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The Ethics of Selective Reduction
August 12, 2011 8:03 AM   Subscribe

The Two-Minus-One Pregnancy. (SLNYT article on selective reduction)
"For all its successes, reproductive medicine has produced a paradox: in creating life where none seemed possible, doctors often generate more fetuses than they intend. In the mid-1980s, they devised an escape hatch to deal with these megapregnancies, terminating all but two or three fetuses to lower the risks to women and the babies they took home. But what began as an intervention for extreme medical circumstances has quietly become an option for women carrying twins. With that, pregnancy reduction shifted from a medical decision to an ethical dilemma. As science allows us to intervene more than ever at the beginning and the end of life, it outruns our ability to reach a new moral equilibrium. We still have to work out just how far we’re willing to go to construct the lives we want."
Single page version

An additional article from the Washington Post, 2007: Too Much to Carry?
posted by zarq (166 comments total) 8 users marked this as a favorite

 
Fertility drugs to have MORE kids at 45 when you already have multiple grade-school aged children? SWEET BLISTERING JEEBUS STOP BREEDING YOU NARCISSISTS YOUR GENES ARE NOT THAT FUCKING SPECIAL
posted by FatherDagon at 8:09 AM on August 12, 2011 [78 favorites]


I only skimmed the article - is it possible that the school aged children they have now aren't from the current marriage, but rather children from a previous marriage of one of the two parents? If so, I can see wanting to have a child that is from both parents. And they've been trying for 6 years, so it's not like they just decided to get fertility treatments at age 45.

Having said that, it's interesting to me that if they had gotten pregnant with twins naturally, they would have kept them both, but because it's part of the process of artificial insemination, they have no problem getting rid of one of them. HOW the baby was conceived wouldn't have *any* bearing on this kind of decision, were my wife and I in the same position.
posted by antifuse at 8:16 AM on August 12, 2011 [2 favorites]


SWEET BLISTERING JEEBUS

"Sweet Blistering Jesus" is perhaps the worst action figure name, ever.
posted by GenjiandProust at 8:17 AM on August 12, 2011 [11 favorites]


I can't even read it. The first two paragraphs just make me sick and ruined my day.
posted by sanka at 8:17 AM on August 12, 2011


I see no problem with this whatsoever. I tend to joke that the reason people dress twin babies and toddlers completely alike is that they only inteded on having one kid, and this is as close as they're going to get.
posted by griphus at 8:19 AM on August 12, 2011 [1 favorite]


They should bring both children to term and abort the parents.
posted by Splunge at 8:19 AM on August 12, 2011 [8 favorites]


I find it's weird that doctors think it's ethically okay for white people to have preferences for having one girl after a lot of boys, or vice versa, or one of each, but it's ethically bad for people from different cultures to have preferences for sons.
posted by jeather at 8:20 AM on August 12, 2011 [12 favorites]


(Literary and cinematic Godwin's law analogy self-deleted)
posted by longsleeves at 8:21 AM on August 12, 2011


I'm quite amused how having 4+ kids has become a status symbol in fancy suburbs. Can't wait for the parents to be paying several hundred thousand a year to send them all to college at pretty much the same time.
posted by JPD at 8:22 AM on August 12, 2011 [3 favorites]


"Sweet Blistering Jesus" is perhaps the worst barbecue sauce name, ever.
posted by fleetmouse at 8:22 AM on August 12, 2011 [19 favorites]


(Uh, "this" being to choose a single child over twins. The specific situation the parents are in is something different altogether.)
posted by griphus at 8:22 AM on August 12, 2011


almost as if having half an abortion

OK... "almost?" Also, having "half an abortion" is pretty much the flip side of being "a little pregnant."

If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it.

I... am at a loss for words over the weakness of this thinking. I get it, but I don't get why they don't get that it's basically an irrational justification for what is a personal decision that doesn't need external justification. This is why choice is so important. Argh!

Alright, I wasn't at a loss for words, I was merely stunned.
posted by GenjiandProust at 8:23 AM on August 12, 2011 [2 favorites]


It gives me the ishies... about on the same level as siblings making out. But really it's not any different than another abortion.
posted by Blisterlips at 8:23 AM on August 12, 2011


Michael Sandel often puts it eloquently: Openness to the unbidden
posted by stroke_count at 8:32 AM on August 12, 2011 [2 favorites]


This is one of those situations where I completely support their right to make this choice, but I don't understand it at all. The added logic of explaining that it would have been different if it had been a naturally conceived set of twins is just so strange.
posted by bizzyb at 8:33 AM on August 12, 2011 [7 favorites]


"Sweet Blistering Jesus" is perhaps the worst action figure name, ever.

But a great band name.
posted by Billiken at 8:35 AM on August 12, 2011


I'm quite amused how having 4+ kids has become a status symbol in fancy suburbs. Can't wait for the parents to be paying several hundred thousand a year to send them all to college at pretty much the same time.

This is why I tell my wife I want to stop at 2. She's Irish, and has this notion that a huge family would be awesome... We're in Canada, not the States, but we still have to pay for university here (unlike in Ireland). It's going to be hard enough paying for university for 2 kids, even with the RESP that we've started for the first one already.

Oh, and I meant to comment on the "almost as if having half an abortion" bit too - this is EXACTLY having an abortion. You are aborting a fetus. Please don't pretend that you're not. I mean, I support anybody's right to do this, but man, quit trying to fool yourself about what you're doing.
posted by antifuse at 8:36 AM on August 12, 2011 [1 favorite]


If a woman can get an abortion for any reason, it's not a big step think she can reduce twins to one, for any reason.
posted by Brandon Blatcher at 8:38 AM on August 12, 2011 [2 favorites]


"Sweet Blistering Jesus" is perhaps the worst action figure name, ever.

But a good name for a friendly character in deep fat fryer safety infomercials.
posted by rhymer at 8:42 AM on August 12, 2011 [1 favorite]


I've had many students who were born of older parents who underwent the test tube procedure, and many of them opt to keep both (or all three in some cases..this is in an affluent area, they can afford it). I'm trying to think of one set that doesn't have lots of medical and/or learning problems. I can't.
posted by Huck500 at 8:42 AM on August 12, 2011 [3 favorites]


I'm quite amused how having 4+ kids has become a status symbol in fancy suburbs. Can't wait for the parents to be paying several hundred thousand a year to send them all to college at pretty much the same time.

Demographic trend, meet political complaint. I'm sure you two will get along famously.
posted by condour75 at 8:45 AM on August 12, 2011


"Jenny desperately wanted another child, but not at the risk of becoming a second-rate parent."

That is, a second rate parent in the eyes of the public. She is certainly not a first-rate parent to the one who got the needle. Sad.
posted by michaelh at 8:45 AM on August 12, 2011 [3 favorites]


That is, a second rate parent in the eyes of the public. She is certainly not a first-rate parent to the one who got the needle. Sad.

... and second rate in the eyes of her OTHER children who she feels she would have to neglect in order to care for twins.
posted by antifuse at 8:48 AM on August 12, 2011 [1 favorite]


Do fertility clinics -- before implanting embryos -- have to disclose the risks of multiple pregnancies, and their policies about selective reduction? It seems like this should be made clear from the outset, so families can decide how many embryos to implant with some knowledge.

And what are the legal limitations -- if any -- on embryo implantation? (The law in Quebec -- where some IVF is covered by the government -- is only one at a time.)
posted by jeather at 8:48 AM on August 12, 2011 [2 favorites]


I find it interesting that Dr. Evans initially opposed reducing pregnancies below twins, but had changed his position based on a better understanding of the social, personal and economic constraints a woman might have on raising more children than desired or expected.

