Between 'fetal viability' and the 'viability of families' : Decision-making for extremely premature infants in Spain
Martone, Paula (Universitat Autònoma de Barcelona. Departament d'Antropologia Social i Cultural)
Molas, Anna (Monash University (Melbourne, Austràlia))
Marre, Diana (Universitat Autònoma de Barcelona. Departament d'Antropologia Social i Cultural)

Data:	2025
Resum:	Neonatal expertise and technologies have been perfected over the last decades, improving preterm infants' survival rates and allowing a gradual reduction in the gestational age limits of fetal viability. Using the concept of viability as a starting point, we analyze decision-making processes regarding extremely preterm newborns at the limits of viability. Drawing on extensive ethnographic fieldwork in a public hospital in Barcelona between March and November 2023, we examine the knowledge forms, rationalities and values that healthcare workers employ when guiding families in decisions about infants' viability. In this respect, we thoroughly analyze the actors involved and the extent of their agency. The findings point out that although neonatal decisions in Spain are embedded in an ethos of "individual responsible choice," they are in practice collectively produced and shaped by two main (sometimes conflicting) drivers: the perceived means of families to face the challenges posed by infants with high chances of severe sequelae (the 'viability of families'), and the preterm patients' perceived "will to live" ('fetal viability'). The study highlights how viability in this context needs to be understood within the structural socioeconomic constraints and struggles to make and raise families in Spain.
Nota:	Altres ajuts: acords transformatius de la UAB
Nota:	Article fieldwork was supported by the research project Artificial Placenta, an interdisciplinary program for the development of an experimental prototype, evaluation of the impact on fetal programming, development and clinical application, financed by Obra Social Fundaci\u00F3n la Caixa. IP: Eduard Gratac\u00F3s, Hospital Clinic / Hospital Sant Joan de D\u00E9u, University of Barcelona. Anna Molas work was supported by the Juan de la Cierva postdoctoral fellowship of the Spanish Ministry of Science and Innovation [FJC2021-046533-I grant]. Diana Marre\u2019s work was also supported by her ICREA Academia Award and by RICORS project financed by the Spanish Ministry of Science and Innovation and the European Union [RD21/0012/0018].
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Preterm birth ; Fetal viability ; Decision-making ; Neonatology ; Reproduction ; Anthropology ; Spain
Publicat a:	Social science & medicine (1982), Vol. 367 (february 2025) , p. 117760, ISSN 1873-5347

DOI: 10.1016/j.socscimed.2025.117760

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