Medicine: Helping Hand for the Newborn

A bold experiment in regional care reduces infant mortality

Mary Herrera, a Glendora, Calif., housewife, had long been discouraged from having babies. She had under gone open-heart surgery at age 8, and the physicians feared that her heart might not be able to withstand the strain of pregnancy. Yet, at 31, she has just given birth to her second child at Los Angeles County Harbor General Hospital. The infant boy weighs only 2 Ibs, and is being kept in an incubator, but he is given a good chance to survive. Says Herrera of her doctors and nurses: "They're doing a fantastic job. They really are."

— Mary Drumm, 32, of Erie, Pa., and her husband are self-confessed "baby freaks." Though they have two children of their own and have adopted three others, they wanted still more. But Mary has had three miscarriages, possibly because of blood disorders. So when she became pregnant again, she decided that "we're not just going to sit back and lose another baby." Now, she has given birth to a 7-lb. girl at the University Hospitals of Cleveland. While the baby may still need an exchange transfusion, mother and daughter should be discharged shortly.

— When Shirley Aranda, 34, of Phoenix, lost her first child shortly after birth, doctors found she had a congenital uterine problem. In the past, they might have dissuaded her from becoming pregnant again. Instead they performed corrective surgery and encouraged her to try once more. Twice she gave birth—once to a baby weighing only 1 Ib. 13 oz. Both infants survived and are now, at ages 5 and 2½, healthy, normal youngsters.

Such difficult, yet successful pregnancies are no longer unusual— thanks to better medical understanding, new drugs and such sophisticated monitoring and screening techniques as ultrasonics and amniocentesis. Yet while the U.S. helped start this revolution in perinatal and neonatal* care, it still lags behind a dozen other countries in infant-survival rates. To help solve this problem, the Robert Wood Johnson Foundation of Princeton, N.J., allocated $20 million for a five-year experiment that established or expanded regional networks—three in California, two in New York and one each in Ohio, Texas and Arizona. All deliver specialized care for high-risk pregnancies, that is, those that pose danger to mother or child.

Such pregnancies are disturbingly common. Of 3.1 million babies born in the U.S. each year, nearly 30,000 do not survive their first week. Many are born prematurely and weigh less than 5½ lbs. Another 20,000 die in the uterus late in pregnancy. While the number of doctors and nurses with the skills needed to deal with such cases is growing, they are often situated at scattered medical centers not easily accessible to women and infants who most need them.