twin " reductions"

[Portia]

http://nyti.ms/r4QGzv

I'm pretty moderate when it comes to many questions of rleproductive ethics - I dont think kids are for everyone, & don't believe a god has fore-ordained how many "spirit children" a woman will have... But this article made me a little sick with its <i>The Giver</i> -esque euphemism (let's just call a spade a spade: it's selective abortion) and the rather callous disregard for human life such a step shows. If you wanted to get pregnant so ardently, why not let me adopt you other kid?! The part that made me upset the most was when the wife & doctor crapped all over the husband's feelings. I cannot imagine how upset ANY of the men I've dated would be over my making a unilateral decision like that. I hope the cultural zeitgeist shifts the "normal" age of childbearing back to about 22- 35, where it belongs biologically. Even in Seattle, most

[Rifka]

That's disgusting! I can understand selectively killing fetuses in large multiple births to ensure safety of the mother and other children, although I don't think I would feel comfortable doing it myself. It's a sticky issue. But aborting a baby just because it's inconvenient or disabled is not okay. I have a friend who was born with cerebral palsy. I'm sure she would much rather exist with her condition than not exist at all. I do think it would be different for a pregnancy where the baby was highly unlikely to live until birth. But aborting a baby because it has a disability is just plain selfish.
One thing that majorly stuck out to me as I read was the hopeful parents' lack of preparation before choosing to try for a pregnancy. Many of them seemed shocked to be having triplets or twins-- hello!-- didn't that possibility occur to them when they were taking fertility drugs or having multiple embryos implanted? I think parents need to be better educated before they use fertility treatments. They need to sit down with their fertility doctor and discuss the possibility of multiples and what they might want to do in that case (notice I used the word might-- I understand things can change and a parent might not be able to really make the decision until the circumstance is there, but that doesn't mean they can't start thinking about it before). If it's not a good time to have multiples, then maybe they shouldn't be trying to get pregnant-- particularly not through fertility treatments.
I especially abhorred the statement "and yet here she was, 14 weeks into her pregnancy, choosing to extinguish one of two healthy fetuses, almost as if having half an abortion." It wasn't almost as if she were having a half abortion. She was having an abortion! Also, her stating that chosing the amount of babies was just another choice was disgusting. How can you view chosing to kill one of your children as "just another choice." It saddens me that life is valued so little in our society today.
My stance might seem hardnosed, but my husband's father and maternal grandmother are twins-- if their parents had been selective about which baby to keep (if such technology existed back then and they were willing to use it), my husband would probably not be here today.
Next point: impregnating lesbians, single women, and women much over 40 is just wrong. There's a reason women's bodies stop being able to get pregnant around 40-- it's not safe, it's difficult, and it's very old to have a child.
In summary: women need to better understand what they're getting into before having fertility treatments. They need to discuss with their spouse and doctor what they want to do in the case of multiple fertilizations or disabled infants. If they're not ready for the possibility of having multiples or disabled children, they shouldn't be trying to get pregnant. Inconvenience is no excuse to kill a baby in utero. Selective reduction should be allowed, though, if the risks to the mother and infants of a multiple birth are deemed too great by a competent medical professional and the parents of the children.

[Katya]

Next point: impregnating lesbians, single women, and women much over 40 is just wrong. There's a reason women's bodies stop being able to get pregnant around 40-- it's not safe, it's difficult, and it's very old to have a child.

Your stance against impregnating lesbians or single women doesn't seem to follow from the other arguments you've made.

[Eirene]

What an interesting medical ethics problem--not just the decision of whether to "reduce" twins to one, but any decision of reduction, even for, say, quadruplets to twins, would be really difficult. I mean, whether something is Medically Necessary is not a yes-or-no, binary decision. If the situation was "all babies and the mother will certainly die if nothing is done," then that's pretty clear cut. But what if the chance of carrying the quadruplets to term without complications is only 70%, but you can bump it up to around 90% by reducing to twins? Is that ok, then? Or what if the mother had already had two complication-free pregnancies before, and now she's having triplets, so do statistics about likelihood of developing gestational diabetes and hypertension still apply? In other words, can you even accurately estimate risks in pregnancies?

If you're the parent, you can probably rationalize a lot of things as long as the doctor tells you it was necessary. But as the physician, how can you ever tell someone when they "had to" and when they didn't?

I think most medical ethicists would say that in general, you should fully educate the patient and then provide them the autonomy to make the final decision, but that's not what most patients want to hear--everybody wants the bottom line.

[Rifka]

Next point: impregnating lesbians, single women, and women much over 40 is just wrong. There's a reason women's bodies stop being able to get pregnant around 40-- it's not safe, it's difficult, and it's very old to have a child.

Your stance against impregnating lesbians or single women doesn't seem to follow from the other arguments you've made.

You're right, Katya. I probably should have clarified there. My stance against impregnating lesbian or single woman is based on my belief that children have a right to grow up in a family with a mother and father to love and care for them. I understand that sometimes divorce and death leave a child with only one parent to care for them, but I feel that's a different matter than impregnating women that have never been married or are in a lesbian relationship.

