Film looks at the emotional, ethical side of ‘micropreemies’
Published: Saturday, April 25, 2009, 6:15 AM Updated: Wednesday, April 29, 2009, 1:44 PM
When my son was in the neonatal intensive care unit at Providence St. Vincent, we joked that at 5 pounds, he was “the giant of the NICU.” With the stress we were experiencing, we didn’t dare imagine what the other parents were going through.
Now Portland native Candy Campbell is offering help to such parents through two avenues: her new blog, the Preemie Post, and her newly available documentary film, “Micropremature Babies: How Low Can You Go?”
Campbell, who lives in the San Francisco area, has been a registered nurse for 30 years, the last 20 in the NICU specialty area. The idea for a film about “micro-preemies” came to her in the mid-1990s following media coverage of research on children born premature in the 1980s. Researchers were reporting that such children ended up with low IQs and mostly did not finish high school; numerous articles quoted some experts implying that micro-preemies were a drain on society. In Campbell’s world, the articles “devastated” the parents of such babies.
So Campbell decided in her film to focus on the emotional and ethical angles of treating extremely low-weight babies. That was also a natural step for a nurse who’s seen neonatal technology and knowledge expand over the last 20 years.
“The difference between babies being born now and when I started in 1989 in the NICU … then, we could only barely keep a 28-week-old baby alive,” she recalls. “I was morally opposed to what we were doing.” These days, by contrast, a baby born as early as 24 weeks’ gestation is considered to have a decent chance for survival.
Neonatology, Campbell says, wasn’t even a specialty until about 1965. The first preemie monitors showed up around 1969. But it wasn’t until the 1980s that NICUs had ventilators sized for their patients, she says. And when she moved to neonatal care in 1989, doctors and nurses didn’t have the equipment for long-term IV access to such tiny babies, she recalls.
Neonatal technology finally took off around 1995. “We started saving these babies to good effect,” says Campbell. That led to a big shift in medical thinking, as doctors would see babies coming off ventilators at 34 weeks. “They were so amazed at the differences that they just got to thinking that all we do (in the NICU) is miracles — give us nothing and we’ll make it walk and talk and be normal,” Campbell says.
But surviving a premature birth was only the first step, Campbell realized. She wondered: How did these babies’ health fare later? What happened in terms of their development? How did they — and their parents — handle life without the safety net of the NICU?
“I wanted a vehicle that would answer all of these questions and more … that would touch on ethical issues, that would really concentrate on what happens when you take this baby home.”
Campbell does acting jobs on the side — voiceovers, industrial films — so she began pitching her film idea to the producers she knew. No one bit, but everyone found the idea interesting. Finally, Campbell decided to do it herself. She enrolled at a local college and took technical certification courses in film production.
“I interviewed, first of all, lots of families that I knew … I was either the primary nurse or very close on most of these cases. Then I went around and shot a bunch of footage — mostly at home with the families.”
Eventually, she winnowed the families down to a half-dozen. And she followed them as the children grew. “The oldest child was 8 when I first started … when I finished she was 11.”
When it came to the parents Campbell interviewed, she says, she found that unresolved grief was the biggest issue. In the initial frenzy of the birth and the intensive care, then in the subsequent chaos of having a newborn at home, many of the parents simply sealed off their emotional reaction to having a premature baby.
“You don’t have time for your own personal thoughts and you don’t realize you are burying something very deep,” Campbell says. “It was cathartic for these families” to participate in the film.
For the ethical perspective, Campbell interviewed a neonatology expert at the University of California, San Francisco. He told her that the statistics for babies born at 24 weeks’ gestation include a variety of births, from unexplained prematurity to multiple births to babies born addicted to street drugs. “You wind up with a bell curve that shows that you have increased the number of babies with an IQ of less than 69,” Campbell says. The ethical question, then, when it comes to saving such premature infants: “We can, but should we?”
“Micropremature Babies: How Low Can you Go?” runs approximately 42 minutes. It is available now for $19.95 on Campbell’s Web site; she says it also will be available at Amazon.com within the next couple of weeks.
– Amy Wang; firstname.lastname@example.org