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Due to various reasons, some within human control and others that can not be determined by human power, a premature infant can be the result. Until the late 19th Century, there was no aid that was given to these premature babies. With the first invention of a wooden incubator by Tarnier, which he borrowed from the plan of a chicken incubator, there was now hope for the premature born babies. From the wooden incubator, there emerged a convention-ventilated incubator from Tarnier’s successor who went by the name Professor Pierre Budin. Through the assistance of Couney, Budin was able to propagate his newly modified technology in other cities for instance Berlin and London. This did not stop here as it was introduced in most parts of the United States including the Coney Island. Since then, the infant incubator has undergone a number of modifications to have the modern infant incubators which are normally used. This infant incubator came as a life savior to the premature infants. We cannot fail to realize that there are associated disadvantages which are associated with this modern incubator. Thus, more technology needs to be incorporated in the modification process of the modern incubator so that some of the shortcomings linked to it can be addressed. Just like any other patient in the hospital, the premature infants under the incubator need to be handled with care in regard to certain ethical aspects.
It is amazing how the incubator came to be, but despite how it was instigated, it serves a very important role of saving the dear lives of infants who could otherwise die due to problems linked to premature birth. During the year 1880, “Stephane Tarnier who was a celebrated obstetrician and chef at Maternite hospital in Paris was having a casual visit at the Jardin d’ acclimatation show where he got to note the new incubators for chicken” (Mazurak & Czyzewska 2006). The incubators had been created by the zookeeper of the Paris Zoo for the purposes of hatching poultry. Intrigued by this kind of technology, Tarnier decided to replace the egg with a premature infant. He therefore requested for the construction of an infant incubator which would adopt the plan of the chicken incubator. However, the infant incubator had to be large enough so as to accommodate the size of a premature infant.
The resultant was a “couveuse which was wooden with several characteristics that were; it was well insulated, had two chambers, an air opening and a cover glass” (Mazurak & Czyzewska 2006). Water was filled in the lower chamber. This water was meant to warm up the air in the upper chamber where the infant was placed after getting heated by an oil lamp.
This incubator technology by Tarnier was taken up by Professor Pierre Budin who was eminent for his pioneer work in premature infant care at the Maternite Hospital in Paris. He was assisted by Martin Couney who was his assistant. Budin modified the incubator brought on board by Tarnier. He included a thermostat as well as glass plates that would allow for observation of the infant. He also dismissed the water in the lower chamber and instead adopted the use of natural gas for heating so as to maintain the infant’s temperature to normal. This modified incubator by Budin was known as the convention-ventilated incubator.
Budin told Couney to attend the Berlin exposition with the sole purpose of exhibiting this newly modified technology of the infant incubator. At the exposition ha set up a structure that held six incubators with six premature infants. Couney named his exhibit as the “kinderbrutanstalt to mean child hatchery” (Mazurak & Czyzewska 2006). This exhibit aroused a lot of interest among the Berliners and each paid a German mark to view the premature infants. Couney proceeded on to London to carry out another exhibit, but unfortunately his proposal was not perceived so well by the conservative doctors. The doctors refused to offer him with English neonates for his exhibition. He was forced to go back to Paris where he got three infants to use for his exhibit in London. Good for him as the exhibition was successful. He later moved on to the United States. In the U.S., he set up an empire to host incubator sideshows. This was in the year 1898 and for the next 50 years, Couney was busy setting up exhibitions for different fairs and traveling shows. In the year 1903, Couney established a permanent exhibit on Coney Island in New York which was ran for the longest time; from 1903 to 1943.
When Couney launched his sideshows and exposition s in Coney Island, a thorough investigation by the Brooklyn Society for the Prevention of Cruelty to Children was carried out. The findings of the investigation would lead to the suspension of quite a number of the sideshows held by Couney in the Coney Island. However, after convincing this body of the necessity of the admission charge which was very important to sustain and maintain the care provided to these infants, he continued with his project. With the sole purpose of reserving semblance of decorum in a turbulence of Coney Island’s mayhem, Dr. Couney decided to apply some ethical procedures that entailed lecturers to guide visitors through the exhibit. In addition, all his staffs were not allowed to make any slight joke pertaining to the incubator babies’ project or to accept any gratuity from the visitors or parents (Mazurak & Czyzewska 2006).
