EARLY

Impelled by the premature birth of her daughter, a journalist explores how modern medicine has changed regarding the care of babies born too early and of the ethical issues that can be involved.

In the prologue, DiGregorio, a Brooklyn-based freelance journalist (New York Times, Wall Street Journal, Food & Wine, etc.), describes the experience of having an extremely-low-weight child in the hospital’s neonatal intensive care unit. Her focus then broadens from memoir to journalistic report. In the first chapter, she reveals how common preterm births are: 15 million annually worldwide, with the United States having “the worst rate in the industrialized world.” Throughout, DiGregorio provides illuminating chronicles of her interviews with neonatal care professionals. She examines the development of incubators and then looks into the future, when we may see the use of a biobag, a sort of artificial womb that has been used successfully with premature lambs. The author also explores such issues as retinopathy and breathing problems and the techniques that doctors have adopted to handle them. In this section, she shows how the death of Jaqueline Kennedy’s premature son, Patrick, led to greater funding for research into respiratory care. DiGregorio makes clear that the problems facing preterm babies can be enormous, that consequences may not be apparent for years, and that the appropriateness of treatment can be debated, and she argues for deep consideration of the question of whether to use or to withhold life support for extremely premature babies. The author then turns to the causes of prematurity. One among the many factors is stress, leading her to suggest that the higher rate of premature births among African American women is a result of living in a racist environment; a separate chapter on prematurity in Mississippi illuminates this issue. Finally, DiGregorio gives voice to grown preemies and their parents, selecting a few of them to share their stories with readers.

Clear reporting that wisely urges careful decision-making by clinicians and parents alike.