[Imogen]

i believe in a woman's right to choose, but reducing from twins to a single birth because you only wanted one seems so selfish. maybe it's because i really want three or four kids, but...i dunno...this just rubs me the wrong way.

eta: and the woman who didn't want to "deal with" her husband's feelings...ugh....

[Whistler]

Hmmm... I have to admit that after all the artificiality in making a test-tube baby and implanting multiple embryoes, I don't find aborting one of them any more outrageous than having an abortion.

[Genuine Article]

It bothers me when people think they can choose the consequences of their actions. I'm sorry, but if you're carrying a child, it's because somewhere along the line you made the choice* to get pregnant, and if that means having twins in your 50's, so be it.

*this is discounting rape, obviously.

[TheAnswerIs42]

As my husband and I were discussing this, we noted that it is (as always) hard to decide where the line is drawn. Most of us would say that birth control is fine. But isn't that also preventing the natural consequences of your actions? Obviously, in the cases in this article, the consequences are much more real. And reading some of those stories made me rather upset. But how on earth could we or any judicial system say for sure who is justified in avoiding the consequences and who isn't? Maybe some of them were just being selfish. Maybe they should have thought about it beforehand. Or maybe it really was the best thing for their family on some level somewhere. I'm certainly not the person to say.

[Rifka]

42- I think one of the main differences between birth control and selective abortion is the attitude. Taking birth control indicates that the partners have thought about the possibility of conceiving ahead of time and have planned preventive measures ahead of time. That is very different than waiting until afterward to say "Oops! I'm pregnant and I don't want to deal with the fact that I wasn't responsible enough to think about getting pregnant." Refusing to consider consequences to our choices is a major problem with the American mindset (as a whole). Think about it like buying a house. If a person took out a loan to buy a house without first sitting down to make sure they could afford the house payments, would you feel very sympathetic if they then lost the house because they couldn't make house payments? You might feel sorry that they had to suffer homelessness, but you'd probably also realize that they should have counted the cost first, and that they need to suffer the consequences. Or, for another example, think about school work. If you slack off and party instead of doing your homework, is it fair to expect the teacher to just give you good grades anyway because your life will be too hectic next semester to retake the class? No. You should have thought of those things before you partied all your free time away! Twin reduction is the same twisted mindset. Parents are wanting to jump into pregnancy without considering possible outcomes. And when they end up with multiples, it's not fair to kill off extra babies just because they didn't stop to think about the situation before trying to get pregnant. If you're going to use fertility treatments, you'd better be prepared to deal with multiple children. Period.

[krebscout]

I think both parties here (those who use birth control and those who use abortion/reduction) are considering their actions "preventative," some of us just vary on where we draw the "prevent/too late" marks on our timelines

[Yarjka]

Refusing to consider consequences to our choices is a major problem with the American mindset (as a whole). Think about it like buying a house. If a person took out a loan to buy a house without first sitting down to make sure they could afford the house payments, would you feel very sympathetic if they then lost the house because they couldn't make house payments? You might feel sorry that they had to suffer homelessness, but you'd probably also realize that they should have counted the cost first, and that they need to suffer the consequences.

I don't think any child should come into the world as a "consequence."

[Unit of Energy]

all children come into the world as a consequence. a consequence can be a good thing too. we just often forget that good things are a result or consequence of an action as well as the bad.

[Yarjka]

all children come into the world as a consequence. a consequence can be a good thing too. we just often forget that good things are a result or consequence of an action as well as the bad.

Well, as a "consequence that needs to be suffered" then.

[Dragon Lady]

Would "deal with the consequences" be better? Because I'll be honest. I willingly and happily chose to get pregnant, and 98% of the time, I'm thrilled with the consequences. But I'd be lying if I didn't say that there are definitely times that I suffer the consequences. But it does sound a whole lot nicer to Dragon Baby to say "deal with the consequences" instead.

And as a current pregnant woman, I'm going to definitely say that right now I am suffering the consequences. And I don't feel like I'm a bad person for saying so.

[Rifka]

Would "deal with the consequences" be better? Because I'll be honest. I willingly and happily chose to get pregnant, and 98% of the time, I'm thrilled with the consequences. But I'd be lying if I didn't say that there are definitely times that I suffer the consequences. But it does sound a whole lot nicer to Dragon Baby to say "deal with the consequences" instead.

And as a current pregnant woman, I'm going to definitely say that right now I am suffering the consequences. And I don't feel like I'm a bad person for saying so.

Yes, "deal with the consequences" probably would be a better way to say it.

[TheBlackSheep]

Next point: impregnating lesbians, single women, and women much over 40 is just wrong. There's a reason women's bodies stop being able to get pregnant around 40-- it's not safe, it's difficult, and it's very old to have a child.

Oh the incredible angst that this fills me with. However, as it's not exactly on topic, I'll leave it alone.

