Monday, February 2, 2009
The Story of 21 Wk Baby Samuel
Monday, February 02, 2009
Baby Samuel, mom doing well
Controversy over fetal surgery continues after birth of famous infant
Posted: February 16, 2000
1:00 am Eastern
By Julie Foster
Samuel Armas, the infant whose in utero surgery made history after a photo of the pre-born baby grasping the finger of his surgeon through an opening in Mrs. Armas' uterus energized pro-life groups and led to Matt Drudge's departure from Fox News, was born without fanfare.
Baby Samuel's hand
"We didn't want anyone intruding on his birth," said Julie Armas, who has had two previous miscarriages.
A Cesarean section was performed Dec. 2, 1999, bringing "Baby Samuel" into the world with new hope -- he had been diagnosed with spina bifida just weeks after his conception. Samuel's parents, Julie and Alex Armas, chose to subject mother and child to a relatively new procedure aimed at reducing the effects of spina bifida.
The debilitating disease damages the spinal cord, which can cause paralysis or weakness of the legs, bowel and bladder incontinence, neurological impairments and learning disabilities. Nearly all children born with spina bifida must undergo surgery to implant permanent shunts -- thin tubes that remove excess fluid that could otherwise cause brain damage.
While only time will tell how successful the surgery was, Samuel was born healthy and is home with his parents. Samuel now weighs more than 7 pounds.
"It's not a cure," Julie Armas told The Tennessean. "We understand that. It is some hope."
So far, he has not developed hydrocephalus, the potentially dangerous build-up of fluid in the brain that is a common complication of spina bifida. The latest ultrasound test of his head "was almost completely normal," said Armas, who has worked as an obstetrical nurse.
Leg weakness is another complication of spina bifida, and Samuel is receiving physical therapy to improve his leg function. Although he may eventually need braces below the knees to help him walk, "his orthopedist is very pleased with the way he's coming along," Armas said. "That really made us feel better."
"He's a typical little baby, keeping us up at night," his mother said.
The Armases have declined most interview requests since Samuel's birth, but the couple did go on record with USA Today about their ordeal. In an email to Dr. Laura Schlesinger, Julie Armas explained: "The decision to do the USA Today interview stemmed from the fact that it is believed that the vast majority of babies with spina bifida are aborted in this country."
"We wanted people to know that there is an educated, professional couple out there who love and value their child even though he is 'defective' by society's definition ...," she wrote. "No matter what Samuel's outcome is, we know that God has allowed him to impact others with a photograph of his tiny, unborn hand."
Dr. Joseph P. Bruner
Dr. Joseph P. Bruner, director of the Vanderbilt fetal diagnosis and therapy program, indicated the photo has less significance for him.
"Depending on your political point of view, this is either Samuel Armas reaching out of the uterus and touching the finger of a fellow human, or it's me pulling his hand out of the uterus ... which is what I did," he said.
Dr. Noel B. Tulipan, director of pediatric neurosurgery at Vanderbilt who closed the hole in Samuel's spine, noted both mother and fetus were anesthetized.
Even if he had not been under anesthesia, a fetus at Samuel's stage of development at the time of the surgery "would have no ability to reach out and grab anything," Tulipan said.
The operation was performed just 21 weeks after conception -- weeks before Samuel, the youngest child ever to undergo the procedure, could have survived on his own outside the womb. Full term is about 40 weeks.
Though babies undergoing fetal surgery to reduce the effects of spina bifida are given anesthesia to prevent pain during the procedure, a proposal to anesthetize third-trimester fetuses prior to abortion, also termed a "surgical procedure" by abortion rights activists, was rejected in California.
California State Assemblyman George Runner
California State Assemblyman George Runner introduced the Fetal Pain Prevention Act of 1998 which failed in the Assembly Health Committee on a party-line vote: 11 of the 13 Democrat members of the committee opposed the bill. Two Democrats did not vote at all on the measure.
An analysis written by Democrat staff on the committee notes the strong opposition of the bill by Planned Parenthood Affiliates of California.
"PPAC asserts that this bill disregards the health implications of anesthesia use in the third trimester for the mother," says the analysis. "To anesthetize the fetus, one must also anesthetize the mother. Based on her medical history and the present health crisis which requires an abortion, the use of anesthesia could be a serious threat to the woman's life and her future health."
