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May 24, 2007

Which ones would you keep?

http://www.jewishjournal.com/blog/item/which_ones_would_you_keep/

It’s called “selective reduction”—the choice IVF patients make to abort one or more fetuses when several embryos take. GetReligion has a good wrap-up of a few stories published recently about fertility treatment and this medical procedure, and on Tuesday, I heard Washington Poster Liza Mundy talking about it on NPR.

Mundy had a powerful piece in Sunday’s WP magazine and is the author of a new book about the complications of fertility treatment, particularly the health complications that drug- or treatment-induced multiple pregnancies can cause both the mother and the unborn children.

Selective reduction is one of the most unpleasant facts of fertility medicine, which has helped hundreds of thousands of couples have children but has also produced a sharp rise in high-risk multiple pregnancies. There is no way to know how many pregnancies achieved by fertility treatment start out as triplets or quadruplets and are quietly reduced to something more manageable. The U.S. Centers for Disease Control and Prevention, which publishes an annual report on fertility clinic outcomes, does not include selective-reduction figures because of the reluctance to report them.

Two weeks ago in the LA Times, Dan Neil shared this personal story of reduction:

MY WIFE AND I just had an abortion. Two, actually. We walked into a doctor’s office in downtown Los Angeles with four thriving fetuses — two girls and two boys — and walked out an hour later with just the girls, whom we will name, if we’re lucky enough to keep them, Rosalind and Vivian. Rosalind is my mother’s name.

We didn’t want to. We didn’t mean to. We didn’t do anything wrong, which is to say, we did everything right. Four years ago, when Tina and I set out on this journey to have children, such a circumstance was unimaginable. And yet there I was, holding her hand, watching the ultrasound as a needle with potassium chloride found its mark, stopping the heart of one male fetus, then the other, hidden in my wife’s suffering belly.

We don’t feel guilty. We don’t feel ashamed. We’re not even really sad, because terminating these fetuses — at 15 weeks’ gestation — was a medical imperative. This has been a white-knuckle pregnancy from Day 1, and had it gone on as it was going, Tina’s health would have been in jeopardy, according to her doctor. The fact is, multiple pregnancies are high risk, and they can go bad very suddenly. I wasn’t going to allow that, though the fires of hell might beckon.

But does “selective reduction” constitute abortion in the generally understood sense? Life is being ended, but life is also being created. Because doctors won’t implant multiple embryos without a patient’s acceptance that reduction may be necessary, the willingness to abort has become a prerequisite to older mothers bringing into this world a new life.

What do you think?

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