It's almost like the best person to make decisions about a woman's reproductive capacity is the woman herself.
posted by endless_forms at 8:48 AM on August 12, 2011 [47 favorites]


I read through this yesterday and decided it's okay - like Brandon just said, it's not really fair to deny these women an abortion if we support abortion rights for any other women.

In my pregnancy forum, two of the women pregnant with twins have been on complete bedrest for weeks already.

Even if there weren't greater risks to mom and babies with twin pregnancies, how can we condemn these women for planning their families when access to family planning is one of the great pillars of social justice?

That is, a second rate parent in the eyes of the public. She is certainly not a first-rate parent to the one who got the needle. Sad.

Do you think this about anyone who gets an abortion?
posted by thirteenkiller at 8:48 AM on August 12, 2011 [17 favorites]


Do you tell the child, wait intil they are an adult, leave a note in a drawer for them them to find after you die, or keep it from them forever and hope it doesn't get back to them?

I would not want to know, if I were the chosen to be born.

As a twin, this whole situation is a horror to me.
posted by longsleeves at 8:49 AM on August 12, 2011 [7 favorites]



I only skimmed the article - is it possible that the school aged children they have now aren't from the current marriage, but rather children from a previous marriage of one of the two parents? If so, I can see wanting to have a child that is from both parents.


Well, they used donor eggs, so the fetuses weren't exactly going to be children from both parents.
posted by coppermoss at 8:49 AM on August 12, 2011 [1 favorite]


If a woman can get an abortion for any reason, it's not a big step think she can reduce twins to one, for any reason.

Your comment reminds me of one of Doug Stanhope's most irreverent jokes:
(on his ex-wife's abortion) Has anyone had an abortion? You're all rapt with attention now, all of a sudden, so I assume you all have... The reason we had an abortion was... It wasn't because... It wasn't frivolous. We didn't have an abortion because we weren't ready to take care of a child, we were irresponsible, or because we're not financially capable of taking... The reason we had it is 'cause I really wanted to see what it felt like to kill a baby.
posted by BobbyVan at 8:49 AM on August 12, 2011 [8 favorites]


I didn't finish the article. It was icky. Its icky how much judgement people give other peoples choices.

If abortion is allowed I don't think is any worse. Its about choice and making hard decisions for the children/parents who are going to live with it.
posted by SpaceWarp13 at 8:50 AM on August 12, 2011 [3 favorites]


Typical New York Times navelgazing-by-proxy for rich white people. You mess with nature, you must be fully committed to messing with nature. You already elected to do it when the carrying partner swallowed her first Clomid; there's no sense in feeling bad about it.

My daughter was conceived through fertility. We messed with nature. Every day I'm glad that we did it. But it was made clear to us that it was possible that we might have to selectively abort to protect my wife and the viability of the one embryo that we wanted. And if that had happened, we would have done it and been fucking thankful for the actual baby that we got after years of disappointment.

When basic needs are really fucking fulfilled, some people need to look for anguish, huh?
posted by Mayor Curley at 8:51 AM on August 12, 2011 [8 favorites]


Part of my belief in reproductive freedom means allowing for the fact that people might make different choices than I'd make.
posted by padraigin at 8:52 AM on August 12, 2011 [59 favorites]


Ahem. Maybe I am just being paranoid, but "Jenny" sounds a lot like that woman who tried to make an abortion decsion via online poll...in other words, she sounds like a ringer from the anti-abortion movement (most of which also opposes IVF). There are legitimate questions around selective reductions, but this quote is a little too loaded with anti-abortion buzzwords for me to really believe that it comes from someone who isn't steeped in that movement's literature.

Things would have been different if we were 15 years younger or if we hadn’t had children already or if we were more financially secure,” she said later. “If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner — in a test tube, choosing an egg donor, having the embryo placed in me — and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.”

So let's see - she's too old to 'really' have kids, she's defied the 'natural order' to have IVF and therefore has totally disregarded the 'natural order' and that makes abortion OK, the artificiality of IVF makes for no bond with the resultig child, it's 'just another choice' because women already have too many choices, and technology has made pregnancy 'consumerish."

That really is straight out of the rhetoric about the 'contraception mentality' and 'casual IVF to have it all' at too late an age that pervades anti-choice literature. If you were an anti-IVF campaigner, and wanted to get the movement fired up, you'd want to hook your opposition to IVF to a more motivating issue...so IVF=casual, thoughtless abortion is a total winner.

Admittedly, there are other reasons this woman might be using this sort of canned language (perhaps she grew up in an anti-choice church, disregarded the prohibition against IVF, and now regrets doing so?), but this rhetoric just sounds a little too familiar to me.
posted by Wylla at 8:53 AM on August 12, 2011 [21 favorites]


I am truly horrified and disgusted by these parents. It never occured to them that instead of going through fertility treatment and then terminating (this is a polite way of putting it) a featus they themselves have willingly brought to life, they could actualloy adopt a child in desperate need of parents and a home?

(If the subject of adopting a child was covered in the article, please excuse me. I could not read more than the first couple of paragraphs before I felt like vomiting, so I had to stop there.)

Good luck to the baby who was granted life by these selfish, demented and ice cold people. The child is certainly gonna need it with those parents.
posted by TraumaT at 8:55 AM on August 12, 2011 [1 favorite]


I would not want to know, if I were the chosen to be born.

But their not choosing one person over another, its fairly similar to choosing not to have you a sibling at a later date. I can understand how horrible this is to think of it you have a twin but the reality when it happens is totally different.

The couple choosing the number of children which they feel capable of raising and loving. Being pregnant should be a punishment that one has to take it should be a joy.
posted by SpaceWarp13 at 8:56 AM on August 12, 2011


I find it's weird that doctors think it's ethically okay for white people to have preferences for having one girl after a lot of boys, or vice versa, or one of each, but it's ethically bad for people from different cultures to have preferences for sons.

It's okay because you're saying that you want to have at least one of each, so it doesn't mean you like one sex more than the other.
posted by madcaptenor at 8:57 AM on August 12, 2011 [1 favorite]


jeather: "Do fertility clinics -- before implanting embryos -- have to disclose the risks of multiple pregnancies, and their policies about selective reduction? It seems like this should be made clear from the outset, so families can decide how many embryos to implant with some knowledge.

I'm not sure if there is a law requiring disclosure, but most fertility clinics in the US do indeed disclose the risks of higher order multiples that may occur from various procedures. They do this because if they don't, they could easily be sued for not warning their patients of potential risks.

Certain ART (artificial reproductive technology) procedures are more likely to produce twins or greater. IUI (artificial insemination) carries a higher risk of higher order multiples than IVF, for example. When my wife and I went for fertility treatment, the doctor warned us repeatedly of the risks.

And what are the legal limitations -- if any -- on embryo implantation? (The law in Quebec -- where some IVF is covered by the government -- is only one at a time.)"

US Federal law does not limit the number of embryos that can be implanted in IVF procedures. A handful of states have attempted to pass one. Most recently Georgia and Missouri tried in '09. Georgia's Ethical Treatment of Human Embryos Act was nicknamed the "Octomom bill" and died in committee. I believe the Missouri law did too.