The American College of Obstetricians and Gynecologists also opposed the bill, calling anesthetizing a fetus "the specific practice of medicine by the legislature. A political body would never consider dictating medical procedures for other conditions such as heart disease, brain surgery or eye care. It also is inappropriate for the safe, legal procedure of termination of pregnancy."
Staff goes on to say, "Third trimester abortions are very rare and are most often performed in hospitals. Most hospitals require approval of the procedure by a bioethics committee, and the procedures are discussed by medical authorities on the hospital's staff. These procedures are done only when women are faced with a serious medical condition and the life of the mother and/or fetus is in jeopardy."
However, statistics from the Center for Disease Control indicate 3,900 abortions are performed in the third trimester annually in California alone.
The Royal College of Obstetricians and Gynecologists, a British panel of medical and scientific experts, affirmed in October 1997 that fetal pain does exist and recommends that "practitioners who undertake termination of pregnancy at 24 weeks or later should consider the requirements for feticide analgesia and sedation."
American medical experts also indicate that fetuses beyond 20 weeks are capable of experiencing pain, or at least react to stimuli in a manner that could be interpreted as reaction to pain. One expert, in Congressional testimony, characterized the pain experienced in a partial birth abortion procedure as a "dreadfully painful experience."
The Committee on Moral Concerns supported the bill saying, "Since abortion is going to continue for the foreseeable future, the least we can do is treat human fetuses with the compassion we have for unwanted dogs."
Apparently fetal surgeons agree that their patients feel pain since anesthesia is given to both the mother and her child, although Bruner, who has performed 80 in utero spina bifida operations, continues to abort fetuses with the disease at the woman's request -- "an increasingly difficult position to be in," the doctor has said.
"Because we are performing surgery to improve the lifestyle of fetuses who have spina bifida, it is difficult to justify an operation that could also take that life away," he said. "As we walk through this mine field, society is going to have to take a good, hard look at itself, because it is untenable to hold both views."
Bruner has estimated that about half of women in the United States who discover they are carrying a fetus with spina bifida choose abortion.
Journalist Matt Drudge, author of the Drudge Report, attempted to use Baby Samuel's famous photo on his Fox News Network television show, but was forbidden to do so by network management.
"He was using this photo [also seen in] the National Enquirer as a jumping-off point to talk about partial-birth abortion," said Fox News spokesman Brian Lewis. "It was a picture of an emergency operation for spina bifida. We thought it was a blatant misrepresentation. It was a straight editorial decision."
WorldNetDaily columnist and Associate Editor Elizabeth Farah cautioned the network about its reason for censoring the picture.
"Would you have allowed Matt to make his point by displaying a picture of a different pre-birth child -- this one a victim of abortion?" she asked.
"If memory serves, no picture of an aborted baby's body or video has ever been seen in an establishment paper or on an establishment network," Farah continued. "The word censorship comes to mind."
Drudge parted ways with Fox News, canceling his weekly show. A Fox News spokesman told WorldNetDaily the desire to split was "mutual."
But Drudge isn't the only one under fire for trying to publicize Baby Samuel. Doctors meeting in Washington in December criticized a website maintained by the Vanderbilt doctors performing the crucial operation, saying it was used for "recruiting" women for the procedure. The critics also said the surgery should be stopped until it can be properly tested.
The Vanderbilt doctors insist, however, the website is only designed to provide information to parents.
Julie Armas said she might not have known about the procedure if her mother had not found the Vanderbilt website during an Internet search.
But the revolutionary new surgery is not just changing the lives of children with spina bifida or even just their parents. The photographer of Samuel's outstretched arm said the experience has changed his life.
The Armases agreed to let Nashville free-lance photographer Michael Clancy take pictures of the Aug. 19 operation. Clancy's now-famous photo of Samuel's hand was published in newspapers around the world.
The 43-year-old photographer, who had never before taken pictures of a surgical operation, said, "It has made a pro-lifer out of me."
Clancy said he hadn't realized abortions could legally be performed into the fifth month of pregnancy and later. In fact, abortions are legal until a day before birth, although states were given the ability to outlaw third-trimester abortions in the Supreme Court's decision of Roe v. Wade.
"It's an amazing experience," he said.
See Elizabeth Farah's column:
Why Fox censored Drudge