Luna Park in Coney Island was the permanent sideshow and one that made Dr. Couney famous, it ran from 1903 to 1943 and a zone of astounding success for Couney. According to his statistics, he saved more than 6,500 of the 8,000 premature babies brought to him. Couney resided within the vicinity of this amusement park in Sea gate. His sideshows in this park marked a historic project in Coney Island hence; up to this day, Coney Island is still remembered for its incubator babies’ historic project. Nonetheless, other than the Luna Park, Couney made use of two other amusement parks, namely; Dreamland and Steeplechase amusement parks. Unfortunately, in 1911, a disastrous fire brought Dreamland amusement park down. After the fire, there occurred a massive emergency transport of the premature neonates as they got transferred to Luna Park (Journal of Perinatal Medicine).
In the midyear of 1904, the alumni of the incubator sideshows by Couney on Coney Island and who were saved through science from the incubator device held their first and one of the most remarkable reunions. The aim of this reunion was to monitor the progress of these incubator babies. To the eminent satisfaction of Dr. Couney, the infants could not be any better and healthier than they already appeared. It was a thrilling show as everyone celebrated the success of the incubator device that saved the lives of the prematurely born infants (Baker 1996).
Despite the fact that the extended subway deemed to increase the number of people who would be visiting the exhibit, the converse happened. Public interests in Couney’s exhibitions began to dwindle such that in 1937, Couney lowered his admission fee to 20 cents. In 1939, he then raised his admission fee to 140USD. All the same, the returns that he was getting had reduced as he commented in an interview in 1940 that what he was making then was low yet he had five hundred thousand visitors as compared to sixty thousand visitors thirty five years back. According to him, Coney Island was so degraded, as people bargained when they needed to see his incubator babies instead of paying the already stipulated charge (Eidelman, 1993).
The incubator device came about after the realization that infant mortality rate was very high. Fears associated to the high mortality rate arose because after the Franco-Prussian war which took many lives, there was a need to replace the numbers of soldiers lost in the war. Invention and use of the infant incubator reduced infant mortality rate by half in France for babies whose weight was less than 2000g (Baker 1996).
Continued modifications and improvements on the incubator have brought about the modern incubator which is found in Coney Island and whose optimal temperature is 37 degrees Celsius. The infant is placed on a mattress which is enclosed in a transparent plastic canopy. The temperature of the incubator is regulated by a heater element installed below the mattress. An automated fan near the heater element is charged with drawing in filtered air past the heater and after the air has warmed up, it is moved up through slots into the infant’s compartment. There are temperature sensors to monitor the air temperature of the incubator. This modern incubator is also equipped with a skin temperature probe which is attached onto the infant’s skin to monitor its skin temperature. The incubator can be supplemented with oxygen through an oxygen inlet connection, where it mixes with the filtered air. In addition, humidity can be increased or reduced accordingly. This modern incubator is near to perfect with an ultimate purpose of meeting the needs of various infants (Sandham on Baby Incubation).
An infant is placed under an incubator if it is premature. Premature babies come about due to different factors which range from medical to accidental to socioeconomic (Flinders University Adelaide on Infant Incubator- Basics). Medical factors which are associated to premature infants include; “malformation of the uterus, distension of the uterus as well as detachment of the placenta and placenta previa” (Flinders University Adelaide on Infant Incubator- Basics). Infectious diseases like diabetes, hypertension, urinary infections and listeriosis are other medical factors responsible for bringing forth premature babies. Nutrition is another medical aspect which should not be taken lightly. When a pregnant woman fails to consume adequate nutritious foods based on her status, she will not be able to support the baby. This mostly results to premature and low weight babies that are put into incubators first before facing the harsh environment which, they are not prepared for (Flinders University Adelaide on Infant Incubator- Basics).
Accidents and surgical operations are another cause for premature babies. These lead to transmission of violent shocks to the stomach which induce labor pains before the due time for birth of the infant. Subsequently, a woman delivers before her time. Socioeconomic factors will affect the quality of care; a woman is placing upon herself and her unborn child. Professor Papiernick outlines the following socioeconomic factors to be associated with premature babies; “long journeys, physical labor, working outside in the open air and unaccustomed exercise” (cited in Flinders University Adelaide on Infant Incubator- Basics). Unhealthy habits which involve substance abuse also come into play as far as premature babies are concerned.