Many fertility clinics will now refuse to implant more than two embryos in IVF procedures. But IVD is not the only service they offer. And twinning of an embryo can still happen in utero, up to 14 days after blastocyst transfer.
posted by zarq at 8:57 AM on August 12, 2011 [1 favorite]


"Sweet Blistering Jesus" is perhaps the worst lubricant name ever.
posted by eriko at 8:57 AM on August 12, 2011 [10 favorites]


"Sweet Blistering Jesus" is perhaps the worst Ben&Jerry's flavor, ever.
posted by Kabanos at 8:58 AM on August 12, 2011 [5 favorites]


Well, they used donor eggs, so the fetuses weren't exactly going to be children from both parents.

Ahh, see, I missed that bit (hence my caveat that I had skimmed). In that case, DAMN, I can't imagine going through all that effort to have a 3rd (or possibly 4th or 5th, I didn't see how many school aged children they already had, in my skimming) kid.
posted by antifuse at 8:58 AM on August 12, 2011


Now I know why people want an edit window...

Should NOT be a punishment
posted by SpaceWarp13 at 8:58 AM on August 12, 2011


If you do read the article, mentions that there is disagreement among some doctors as to whether twins born to mothers in their forties do as well as other children or whether they have more developmental problems.
posted by longsleeves at 8:58 AM on August 12, 2011


My kingdom for an edit window. That last "IVD" in my comment should be "IVF."
posted by zarq at 8:58 AM on August 12, 2011


...they could actualloy adopt a child in desperate need of parents and a home?

Can we give this a name, considering it happens every goddamn time an abortion thread comes up? I vote for "Kal-el's Law," because the likelihood of an adoption going through coinciding with the time period people are ready to have kids is about even money with a spaceship with a baby falling out of the fucking sky and into their backyard.
posted by griphus at 8:59 AM on August 12, 2011 [46 favorites]


I am truly horrified and disgusted by these parents. It never occured to them that instead of going through fertility treatment and then terminating (this is a polite way of putting it) a featus they themselves have willingly brought to life, they could actualloy adopt a child in desperate need of parents and a home?

This viewpoint is extremely hard for me to comprehend. Are you opposed to all abortion and all fertility treatment? Tons of fetuses are destroyed in some types of fertility treatments. How can you possibly justify forcing a woman to continue a pregnancy she doesn't want?
posted by thirteenkiller at 9:02 AM on August 12, 2011


This viewpoint is extremely hard for me to comprehend. Are you opposed to all abortion and all fertility treatment? Tons of fetuses are destroyed in some types of fertility treatments. How can you possibly justify forcing a woman to continue a pregnancy she doesn't want?

It's possible to find something abhorrent and disgusting and not think it should be made illegal.
posted by BobbyVan at 9:05 AM on August 12, 2011 [8 favorites]


Yes, absolutely that pro-choice means I must support people who'd choose differently from me. An irrational part of my mind produced by who knows what cultural conditioning wants to say, "Listen, either choose to keep the whole pregnancy or abort the whole thing," but I recognize that this is weird type-A neat-freak thinking.

So much of this stuff could be avoided if there were a one-embryo implantation standard. Yes, that lessens your odds of conception in that IVF run, but nobody promised us guaranteed fertility.

I really hope that if I were in the situation of being pregnant with an unwanted twin, I'd just go to term with both and give the extra one up for open adoption. Everybody wins.
posted by FelliniBlank at 9:05 AM on August 12, 2011


The thing with adoption is that it's not like you're going to the Baby Store. Or even the Older Child With Special Needs Store. They don't make it easy, which is a good thing in my opinion, but it's so much more involved than "Hey, I know, let's just go adopt a kid!" that suggesting it in the context of a discussion of fertility treatments and family planning is kind of weak most of the time.
posted by padraigin at 9:06 AM on August 12, 2011 [9 favorites]


I love how this is the only expression of American Consumerism tolerated on MetaFilter. "Well, gawsh, it's not the way I'd want it, but I guess we just have to accept what Abortion says." So pious.
posted by resurrexit at 9:06 AM on August 12, 2011 [3 favorites]


uh, what?
posted by gaspode at 9:07 AM on August 12, 2011 [1 favorite]


I think this practice is absolutely ok, but the article's statement of "almost as if having half an abortion. ", is ridiculous.

It is and abortion, and there's no way to sugar coat that.
posted by sunshinesky at 9:08 AM on August 12, 2011 [3 favorites]


Why are people sugar-coating this at all? It's totally fucked.
posted by resurrexit at 9:09 AM on August 12, 2011 [3 favorites]


If you don't sugar-coat it, it's just Blistering Jesus.
posted by ODiV at 9:10 AM on August 12, 2011 [31 favorites]


FelliniBlank: " So much of this stuff could be avoided if there were a one-embryo implantation standard. Yes, that lessens your odds of conception in that IVF run, but nobody promised us guaranteed fertility."

It lessens the risk. But does not eliminate it. Any time a woman takes fertility drugs, specifically gonadotropins, there is an increased possibility of multiple births. This is all from memory, but I believe the risk averages 10% for clomid alone. Up to 20% for a gonadotropin cocktail.

IUI on its own does not increase the possibility of twins. But when combined with gonadotropin treatment, the incidence of multiples is actually slightly higher than with IVF.
posted by zarq at 9:11 AM on August 12, 2011


I love how this is the only expression of American Consumerism tolerated on MetaFilter. "Well, gawsh, it's not the way I'd want it, but I guess we just have to accept what Abortion says." So pious.

I love how everything for some people can be reduced into a facile argument against some perceived current flaw in society as a whole.

There are many good reasons to have an abortion or a selective reduction. Having kids/having more kids is a gigantic commitment.

It is not shopping. Comparing it to shopping is facile argument.
posted by SpaceWarp13 at 9:13 AM on August 12, 2011 [5 favorites]


I love how this is the only expression of American Consumerism tolerated on MetaFilter. "Well, gawsh, it's not the way I'd want it, but I guess we just have to accept what Abortion says." So pious.


this only doesn't sound insane if you believe a large proportion of the people using fertility treatments and considering selective termination are people who already have multiple children, rather than couples that have had difficulty conceiving.

in other words I don't think you are wrong if the majority of people doing this are 42 year olds from Fairfield County who want a fourth kid. But until I see the data I sort of doubt this. I'm guessing the majority of people nationwide who undertake fertility treatments are either couples that got married in their late 30's, couples that have other health issues that have limited their fertility, or couples for whom traditional methods are a physical impossibility.
posted by JPD at 9:14 AM on August 12, 2011 [4 favorites]


I'm not sure if there is a law requiring disclosure, but most fertility clinics in the US do indeed disclose the risks of higher order multiples that may occur from various procedures. They do this because if they don't, they could easily be sued for not warning their patients of potential risks.

But what I think is equally important is their policies regarding what they will do in the case of multiples.

Many fertility clinics will now refuse to implant more than two embryos in IVF procedures. But IVD is not the only service they offer. And twinning of an embryo can still happen in utero, up to 14 days after blastocyst transfer.

The numbers suggest that, in Quebec, since implantation was legally limited to 1 embryo at a time, there have been no IVF-related triplets, and the number of IVF pregnancies with twins have gone from 30% to 3% of pregnancies, which sounds offhand like the number of natural pregnancies with twins.

I do not know enough about IUI vs IVF, but it sounds like the incidence of multiples with IVF is mostly because multiple embryos are implanted.

(I am not against selective reduction, for the record.)
posted by jeather at 9:14 AM on August 12, 2011 [5 favorites]


“If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner — in a test tube, choosing an egg donor, having the embryo placed in me — and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.”

