Early delivery of "non-viable" babies

The Story...
As part of my anesthesia rotation I have been learning to do epidural and spinal blocks for women in labor. My first case yesterday morning was a C-section for a woman in her early forties, only 19 weeks pregnant.

The average Joe knows that 19-week-old babies can't survive outside of mom. Nonetheless, I was informed that this baby had a "lethal fetal anomoly." So the baby would likely die before delivery, during, or soon after. The reasoning behind "delivering early," as far as I can guess, is to relieve the mother of the last few harder months of pregnancy - because the baby will die anyway.

The Questions
Now what is the point of continuing a pregnancy once you know your baby cannot live outside the womb? If baby will die on the day of delivery, why not deliver sooner and get the whole tragic ordeal overwith and get on with life? Is there really a difference between letting the pregnancy go to term, and inducing early, when the end result is the same?

The Answers
There's a big difference - morally, psychologically, emotionally and even physically. The moral issue is huge: when the direct effect and intent of inducing labor early is to bring about the death of the infant, the act is immoral (it is murder, abortion, etc.). However, the intent and direct effect of delivering the baby at the end of pregnancy -induced or not- is that the baby moves from the now inappropriate location of the womb to the appropriate location outside. (After nine months, a baby's appropriate environment is outside the womb. Those that don't get out, don't make it.) So when a mother delivers her terminally ill baby at term, and it dies in her arms, this death is unintended and only an indirect effect of the delivery.

Psychologically, when an anomalous baby is "terminated" early, the parents remain very fragile and forever scarred. There is enormous guilt because there was immoral intent. The parents did not want their baby to die, of course, but what they did caused its death. If they wait till the baby comes by itself, they suffer to watch their baby die, but they had no hand in its death. On the contrary, they were able to participate fully in its short but beautiful little life.

Emotionally there is a lot of stress - not to mention bitterness and resentment. This one is hard on marriages, especially if one spouse pushed for it (often the father) and one would rather have waited. I think the majority of pressure for early delivery is from the doctors - they don't offer much support if you want to keep your baby to the end of pregnancy.

Physically, there is a lot of benefit to continuing a pregnancy. When a pregnancy is artificially interrupted, there are many hormonal effects - most of which we don't understand well at all. Post-abortion research is beginning to bear this out (e.g. breast cancer, fertility, etc.). Even so, the whole argument is that a woman will be much better of physically if she avoids the last few months of pregnancy. That may be true.

The Rest of the Story...
So I showed up a little late to the operating room, and didn't have to participate. I just observed from the head of the bed where Dad was sitting next to Mom's head. Before I knew it there was this tiny little bluish squirmy thing on the warming table. She had cute little fingers and toes. She even had her fingers in her mouth. Everything about her was right, just small. She would have fit perfectly in my hand. She was soft and warm to touch and I could feel her little heart beating fast. She was perfect.

They wrapped her in a little knitted blanket and gave her to her Dad to hold. He broke down sobbing. Mom couldn't really move on the OR table, but just stared kind of glassy-eyed at this little creature. I put my arms around Dad's shaking shoulders, and did my best to console them. And then the pager went off and I went off to another job. Another encounter with medicine. It's hard to see the positive side to this one. But out of all this evil good will come.