The infant incubator has several advantages but the most important of all is that it saves the neonates’ lives. As we saw earlier, there are various reasons which could lead to the wind up of an infant into the incubator which, all revolve around a premature baby. This premature neonate is not fully developed to face the environmental conditions that surround him or her. Through the invention of an incubator, the neonates’ chances of survival have improved. This is because the incubator provides the infants with a suitable environment at a favorable temperature. From its structure, it is clear that the infant incubator is equipped with several facilities to enhance its functionality (Flinders University Adelaide on Infant Incubator- Basics).
The most important environmental aspect that affects a premature child is temperature. Through the infant incubator, the premature neonate is kept warm and the other requirements fall slowly in place. There is the heater element which is the source for warmth in the incubator. Then there is the oxygen inlet which allows for supplementation of oxygen so as to enhance the infant’s breathing and circulation. The incubator also makes it easy for one to regulate the air temperature as well as the infant’s skin temperature. Thus, it is possible to have the incubator remain at a temperature which is favorable for the infant (Journal of Perinatal Medicine).
The infant incubators can be monitored and controlled using various sensing and control systems. There is the manual mode and the air control mode. The manual mode is applicable where there is available information regarding to the temperature of the infant space. What follows is that the heater output is set manually. A particular alarm is present to detect any termination of the heater power of not clarified by the caregiver. The air control system prevails through the standardization of the incubator’s temperature to the desired level. This system will enable the caregiver to get the actual measurement of the incubator. It then allows for regulation of the heater so that it can propagate enough heat until the incubator attains the desired air temperature. An alarm can also be used in this air control system to detect any deviation (Journal of Perinatal Medicine).
The incubator is coupled with some disadvantages as well. For one, it leads to too much heat loss from the neonates themselves and eddies around them. This greatly affects temperature and humidity control. Thus, the infant incubators are not able to ensure a standard and constant temperature and humidity. Maintaining an optimal environment is the desired goal but due to fluctuating temperature and humid levels it therefore call for 24 hour surveillance on the condition of the incubator. Failure to which will lead to death of the infant (Journal of Perinatal Medicine).
Then there is the issue of noise. The incubator is not designed in such a manner as to reduce the intensity of noise which can have devastating effects on the infant later on. Abrupt loud noises can psychologically startle the baby such that even after getting out of the incubator, it will suffer from startle reactions.
Another disadvantage is that the incubator does not control the amount of light the infant is exposed to. This is a premature baby, therefore their organs are not fully formed and when exposed to too much light, visual impairment can result. There is also the problem of susceptibility of the incubator to electromagnetic fields. Electromagnetic fields can make predispose the baby to the risk of suffering from cancer later on. According to researches that have been carried out on the relationship between electromagnetic fields (Emfs) and exposure to these Emfs, they have revealed that these electromagnetic fields could affect some neurological or clinical components of the body make up.
When the infant incubator device was first invented, we realize that there were a number of ethical aspects that were not observed. The first and most important ethical aspect is to make sure that a premature infant is placed under an incubator as soon as possible. No prematurely born infant should be denied access to an incubator (Eidelman, 1993).
In Coney Island, the infant incubator was used as an object in a side show instead of its intended purpose during its invention. The incubator was supposed to be exclusively used for the purposes of saving the neonates’ lives as opposed to being displayed for commercial gain. This was plying into the privacy and confidentiality advocated for in the medicine field. Therefore, like any other patient whose condition should only be known and monitored by the doctor, so is the neonates’ health condition. They should be kept in a private room and their status should not be exposed to outsiders.
Another aspect is that the incubators should be kept in a warm room away from any kind of noise that will unnecessarily startle the baby. These infants while in their incubators are very fragile and susceptible to any reaction in the environment. The most crucial aspect of these infants is a favorable atmosphere free from bacteria and unhealthy noise (Eidelman, 1993).
While the infants are placed in the incubators, they should be treated like any other patient. They have a right to adequate and effective medical care and attention. They should not be seen like some show objects on display to intrigue or fascinate the viewers. The incubator should be maintained at an optimal temperature and humidity to guarantee survival of the infant. The environmental conditions should be based upon the best interests of the infant.
As we can clearly see, the incubator device is a life saver. It is because of great minds that the incubator device which is used up to today, continues to save lives of the prematurely born infants. Despite the fact that it appeared unethical to exhibit the premature infants for money by Couney in Coney Island, lives continued to be saved. I am glad that today the incubator babies are usually kept in a special room with restricted entry upon where they get special medical attention as they continue to recover. However, as we have seen, more modification is necessary to overcome the few challenges associated with the current incubator device.