Just short of words failing me - All I can say is this is very fucked up.
posted by therubettes at 9:15 AM on August 12, 2011 [3 favorites]


Yeah, the reporter chose a pretty provocative and outlier "representative" example in Jenny.
posted by FelliniBlank at 9:17 AM on August 12, 2011 [3 favorites]


There are many good reasons to have . . . a selective reduction. Having kids/having more kids is a gigantic commitment.

The fertility procedure itself costs tens of thousands of dollars. People know what they're getting into especially with regard to the "risk" of multiples. It's absolutely all about the consumer is always right, no matter how fucked up the consumer's decision. Shame on anyone who won't call that decision wrong just because it's "different that what I'd do."
posted by resurrexit at 9:18 AM on August 12, 2011


jeather: " The numbers suggest that, in Quebec, since implantation was legally limited to 1 embryo at a time, there have been no IVF-related triplets, and the number of IVF pregnancies with twins have gone from 30% to 3% of pregnancies, which sounds offhand like the number of natural pregnancies with twins."

That's wonderful! Sincerely, I had no idea. Thanks for explaining.
posted by zarq at 9:19 AM on August 12, 2011 [2 favorites]


This is one of those discussion where I feel like it would be completely pointless to engage anyone without a precis on their feelings on abortion in general. I mean, if you're opposed to abortion under any circumstances (or only circumstances of pregnancy via rape/incest and/or extreme medical necessity) then of course you think this is horrible, who cares.

But if you support legal access to elective abortion I can't figure your position on this out at all. It's okay for someone to decide they can't handle having a baby at all but if they decide they can only handle having one it's suddenly unethical? I mean I understand it as an emotional reaction, but to act as if it has any logical sense? I find the pervasive attitude in the article that it's okay to abort to bring a multiple pregnancy down to 2 but suddenly that last one becomes unethical.
posted by nanojath at 9:19 AM on August 12, 2011 [7 favorites]


The thing with adoption is that it's not like you're going to the Baby Store.

"Hi, yes, I'd like a baby. Male, white. What size? Hang on, let me call my husband [beep beep beep]. Hi honey, I'm on my way home and I'm at the baby store and they want to know what size. Medium? Do you have medium? They have one in stock, honey they're bringing it up. Okay, it looks good but wait. It's a little ... I don't know ... dented? It just doesn't look right. No, I don't think I want this one. Do you have any others? Thursday? Oh, they're not getting any more in until Thursday; that's when the truck comes in. Oh, no, no, no thank you. They're offering me a discount if I take the dented one. What? No it's really dented, look, just trust me okay. Okay, thank you! No, I don't think I want to take a look at any of the Asian ones. Really? Angelina Jolie? Which model does she have? Wait, hang on my husband is saying something. Oh, he's right, we really did decide on white. Look, I'll be back Thursday, thanks for your help! What did you say honey? Okay, a pint of rum raisin? No problem. I'll be home in twenty."
posted by griphus at 9:21 AM on August 12, 2011 [10 favorites]


Ah, so that's what Babies R Us is.
posted by kmz at 9:23 AM on August 12, 2011 [1 favorite]


resurrexit: "The fertility procedure itself costs tens of thousands of dollars. People know what they're getting into especially with regard to the "risk" of multiples. It's absolutely all about the consumer is always right, no matter how fucked up the consumer's decision.""

No, it's not.
posted by zarq at 9:23 AM on August 12, 2011 [6 favorites]


Whomever said "Sweet Blistering Jesus" is the worst name for a barbecue sauce ever is WRONG. It is indeed the BEST name for a barbecue sauce ever. "It's right there in the name!"
posted by eoden at 9:24 AM on August 12, 2011 [6 favorites]


The thing with adoption is that it's not like you're going to the Baby Store.

And the Baby Store has shitty customer service. Everyone's rude and no-body knows anything. Fuck you, the Baby Store.
posted by eoden at 9:25 AM on August 12, 2011 [1 favorite]


Do you tell the child, wait intil they are an adult, leave a note in a drawer for them them to find after you die, or keep it from them forever and hope it doesn't get back to them?

Growing up, my next door neighbors had this happen via fetal developmental issues. She was pregnant with a boy and a girl, and IIRC the ultrasound showed that the girl would likely be extremely disabled, so the mom chose to abort the girl. It's now 20+ years later and the son still doesn't know. I'm not sure that the older son (his older brother) even knows. Hell, the only reason I even know is that my mom couldn't keep a secret to save her life.
posted by elizardbits at 9:27 AM on August 12, 2011 [1 favorite]


But if you support legal access to elective abortion I can't figure your position on this out at all.

I absolutely support legal access to abortion. Hell, I think it should be more accessible. For lots of reasons which are irrelevant to this discussion, but that's my opinion.

What I found weird was the equivocating, the "it's not really abortion" coming from both the parents and the writer (it was a little hard to tell, frankly). No, it is abortion, and it's another look at why legal access to abortion is so vital. Because these parents' hard decision to abort some for their fetuses because they saw that they did not have the resources for those children? That is a pretty major reason for most women who make that difficult decision.

The article bugged me because I felt it was playing a "this is an OK abortion (or "half an abortion," WTF)" as opposed to all those "nasty abortions all those irresponsible sluts have." And that shit we do not need.
posted by GenjiandProust at 9:27 AM on August 12, 2011 [19 favorites]


I just want to know how I can let the parents in my life with who have selectively reduced know that my upcoming party is for adults only. You know, tactfully.
posted by everichon at 9:31 AM on August 12, 2011 [9 favorites]


I imagine the Baby Store would be like Ikea. Upstairs, they've got everything you could over want, but downstairs they're always out of blue.
posted by Bulgaroktonos at 9:34 AM on August 12, 2011 [3 favorites]


I am pro-choice and I think ART is a wonderful thing, but I feel like this decision should have been made at the time of transfer.
posted by juliplease at 9:34 AM on August 12, 2011 [2 favorites]


Sweet Blistering Jesus is the worst name for a feminine hygiene product for diabetic muslims, ever.
posted by Meatbomb at 9:36 AM on August 12, 2011 [3 favorites]


I'm really wondering why more people in this situation -- especially if they are so anguished and guilt-ridden that they have to play word games like "extinguish" and "almost half an abortion" -- don't just deliver both twins and keep only one. I mean, you're planning to complete the pregnancy anyhow, and the doctors have already said there is no health-related reason to abort one twin, so carrying the two to term is no huge deal. If you give one baby away, you not only get your enhanced family but get to help create a second family. And you probably prevent another woman from having to go through the whole fertility treatment, IVF, selective reduction rigamarole.

Is it just fear of the potential stigma if people find out? The difficulty of giving up a baby you gave birth to? You've still got one to pour out all your post-partum bliss hormones onto, so it's not like the situation of a birth mother who adopts out her only infant. You'd just think there'd be more effort to talk up the benefits of this option.

And Sweet Blistering Jesus is the worst name for a TGI Friday's appetizer ever.
posted by FelliniBlank at 9:40 AM on August 12, 2011 [2 favorites]


Why do they wait until 14 weeks to selectively terminate? Is that because they couldn't get anyone to do the procedure earlier, or do you have to wait until the fetus is a certain size before this procedure can be done?
posted by thehmsbeagle at 9:40 AM on August 12, 2011


Do you tell the child, wait intil they are an adult, leave a note in a drawer for them them to find after you die, or keep it from them forever and hope it doesn't get back to them?

