In 2021, approximately 10% of infants born in the U.S. were born premature. In addition, 13.4 million babies worldwide were born premature in 2020. Approximately one million of those children passed away due to complications after birth. Yet, what about the 12.4 million who survived? What has led to this incredible success rate?
Births are considered preterm if they occur before 37 weeks of pregnancy. The categories of preterm births based on the gestational age of the infant are extremely preterm (born less than 28 weeks gestation), very preterm (born between 28 and under 32 weeks), and moderate to late preterm (within 32 to 37 weeks).
While there is a high survival rate for preterm babies today, preterm birth is still reported to be one of the leading causes of death among infants worldwide. Babies need to be in the uterus in order to develop, and the sooner they are born, the higher the health risks are. These risks include underdeveloped lungs, bleeding in the brain, intestinal inflammation, and abnormal blood flow in the heart.
Thankfully, due to the technological and medical advances of our age, the mortality rate among premature babies has decreased in recent years. One study showed a 20-30% decrease in deaths caused by preterm labor from 2000-2013, while another study conducted from 2013 to 2018 revealed that premature babies born within 22-28 weeks were surviving at greater rates than they were from 2008 to 2012.
Neonatologist Krisa Van Meurs commented on the decrease in mortality of babies born preterm, saying,
“When I was in residency in the mid-1980s, babies born at 500 grams and 25 weeks didn’t survive; it just didn’t happen. Now we see the borderline of viability dropping to 22 weeks. With all of these new treatment strategies we’ve developed, we’ve seen an amazing impact.”
One of the most important pieces of life-saving medical treatment for premature babies is the incubator. According to Healthline News,
“An incubator is designed to provide a safe, controlled space for infants to live while their vital organs develop. Unlike a simple bassinet, an incubator provides an environment that can be adjusted to provide the ideal temperature as well as the perfect amount of oxygen, humidity, and light. Without this specifically controlled environment, many infants could not survive, particularly those born a few months early.”
How did these life-saving technologies and treatments begin? What doctor was behind the first revolutionary steps toward this life-saving care for premature babies? What if I told you that it all started with a French obstetrician inspired by a zoo in Paris and a German man with a boardwalk sideshow?
Parisian Incubators for Baby Chicks
Dr. Etienne Stephanie Tarnier was a French obstetrician born in eastern France in 1828. He worked at and eventually became the chief of the Maternity Port Royal hospital, which helped pregnant women in poverty in Paris. Dr. Tarnier’s policies and techniques increased the hygiene of the hospital and reduced maternal mortality. According to Kelsey Rebovich, “…Tarnier dropped the maternal mortality from puerperal infection [infection of genital tract during or within 42 days after birth] at the Maternité from ninety-three out of 1000 deliveries to twenty-three out of 1000 deliveries between 1870 and 1880, then to seven of 1000 in the succeeding decade.”
France was plagued with a population decline in the 1870s due to the Franco-Prussian War and an accompanying famine. Tarnier considered reducing mortality among infants would be a much better solution to the population decline, rather than the French having more children. At the Paris Zoo, Tarnier noticed how incubators were used for and were beneficial to poultry, and he was inspired to construct similar pieces of equipment for infants. While other medical professionals such as Carl Siegmund Franz Credé and Johann Georg von Ruehl had previously developed infant warming devices, Tarnier had little knowledge of these past inventions as he got to work.
Tarnier’s invention has been described in the following terms:
“…a double-walled wooden box with a double-thick glass lid that Tarnier called a couveuse. The spaces between the walls were filled with sawdust for insulation. Tarnier used a gas burner in a separate lower compartment to heat a reservoir of water. Air circulated through the box at the bottom, was heated by the water reservoir, and pushed through vents to the infant above. Each infant had a thermometer near them inside the incubator, which enabled the nurses or caretakers to monitor the infant’s temperature without having to open the box.”
This isn’t the modern incubator of today’s time, but it still resulted in revolutionary, life-saving medical care for infants.
His incubators were implemented into the Maternity Port Royal hospital, but they failed to capture the medical world’s attention. As Erin Blakemore wrote,
“Caring for premature babies was expensive and, many thought, pointless. Babies born at a low birth weight were cared for, but mortality was high and physicians thought that Tarnier’s invention was unscientific. It was so new and unusual that few doctors believe in its life-saving potential.”
Additionally, an article from the Columbia University Irving Medical Center states, “…few in the stubborn medical establishment would listen. Many doctors viewed the practice as pseudo-scientific and outside the realm of standard care.”
