’s of normal height and weight and has no asthma, no allegies, and wears no glasses, but he was diagnosed with Asperger type autism last year. He prefers computers to sports and is somewhat poor at fine motor work. He is healthy and active (and very handsome).
My mother claims I was 3 months early…that I was due in March, and was born on December 24. Which by my reckoning is more like 9 weeks early, or 31 weeks. But this is complicated by the fact that in 1965/66, mothers weren’t given “due dates” to obsess over and be micromanaged over…they were given ‘due months’. She has told me this herself.
At any rate, I was 2 lbs 3 oz at the time (my unviable acardiac twin was 4 lbs - not unusual weights for a pump twin/acardiac twin pair). I was in an isolette for 3 months, with oxygen, but not intubated or anything. I have no eye problems beyond pretty standard myopia, and no breathing problems, not even asthma.
I suspect that a great many of the ‘shoebox babies’ were more likely cases of IUGR (intrauterine growth retardation) and were gestationally older than they appeared to be based on their sizes. Lung development is absolutely critical for premie survival. Also, before pregnancies could be dated accurately in early gestation via ultrasound, women did not necessarily know when they conceived, especially if they had irregular or absent menses (for any of a number of reasons). They would have some idea - within a month or two - but no “date” on which they they were ‘due’. (Personally, I think it’s a great disservice to women to give them “due dates”. It creates expectations their biology may not meet, setting them up for ‘managed’ deliveries, feelings of failure when they don’t perform, and other problems.)
Sorry for the digression. But, a ‘premature’ baby might not be as premature as people think. Getting your dates wrong by a month, yet having some kind of IUGR, could produce a tiny, premature baby, with a lot of advantages for survival.