The embryo that would have been my daughter's twin didn't implant properly and was miscarried very early in my wife's pregnancy. When she's old enough to even understand pregnancy and twins, I will ask my daughter if it was the evil twin that died; or if she is in fact The Evil Twin, who killed her sibling in utero. But only when she misbehaves.
posted by Mayor Curley at 9:40 AM on August 12, 2011 [33 favorites]


don't just deliver both twins and keep only one.

Does carrying twins to term really seem that easy? Is there no extra risk to both fetuses in a twin pregnancy? (I bet there is)
posted by muddgirl at 9:44 AM on August 12, 2011 [1 favorite]


thehmsbeagle: "Why do they wait until 14 weeks to selectively terminate? Is that because they couldn't get anyone to do the procedure earlier, or do you have to wait until the fetus is a certain size before this procedure can be done?"

They wait for several reasons, including the size factor and to see if the second embryo will be viable or die off on its own -- thereby eliminating the need to reduce.

Regarding size, selective reduction is done via ultrasound and a very large needle. A doctor must stop the fetus' heart with an injection of potassium chloride. I believe they then siphon out the amniotic fluid. The larger the fetus and its amniotic sac, the easier it is to target.
posted by zarq at 9:46 AM on August 12, 2011


In other words: I agree with those who are pointing out that this is just another extension of family planning, and one that I support unreservedly. "Jenny" has the right to determine what leeches off her resources for the next 9 months, even if she chose to implant that organism in the first place.

(For those asking why she implanted two embryos if she didn't want twins: She says that they had been trying ART for 6 years. It's pretty certain that she had biological issues that were preventing successful implantation of embryos. They probably looked at the statistics and figured the likelihood of even one successful implantation was pretty low, and she was running out of time. Would I have made the same choice in her shoes? Who the fuck knows?)
posted by muddgirl at 9:47 AM on August 12, 2011 [1 favorite]


I don't really understand why this is anyone's business. The woman whose body's resources are going to be used to grow and build the fetuses, the woman whose health is at stake and who is deciding how much bodily risk to take on, is the person who should decide whether to carry 4, two, or no fetuses to term.

Whether she's privileged or insufferable or shallow, whether her reasons are ok to us, Random Internet People, or not, is completely irrelevant. We are not the ones taking the risks; much like gay marriage, this is the kind of thing that really only affects the people directly involved, and yet, our whole society wants to stare and exclaim and pearl-clutch and judge about it.

It's time for us to grow up and get over our squeamishness around reproductive decision making. Technology is not going away, no matter how much we're scared by watching Gattaca. Choice must not go away, unless we want to model ourselves on The Handmaid's Tale. We're smart enough to navigate the vast middle ground between these two, but only if we stop squealing and running away when faced with reality.

And it's not like women have ever not had to deal with these kinds of gray areas. Before modern contraception and abortion, when the crops didn't come in or a woman was raped or a child was born with a serious defect, women often made much worse choices, choices we can hardly bear to think about, because they and their existing children faced death otherwise. There are women in many places in the world today still having to make those choices. In comparison, having a selective abortion of a fetus that a woman isn't ready to care for is orders of magnitude easier and better for everyone.

Being the childbearing half of the species is a tough gig.
posted by emjaybee at 9:48 AM on August 12, 2011 [38 favorites]


muddgirl: " Does carrying twins to term really seem that easy? Is there no extra risk to both fetuses in a twin pregnancy? (I bet there is)"

Including but not limited to:

* Gestational diabetes
* Low birth weight
* Premature birth (lung issues are very common in preemies, neurologic issues somewhat less so, cardiologic issues somewhat less common than that)
* Preeclampsia
* Anemia and/or various types of maternal organ dysfunction
* Various placental issues, including abruption
posted by zarq at 9:49 AM on August 12, 2011 [3 favorites]


We're smart enough to navigate the vast middle ground between these two, but only if we stop squealing and running away when faced with reality.

But, we don't navigate that middle ground by leaving those issues entirely up to "people directly involved". We navigate them by having the conversation about what we do and do not find acceptable. Giving people the choice doesn't imply that we always have to support that choice, anymore than freedom of speech implies that to agree with what everyone else says.
posted by Bulgaroktonos at 9:54 AM on August 12, 2011 [2 favorites]


Yuppie team is babies.
posted by Slackermagee at 9:56 AM on August 12, 2011


"I would not want to know, if I were the chosen to be born."

"But their not choosing one person over another..."

You're right, the doctor probably chooses the one that's easiest to inject, logistically.
posted by longsleeves at 10:11 AM on August 12, 2011


Sweet Christ, why is this even an issue? Pro-choice means pro-choice. These women are making a choice about their lives and their bodies. The hand wringing is nothing more than a different facet of the tried and true the-only-moral-abortion-is-my-abortion nonsense.
posted by lydhre at 10:12 AM on August 12, 2011 [13 favorites]


I can see when selective reduction makes sense, but I think it's more in the case of "You wanted one child and you are having four". If you wanted a child and you already have children then twins might be more than you were expecting, but it seems odd to me that it qualifies as the end of the world. If there are serious medical concerns then it's a different matter, but that wasn't the case here.

I support her right to do this, but I also support my right to think there is a little bit of whining going on.

FWIW - My wife and I skirted the edge of this issue. We used artificial insemination to conceive and there was a brief panic when we thought we might have been having four babies. That would have been too much and we would have reduced without a second thought. But twins? I think we would have gone into a sustained, nine-month panic marathon and had twins. As it happens, we are just having one.
posted by It's Never Lurgi at 10:28 AM on August 12, 2011


It's Never Lurgi, congratulations. :)
posted by zarq at 10:32 AM on August 12, 2011 [1 favorite]


Sorry, I'm another vote for "this is completely awful and should be illegal". But I also think changing/breastfeeding at the table should be illegal, so....
posted by roomthreeseventeen at 10:34 AM on August 12, 2011 [1 favorite]


I love when people are all "Why get an abortion, why not just deliver the baby and put it up for adoption!?" like there's trivial difference between the getting an abortion and the physical, psychological, financial, and hormonal toll of a full-term pregnancy.
posted by Uther Bentrazor at 10:36 AM on August 12, 2011 [9 favorites]


You know, actually, seriously, I think I insist on it: If you are against this then I want to know if you are generally pro-life (in which case again, I don't care, obviously you would be opposed to this case) and if you consider yourself pro-choice I want an explanation of what you believe the fundamental ethical difference is between a person who makes a choice with known consequences (sexual activity) and has an elective abortion because they find having a child incompatible with their personal life choices and someone who makes a choice with known consequences (IVF and/or other infertility treatments) and has an elective abortion because they find having two or more children at once is incompatible with their life choices. I genuinely find this position logically incoherent.
posted by nanojath at 10:40 AM on August 12, 2011 [2 favorites]


nanojath, I'm pro-life.
posted by roomthreeseventeen at 10:42 AM on August 12, 2011


You can't be that pro-life if the basic functions of mammalian life freak you out so hard you think they should be illegal.
posted by thehmsbeagle at 10:44 AM on August 12, 2011 [21 favorites]


Sure, pro-choice is pro-choice. I can believe in someone's right to that choice and disagree with the choice itself. That feeling doesn't take away anyone's right; I'm still allowed to hold my own opinions on the ethics of the choice.

Just because I agree with the interpretation of the first amendment in the Skokie Affair doesn't mean I like white supremacists and swastikas.
posted by litnerd at 10:47 AM on August 12, 2011 [5 favorites]


When we told my grandma that my wife was pregnant with twins, the look of shock and fear on her face was haunting. She had been a nurse back in the 30s, when twins generally didn't do so well. Of course, we assured her, things were different now.