And I'm with imogen on this one. I'm one of the few pro-choice ladies on this forum, and I wouldn't want to judge another person's carefully considered choice, but this seems... selfish. To me, there is a difference between deciding categorically that you cannot be pregnant at that point in your life and aborting a fetus or choosing to reduce a pregnancy with many healthy fetuses and choosing to abort one fetus of two when you willfully underwent the procedure that put them there. I could not choose that.

[Laser Jock]

And I'm with imogen on this one. I'm one of the few pro-choice ladies on this forum, and I wouldn't want to judge another person's carefully considered choice, but this seems... selfish. To me, there is a difference between deciding categorically that you cannot be pregnant at that point in your life and aborting a fetus or choosing to reduce a pregnancy with many healthy fetuses and choosing to abort one fetus of two when you willfully underwent the procedure that put them there. I could not choose that.

I guess I just don't get this. I don't want you to feel attacked, but how is this different from "normal" abortion? Why does it matter if the woman is pregnant as a result of fertility treatments or as a result of intercourse, either of which could be considered a procedure the woman willfully underwent? (The article also talked about natural multiple pregnancies being "reduced," for what it's worth.)

Again, I'm not trying to argue with your feelings, and I'm especially not contradicting your views of abortion being moral. I just don't understand why "reducing" multiples wouldn't be exactly as moral as abortion of a single pregnancy, whether you're for or against abortion.

[TheBlackSheep]

I guess I just don't get this. I don't want you to feel attacked, but how is this different from "normal" abortion? Why does it matter if the woman is pregnant as a result of fertility treatments or as a result of intercourse, either of which could be considered a procedure the woman willfully underwent? (The article also talked about natural multiple pregnancies being "reduced," for what it's worth.)

Again, I'm not trying to argue with your feelings, and I'm especially not contradicting your views of abortion being moral. I just don't understand why "reducing" multiples wouldn't be exactly as moral as abortion of a single pregnancy, whether you're for or against abortion.

Oh, Laser Jock, you are possibly the most polite person I've ever met, so don't worry about me feeling attacked.

I guess it's a really fine line, but I think the difference for me is intent. The person who chooses to implant multiple embryos or undergo IVF is doing such things specifically to get pregnant. They have devoted significant time and resources to this pursuit. They know that they could end up with multiple healthy fetuses ahead of time. Now I'm not going to say that the woman with many implanted fetuses is selfish to reduce the number, but twins? Twins were a risk that they knew about, and the idea of eeny-meeny-miny-moe-ing it down makes me uncomfortable.

And not that "normal" abortion doesn't. I've never had one and I don't plan on it. But still, women who end up having abortions come from myriad situations that I am altogether uncomfortable passing any kind of judgment on. There's the chance that they did everything "right" as far as birth control and protection goes but they got "unlucky" (sorry, am I using a lot of quotation marks?) or that it was rape or incest. However, even for the woman who had completely irresponsible unprotected sex, I don't feel comfortable insisting that she not have an abortion. Going through all the physical, emotional, financial, and social consequences of not aborting for nine months, bare minimum, is a lot to ask in response to one night/day/hour of irresponsibility when the intent was not to cause pregnancy. (I'm not saying that it is too much to ask, just that it is a lot to ask.) I especially feel this way because in the situation where the woman does carry the baby to term and then puts him or her up for adoption, society requires nothing of the person who contributed the other 50% of the baby's DNA. And I don't know that I believe that abortion is moral; I just don't believe that we can demand that women not have abortions.

I don't know that I explained that well at all, but it's the best I've got at the moment.

[Rifka]

However, even for the woman who had completely irresponsible unprotected sex, I don't feel comfortable insisting that she not have an abortion. Going through all the physical, emotional, financial, and social consequences of not aborting for nine months, bare minimum, is a lot to ask in response to one night/day/hour of irresponsibility when the intent was not to cause pregnancy.

First of all, let me say that I appreciate your response, Black Sheep. You obviously care a lot about the women in these situations. However, I have a hard time with some of your logic. First of all, abortion also takes a large physical, pyschological, and financial toll on women. Not only that, but many women go into abortion without being properly informed about what the abortion will be like, how it will affect them psychologically and physically, what the child's development is like at that point. Many women who receive abortions are poor minorities who don't fully understand what's going on.
Secondly, I struggle with your stance that going through pregnancy is a lot to ask in response to one night/day/hour of irresponsibility when the intent was not to cause pregnancy. Once again, you're trying to take away all accountability. People have to deal with the consequences of one hour of irresponsibility all the time. Is it fair to send people to jail for an hour of irresponsibility because they got road rage and killed someone they didn't mean to, or got drunk and ran into someone and killed them, or got angry and beat their wife, etc? No. People need to be accountable for their actions, and creating life is a very serious action. Why do we punish people more for ending life than for both creating and ending life? That idea blows me away. No matter what people say, passion is controllable and people need to control it, or take responsibility when they don't control it. (I do think exceptions should be made for abortion in the case of rape or incest or endangerment of the life of the mother, though.)

Anyway, I know that was off the topic of the discussion, but I felt so strongly about these things that I wanted to share my opinion.