However, one very important medical expert recognized the potential in Tarnier’s incubators—Dr. Pierre-Constant Budin, now known as the founder of modern perinatal medicine. Along with Tarnier, Dr. Budin made significant contributions to reducing mortality among infants. Budin decided to take the incubators to the World Exposition in Berlin in 1896 in hopes of garnering support. A bit of an unexpected choice, but a brilliant one in the end.
The “Freak Show” That Saved Lives
Budin enlisted the help of a German man named Martin Couney, who we now know actually didn’t qualify as a medical professional. While Couney claimed he studied medicine, in reality, he was most likely a technician. Despite the fact that he wasn’t a physician, he had an interest in caring for premature babies because one of his daughters had been born premature.
Couney set to work on the assignment by asking to borrow premature babies from the Berlin Charity Hospital for the exhibition. Believing that the infants had little chance, the hospital let Couney use six babies for the fair. He hired a body of nurses and began the exhibition at the fair, which was titled Couney’s Kinderbrutanstalt, meaning child hatchery. His operation became a great and unexpected success, as onlookers crowded into the display and paid money to get a look at the preemies. Most importantly, all six babies survived. From then on, Couney and his nurses toured the United States with their incubators and held exhibitions at about every large fair in the country. As Erin Blakemore from History.com noted about Couney’s success, “If hospitals didn’t want to care for premature babies, Couney could, using fairs and exhibitions to draw crowds and money for their neonatal care.”
Beginning in 1903, Couney’s attraction was exhibited at Coney Island in two separate locations, Luna Park and Dreamland. Coney Island is remembered as “America’s Playground,” and thousands of people visited the beach and parks each weekend at the time. Couney took babies at no charge from desperate parents and hospitals around the United States. Furthermore, all funds received from ticket sales were given to the babies’ medical care. As Erin Blakemore so succinctly put it, “Slowly, thousands of babies were nursed back to health, and all because the public loved seeing them warm and cozy in their incubators.”
Though Couney’s most famous exhibition was in Coney Island, he also went on to bring his operation to the Chicago World’s Fair from 1933 to 1934. According to Smithsonian Magazine,
“A sign above the entrance read “Living Babies in Incubators” in letters so large they could be read from the other end of the Chicago World’s Fair grounds…The infant incubator exhibit was built at a cost of $75,000 (worth $1.4 million today) and was painted in a patriotic red, white and blue.”
Hundreds of thousands flocked to see the premature babies, paying 25 cents in order to glance at the miniature, fragile figures in incubators.
A Person Is a Person, No Matter How Small
One of the premature babies who was part of the operation, Lucille Horn, once said concerning the doctors caring for her at first, “They didn’t have any help for me at all. It was just: You die because you didn’t belong in the world.” Thankfully, Lucille, who weighed approximately two pounds, was helped by Couney and his life-saving incubators. “It’s strange, but as long as they saw me and I was alive, it was all right. I think it was definitely more of a freak show. Something that they ordinarily did not see.”
A quote which encapsulates the theme of Martin Couney and his predecessors’ stories is “A person’s a person, no matter how small,” by Dr. Seuss. The medical world of their day acted on the belief that premature babies were unworthy of expensive medical care which would most certainly never save them. In the same way, our society today states that the unborn child is unworthy of being saved from the brutality of abortion.
In actuality, both preborn babies and premature babies have the right to life, just as fully grown human beings do. They should receive the same medical care, the same life-saving treatment, and the same support. Let us follow Tarnier’s, Budin’s, and Couney’s example in defying societal norms and saving, as well as advocating for the weakest, most vulnerable among us.
Couney’s claim was that he saved approximately 6,500 infants in his career, an 85% success rate. As of April of this year, about 30,000 unborn babies were directly saved by the repeal of Roe v. Wade, due to the hard work and dedication of pro-lifers in the U.S. Concerning these results. As The Society for the Protection of Unborn Children stated in response to these results,
“Over 30,000 unborn lives saved is great news, most of all for those babies that can now go on to live life and make their own choices. They will have names, careers, relationships, and even children of their own. Already we can see the practical effect of the repeal of Roe v. Wade. While just a few years ago this seemed almost impossible, 2022 showed us just what can be achieved. This is what pro-lifers around the globe are fighting for. We are one step closer to a world where abortion is unthinkable.”
The development of ultrasound technology has given us the ability to see the developing baby in the womb. Studies and statistics have shown that when a woman sees an ultrasound of their unborn baby, they are less likely to have an abortion. Just as Couney’s incubators helped society see the beauty and worth of premature babies, ultrasounds help women see the beauty and worth of their unborn babies.