We used IVF. But we only put back one egg. The girls were identical.

When our girls were born 8 weeks early, and one of them died in the NICU a few weeks later, we thought we had experienced about the worst that could come of a twin pregnancy. A year later, we're finding that it just keeps on coming, as the daughter who lived has health problems that may last a good long time.

Our girls were identical. We didn't have the option of terminating one of them -- it would very likely have killed the other one. If we had had the option, I doubt we would have taken it. But fuck all if, having experienced the hell that a twin pregnancy can turn into, I'm going to judge someone else for doing it.
posted by gurple at 10:47 AM on August 12, 2011 [32 favorites]


> Whomever said "Sweet Blistering Jesus" is the worst name for a barbecue sauce ever is
> WRONG. It is indeed the BEST name for a barbecue sauce ever. "It's right there in the
> name!"

Name, whatever. If those are the first three words you manage to gasp out after your ears stop smoking and you can talk again (in a hoarse whisper), it was probably a pretty good barbecue sauce.
posted by jfuller at 10:51 AM on August 12, 2011 [1 favorite]


gurple, I am so sorry for your loss.
posted by lydhre at 11:03 AM on August 12, 2011


gurple, I'm so sorry. :(
posted by zarq at 11:04 AM on August 12, 2011


I can believe in someone's right to that choice and disagree with the choice itself. That feeling doesn't take away anyone's right; I'm still allowed to hold my own opinions on the ethics of the choice.

I wasn't telling anyone they didn't have a right to their own opinions, litnerd, I was asking people who felt compelled to state them in public to explain their logic because I find the opinions of people who find and elective reduction to make a pregnancy easier and safer and child rearing more manageable after birth ethically different from an elective abortion to avoid the difficulty and danger of pregnancy and to make life more manageable by avoiding birth altogether logically incoherent.

My growing suspicion is that pro-choice individuals who think the situation described in this article is ethically different than any elective abortion not made for medical necessity or because the pregnancy was the result of non-consensual sex are basing their opinions on emotional reactions to various conception/pregnancy/birth narratives and have no ability to logically defend their opinions. I've seen nothing so far here to make me doubt this suspicion.
posted by nanojath at 11:06 AM on August 12, 2011


I can see when selective reduction makes sense, but I think it's more in the case of "You wanted one child and you are having four". If you wanted a child and you already have children then twins might be more than you were expecting, but it seems odd to me that it qualifies as the end of the world.

It sounds from the rest of your statement (left out for brevity's sake) that you don't currently have any children yet, but rather have one on the way. One baby is a LOT of work (we've only had one so far). I'm currently trying to come to grips with the idea of dealing with another baby in the house with a toddler also running around wanting attention. It's going to be a huge difference, trying to make sure that the little guy we have gets the attention that he needs while still caring for a squalling little ball of pooping, vomiting cuteness. Having multiple school aged kids, and trying to juggle TWO infants while still being a caring, attentive parent to the kids that one already has? I can TOTALLY see not thinking you'll be able to handle that. The only problem I see with these folks' decision (not that I think it's reason for them not to be able to make it, it's just something that makes my brain asplode) is that they seem to think it would be a different decision to make if it had happened naturally. That makes NO sense to me.

I mean, you're planning to complete the pregnancy anyhow, and the doctors have already said there is no health-related reason to abort one twin, so carrying the two to term is no huge deal.

I can't imagine any doctor, ever, saying that there is no increased medical risk in taking twins to full term as opposed to a single baby. Never mind in a high risk pregnancy - such as a 45 year old mom.
posted by antifuse at 11:11 AM on August 12, 2011 [3 favorites]


ethically okay for white people to have preferences for having one girl after a lot of boys...

Because one of these things does not lead to massive, crazy gender imbalances. It's sort of like the ethical difference between the person who chooses to hire a woman after hiring three men (and in this case we can say choosing the sex of your child really is choosing between equally qualified applicant) and the person who hires only one gender.

Selective abortions, leaving aside the person-hood issue, are not a bad thing. Many incurable genetic problems are currently treated with termination, and it's generally considered okay to say "I don't want to have the responsibility for the care of a child with Down's Syndrome". Furthermore, twins have a higher rate of health problems and shorter lifespans, and more babies, just like larger babies, will put an increased strain on the mother.

Hell, I am the "chosen twin" myself, in the sense that many millions of my father's sperm perished in my mother's uterine lining and en-route, and three out of four of her haploid proto-egg cells did not get the nutrients necessary to be an egg. It is possible to create a grisly narrative of parents picking one of two babies and tossing the other into an incinerator, but it is statistically possible the reason why you have no twin is because you "ate" yours. One of the many fates multiple implantations have is the active growth of one twin to the expense of the other, up to its death. Would you rather learn that your closest neighbour was terminated or that it was crushed and strangled by your equally valid right right to exist?
posted by Phalene at 11:14 AM on August 12, 2011 [2 favorites]


If you wanted a child and you already have children then twins might be more than you were expecting, but it seems odd to me that it qualifies as the end of the world.

It doesn't have to be the end of the world; it's just a situation they'd rather not be in, and as it happens there's a fairly efficient way to get out of it.

That seems okay to me, but I am a big supporter of reproductive rights.
posted by thirteenkiller at 11:15 AM on August 12, 2011 [1 favorite]


Sweet Christ, why is this even an issue? Pro-choice means pro-choice. These women are making a choice about their lives and their bodies. The hand wringing is nothing more than a different facet of the tried and true the-only-moral-abortion-is-my-abortion nonsense.

Uh, no. Millions of people have the right to vote. Am I not allowed to criticize how they vote because you'd perceive it as a "tried-and-true" effort to deprive people their suffrage?

Step down from the stage and ease your drama. Some people don't like what other people DO with their choices. It doesn't mean they think their right to choose should be infringed.
posted by eoden at 11:18 AM on August 12, 2011 [5 favorites]


The "just give the other baby up for adoption" line irks me to end. There is a woman's life and body in the equation, too; pregnancy and giving birth often ranges from unpleasant to downright life-threatening. I was lucky to have a relatively risk-free, normal pregnancy last year, until the sudden Zap! You Have Preeclampsia news, followed by an induction and forceps delivery. I'm not being hyperbolic when I say that I think my son and I would have died if it weren't for modern medicine (and having insurance to pay for said modern medicine). Women should absolutely always have a choice about carrying pregnancies to term, and if that choice is 4/2/1/0 babies, I'm grateful there's a safe, competent means of carrying it out.
posted by banjo_and_the_pork at 11:25 AM on August 12, 2011 [6 favorites]


Uh, no. Millions of people have the right to vote. Am I not allowed to criticize how they vote because you'd perceive it as a "tried-and-true" effort to deprive people their suffrage?

Step down from the stage and ease your drama. Some people don't like what other people DO with their choices. It doesn't mean they think their right to choose should be infringed.


I don't think that's a good analogy. To me, this feels more like giving millions of people the right to vote, the criticizing them for voting.
posted by thirteenkiller at 11:30 AM on August 12, 2011


I guess what would scare me when picking which fetus to abort, would be, am I aborting the ugly twin or the pretty twin? We all know there's always the good-looking twin and the slightly not so good-looking twin.
posted by Sweetmag at 11:35 AM on August 12, 2011 [1 favorite]


I don't think that's a good analogy. To me, this feels more like giving millions of people the right to vote, the criticizing them for voting.

