Driving me back to the hospital in early May, my mother tried to distract me with stories of dead relatives from the old country of preindustrial Yugoslavia. I was five days out from an unplanned Cesarean section, slightly high on oxycodone, and distraught that I had been discharged from the hospital the day prior, on Mother’s Day, and had to leave my baby in the NICU.
My mother’s anecdote was about her maternal grandfather, a man named Rade, whose entire first family, except for son Jovan, had died of some plague while he was off fighting in World War I.
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My mom said Jovan lived long enough to have a wife and children. Rade and Jovan, father and son, fought together in World War II. But although Rade survived two world wars, Jovan was killed. The Ustase, a fascist paramilitary organization that collaborated with the Nazis to help genocide the Serbs, threw him off a bridge.
And just like that, my own myopia was subsumed by the reminder that for most of human history, life was indeed nasty, brutish, and short.
On May 6, I walked into the hospital 36 weeks and two days pregnant with a blood pressure of 171/106 and had a C-section the same day. Although my baby was otherwise healthy, she was premature enough that her inability to eat full feeds rendered her hypoglycemic and necessitated a NICU admission.
It was easy to feel nauseating levels of self-pity about my own obstetric failure and three weeks of postpartum recovery spent commuting to the hospital for 12 hours each day instead of on my couch. But in reality, the story of the birth and early life of Anastasija Doescher is a testament to human progress and American excellence.
A Rapid Improvement in Living Standards
A century ago, 6% of all babies born in the U.S. died in infancy, as did nearly eight in 1,000 mothers. Baby Annie’s specific prognosis would have been even worse. A 1929 study of breech births at some of the world’s most prestigious hospitals found that those babies had a mortality rate of around 10% to 14%, even after excluding many of the smallest and least viable infants. One 1927 review of C-sections in Detroit reported that 13% of mothers died after the operation, which was still a marked improvement from 50 years earlier, when C-sections killed more than half the mothers who underwent the procedure.
The contemporary NICU is a museum of medical progress. Until the 1960s, slightly preterm babies like Annie who did survive birth lacked the reliable system of glucose monitoring, intravenous dextrose, standardized tube feeding, temperature control, and specialized nursing to keep them alive and growing while they learned to eat. Her NICU neighbors born at 27 weeks, who today enjoy an over 90% survival rate, would have had a 91% chance of dying.
These improvements have escalated exponentially within my own lifetime: When my parents were born, many children with cystic fibrosis died before starting school. Even when I was a child, the average life expectancy for CF was only around 35. Trikafta, a drug developed by an American company, has pushed projected life expectancy for eligible patients treated with it past 80 years old.
For all that Big Pharma is widely loathed, the American private pharmaceutical sector is responsible for 71% of the planet’s private pharmaceutical research and development, with the U.S. responsible for about half of the world’s total medical research and development.
America is the greatest nation known to man for the bevy of founding principles beyond its colossal wealth — equality, liberty, private property, speech protections, and so on — but it is indeed exceptional for its wealth in ways that we often don’t appreciate. Because a Cuban immigrant gave his stepson a loan to start a bookstore called “Amazon” in a garage, I had a fleet of personal couriers delivering baby formula and diapers overnight with the click of a button.
When I had to head to the hospital solo and was still unable to drive after the C-section, I could verbally command my phone to summon an Uber to chauffeur me to the hospital. If I lived in Texas or Florida, I could have had a self-driving Waymo robot car drive me like the Chariot of the Sun, which the Greeks mythologized was so powerful and impossible for mere mortals to ever obtain that it was reserved for the gods.
Economic power a fortress against outside threats
America’s greatness, both its founding principles and the wealth and power that those principles created, go beyond mere individual convenience. Jovan survived plague and poverty only to be murdered by fascists. Baby Annie doesn’t necessarily live in a kinder world than her ancestors did, but she’s protected from the people who would want to murder her by the largest military on the planet, two oceans, legally binding defense treaties with 50 allies worldwide, and the near-monopoly power of economic sanctions. And that military is only enabled by the exorbitant privilege of the U.S. dollar’s status as the world’s reserve currency.
Unlike her ancestors from less than a century ago, Annie will, statistically speaking, not die from a plague, be murdered by fascists, have her property stolen by a communist dictatorship, see her earnings devalued to zero by that autocracy, lack an education, or go hungry. Unlike the 1 million babies born this year who will die due to growth failure, a panoply of NICU nurses weighing every last diaper ensured that Annie was home safely before her due date with a prognosis of a long, happy, and normal life.
First and foremost, I thank God for bringing Annie and me home safely. And, now, back to our regularly scheduled programming at Tiana’s Take. But I also thank America — including the imperfect health insurance cartel, our ruthless capitalism, messy melting pot, and all — for saving our lives.
Tiana Lowe Doescher (@TianaTheFirst) is an economics columnist for the Washington Examiner.