Only on Metafilter would having an elective abortion be compared to exercising one's civic duty to vote.
posted by BobbyVan at 11:38 AM on August 12, 2011


Eoden, but that entire article was about whether reduction-to-singletons should be legal or available (which isn't the same thing, abortion is legal in all US States, but not, unfortunately, available in all states). This is something that happens, it posits, where does it stand as a moral or immoral action? Is it ethical? If some doctors think it's unethical, should they provide the procedure to women who want it? What do we feel should happen when women who want the procedure cannot find a doctor willing to perform it, despite the fact that those same doctors will reduce one-to-zero and multiples-to-twins? Isn't that policing a woman's motives for an abortion, and isn't that abhorrent to you, if you are pro-choice?

You don't need to be advocating from a pro-life position to be anti-choice. You do not need to be advocating at all for your opinion and judgement to nevertheless shape the choices available to women in the US. Reproductive rights in the US are being eroded every single day and part of that is due to the contingent of people who are "pro-choice, but..."
posted by lydhre at 11:38 AM on August 12, 2011 [2 favorites]


Only on Metafilter would having an elective abortion be compared to exercising one's civic duty to vote.

Well, I compare my right to an elective abortion to my right to vote and measure my status as a citizen accordingly. Can I still get an abortion if I want one? Can I vote? If the answer to both those questions is yes, then there's a chance my government still considers me a person.
posted by lydhre at 11:43 AM on August 12, 2011 [2 favorites]


Only on Metafilter would having an elective abortion be compared to exercising one's civic duty to vote.

I'm pretty sure that's not true, but I probably frequent different web communities than you do.
posted by muddgirl at 11:45 AM on August 12, 2011


I love that the pro-choice, pro-life (or anti-life, anti-choice; however you roll) lines have been drawn out in this thread. In the interests of something new and interesting, let me turn that line into a triangle!

With too many people living on the planet and with many of our economic, environmental, and social problems directly linked to, correlated with, or dependent on overpopulation, perhaps its just time to stop having babies. Just for a little while.

As a species, we don't have a mechanism for sensing a lack of resources. In fact, we do the opposite in many places, having more children when resources are scarce (but not non-existent) as a sort of social insurance policy in the future. More kids = better chance of being cared for as an invalid senior. Even lacking this drive towards long term financial security, having babies is trendy. You aren't going to fit into your new development/bohemian neighborhood/yuppy enclave unless you're carrying around an adorable shrieking banshee.

So, new platform slogan: what sick man sends babies to fight overwhelming global problems?

Back to the original point of the thread: if they have to use science to get pregnant, they might as well use science to try and avoid the horrible complications that will result because something was preventing you from naturally becoming pregnant.
posted by Slackermagee at 11:46 AM on August 12, 2011 [1 favorite]


I would just abort half of each and sew them together. It's what King Solomon would have done. I think.
posted by Eideteker at 11:57 AM on August 12, 2011 [4 favorites]


BobbyVan: " Only on Metafilter would having an elective abortion be compared to exercising one's civic duty to vote."

They're not all that different.

Why is voting a civic duty? The answer is important: it explains that both voting and the ability to choose to have or not have an abortion are ways that people control their own destinies.

You have a right to vote: to help elect people to public office (or deny it to others) and therefore have some control over who runs your government. Governments control most aspects of our lives. By participating in the election process, you help control how much influence they have over you. How much they can dictate how you live your life, what is proscribed to you and what is not.

Under US federal law, you (assuming you're a woman) have a right to have an abortion. This is a right that provides you with control over your own body. It provides you with autonomy, allowing you to live your life free of a certain aspect of government control.

Allowing women autonomy over their bodies and giving them the right to choose is a responsibility that is not dissimilar from voting. Both are symbols of freedom from oppression, and a preventing a regression back into a time when civil rights and the ability to choose one's fate were something to be yearned for, and not achieved.
posted by zarq at 11:58 AM on August 12, 2011 [5 favorites]


I can't imagine any doctor, ever, saying that there is no increased medical risk in taking twins to full term as opposed to a single baby. Never mind in a high risk pregnancy - such as a 45 year old mom.

That makes absolute sense, and that means the article is distorting things. It keeps making the point that many doctors say there is no medical reason to reduce a twin pregnancy to a singleton and that these reductions are being done for "social reasons." Since twin pregnancies are inherently more high-risk, then there is indeed a "medical reason" for the reduction in all these cases, and especially in "Jenny's" case since she's already high-risk for other reasons. I'm even more surprised that she is being used as the example of reduction-purely-on-demand and that her doctors aren't more sympathetic to her situation.

(And regardless, I'm 100% behind women who choose these reductions for whatever reasons.)

Also, to be clear, when I mentioned the adoption route, I was not talking about "abort a pregnancy vs. carry a pregnancy to term for purposes of adoption." I was talking about this specific situation: "carry a single pregnancy to term vs. carry a twin pregnancy to term and make one infant available for adoption." Those are two different conversations -- one about an unwanted pregnancy, period, and one about, for lack of a more graceful phrase, a spare embyro.
posted by FelliniBlank at 12:13 PM on August 12, 2011


From the article:

"Many doctors, including some who do reduction to a singleton, dispute Evans’s conclusions, pointing out that while twin pregnancies carry more risks than singleton pregnancies, most twins (especially fraternal) do just fine. Dr. Richard Berkowitz, a perinatologist at Columbia University Medical Center who was an early practitioner of pregnancy reduction, says: “The overwhelming majority of women carrying twins are going to be able to deliver two healthy babies.”"
posted by longsleeves at 12:32 PM on August 12, 2011


I don't think that it's fair to compare a 45-year-old woman with a history of reproductive problems to the majority of women who get pregnant with twins.

Unless Dr. Berkowitz was misquoted?
posted by muddgirl at 12:35 PM on August 12, 2011


I was unable to stomach the article after the first paragraph, so I stopped reading it. Then again I am a mother. I am a mother who is presently dealing with a health issue that may keep us from having more children.

Thank you for the link.
posted by BuffaloChickenWing at 12:39 PM on August 12, 2011


I guess what would scare me when picking which fetus to abort, would be, am I aborting the ugly twin or the pretty twin?

Abort the one with the goatee. Duh.
posted by eoden at 12:42 PM on August 12, 2011 [1 favorite]


But longsleeves, that's just it - the pregnancy still carries extra risks. Period. The babies will (hopefully) most likely come out healthy, but there's a definite increased risk to the mother. This is not something to take lightly. I had a friend who was put on bed rest something like 8 or 10 weeks before her due date. The babies came early (as they are wont to do, with twins), but she was still on bed rest for 4 or 5 weeks.
posted by antifuse at 12:47 PM on August 12, 2011


Right now in thevHorn of Africa, women are having to decide which of their already born children they can keep on the long, hot walk in a drought afflicted desert. This us a drought so bad it is killing camels, an animal well adapted to deserts.
I cried reading today's local paper because I know these women have had to figure out which of their children stands some chance of survival and which will likely die.
The desert there has many hyenas. Hyenas do not wait until whatever they find to eat is dead.
So there are in times of such hardship some terrible choices for women.
Personally, I don't like artificial means of reproduction. The earth is full of people who can't feed themselves. All the same it is not my personal business what someone else does about becoming a parent or not. It really does need to be between a woman and her doctor.
I would rather see society be more supportive of women having their children during the prime childbearing years. Waiting until 35 or 40 or past menopause is not healthy. That is just how human bodies are made. Eggs are not as good and neither is sperm past a certain point in life.
posted by Katjusa Roquette at 12:48 PM on August 12, 2011 [5 favorites]


When she's old enough to even understand pregnancy and twins, I will ask my daughter if it was the evil twin that died; or if she is in fact The Evil Twin, who killed her sibling in utero. But only when she misbehaves

Ah you joke about this but that is, in fact, what my grandparents told my dad-- that He. Killed. His. Brother. (by taking too long to be born.) Thankfully those evil fuckers (my grandparents) are now both dead.

I suppose if I had had enough money I would have tried some artificial means of getting pregnant at 45. I have one child from a previous marriage and my second husband has no children at all. I sometimes feel bad that I married him and because of our age difference gave him no chance of ever having children. Too late now. But the heart wants what the heart wants, and I would have dearly loved to have a child with him even though I would have been a very old mommy.
posted by Secret Life of Gravy at 12:58 PM on August 12, 2011 [2 favorites]


I am truly horrified and disgusted by these parents. It never occured [sic] to them that instead of going through fertility treatment and then terminating (this is a polite way of putting it) a featus they themselves have willingly brought to life, they could actualloy [sic] adopt a child in desperate need of parents and a home?

Give me an effin' break, TraumaT. What about the 'child in desperate need of parents and a home' that's already been born? We need to make more of them??? Of course, they'd most likely be vanilla and all, since they've been custom ordered, and so are more adoptable.

Let's worry about real children, suffering in real time, not undifferentiated cells.



Part of my belief in reproductive freedom means allowing for the fact that people might make different choices than I'd make.

Clear and succinct. Thank you padraigin

I'd have stated it in a rather crass fashion: Get the fuck out of my uterus and my life, and I'll stay out of yours. (Even if I'm not so excited about fertility treatments to engender kids.)
posted by BlueHorse at 2:09 PM on August 12, 2011 [1 favorite]


But longsleeves, that's just it - the pregnancy still carries extra risks. Period. The babies will (hopefully) most likely come out healthy, but there's a definite increased risk to the mother. This is not something to take lightly. I had a friend who was put on bed rest something like 8 or 10 weeks before her due date. The babies came early (as they are wont to do, with twins), but she was still on bed rest for 4 or 5 weeks.
posted by antifuse at 3:47 PM


I hope over the years she reminds them both of the inconvenience they caused her.
posted by longsleeves at 2:32 PM on August 12, 2011


I second those who said that if you are pro-choice, you should theoretically (at least) support people making whatever decision is right for their family.

Though I'll admit that I do find the idea of aborting 1 of 2 twins to be horrifying, mostly because of what we hear from twins about the special twin bond they often have (even if they aren't identical). I'd be goddamned horrified to find out that my parents had aborted a twin of mine, especially if I wanted one as a kid or whatever. It seems like the people who did have a twin who died in utero/young seem to "know" somehow, don't they? I'd feel horrendous guilt at doing that to my remaining kid. And I'd hope to god they never found out, but in this day and age the kid totally will find out.
posted by jenfullmoon at 2:40 PM on August 12, 2011 [1 favorite]


Maybe if one twin dies in utero the parents should just abort the other one, to save them the "special pain."

It's already been stated that identical twins can not be selectively reduced - only fraternal, and IME very few fraternal twins claim any special bond (since, you know, they're basically just regular siblings). Or something. Personally, I'm glad my mother aborted my (granted: older, not fraternal) siblings - otherwise I wouldn't be alive at all.
posted by muddgirl at 2:43 PM on August 12, 2011 [1 favorite]


I mean, any special bond beyond being raised together, but if one is selectively aborted then that won't occur, will it?

It's always kind of freaky to find out your mom had other kids that she decided to abort, but in my case I was grateful that she chose to wait for a stable, loving family situation.
posted by muddgirl at 2:44 PM on August 12, 2011


You know, actually, seriously, I think I insist on it: If you are against this then I want to know if you are generally pro-life

Very well, since you insist, or at least think you do, I consider abortion a very sad thing and that should be legal, if for no other reason than people will do it in large numbers anyway and technological knowledge will be available to do it if you want to.
posted by longsleeves at 3:11 PM on August 12, 2011


This was an amazing read because it's forced to me to consider something that I'd never really faced before: This could happen to me, and no matter what I chose, someone would insist that I had made the wrong choice. And some would say I was selfish, for choosing either way.

My older sister has identical twin girls. They're natural, because that's the first thing so many people ask her, usually in a whisper. Like seriously, she's a waitress and her husband is a restaurant manager and people think first about fertility treatments?

Anyway, my sister had a remarkably easy twin pregnancy, she waited tables until she was 32 weeks along or something crazy like that. Maybe even 34. Seriously, it was crazy. They were born in the spring, but pretty much as soon as she saw the twins on the ultrasound she was being told that completle bedrest by Christmas was in the cards. Not likely, not maybe. The doctor was saying, you're tiny (I think she's 5'2"?), these kids are going to mess you up. You'll be living in bed by Christmas. She was nervous terrified. Diabetes, blood pressure, birth, just so many horrific statistics.

Thankfully for her, it wasn't true. Her tiny family needed that money, and as she said, the pity tips were awesome. I guess around 5 months she looked like she was going to burst, and it just got more inspiring from there.

I'm taller than she is, but narrower, and my height is all legs. If I find myself pregnant with twins in the future, her experience will make me think twice about keeping both. Don't get me wrong the kids are cute. They're gorgeous. Smart, funny, they love each other.

I guess I'm telling you all this to say, I get it. Having twins is not in my best case scenario, but it seems to be in the genes. And as they say, before helping others with their oxygen masks, make sure your own is secured.

“The overwhelming majority of women carrying twins are going to be able to deliver two healthy babies.” While that is great, I am in the overwhelming minority that has been underweight nearly my entire life. I've never had any reason to ask my ob/gyn this question, but maybe at my next well woman visit, I might. "Hey doc, twins run in my family. If I find myself in that boat, knowing what you do about my health history, should I consider selective abortion?" Obviously, if they're also identical that's not an option. It's a strange thing to be thinking about, since I'm currently so far away from even considering becoming pregnant. But, it's important to know that there are people who can help me make that decision if it ever becomes necessary.
posted by bilabial at 3:13 PM on August 12, 2011 [3 favorites]


Metafilter: No matter what I chose, someone would insist that I had made the wrong choice. And some would say I was selfish, for choosing either way.
posted by muddgirl at 3:30 PM on August 12, 2011 [6 favorites]


Yes, but only if you're a chick.
posted by thehmsbeagle at 3:38 PM on August 12, 2011 [2 favorites]


“The overwhelming majority of women carrying twins are going to be able to deliver two healthy babies.”

Well, since there's no way of tracking every pregnancy that spontaneously aborts, this is a hard assertion to prove or disprove.
posted by Mental Wimp at 3:39 PM on August 12, 2011


I want an explanation of what you believe the fundamental ethical difference is between a person who makes a choice with known consequences (sexual activity) and has an elective abortion because they find having a child incompatible with their personal life choices and someone who makes a choice with known consequences (IVF and/or other infertility treatments) and has an elective abortion because they find having two or more children at once is incompatible with their life choices. I genuinely find this position logically incoherent.

I'm guessing that not everyone sees ethics always as a 100% black and white logical matter.

Difference here may be that in in case one there was no desire for a pregnancy at all and in case two there was.

So it's pushing an already uncomfortable ethical line. Take all you want, but eat all you take sort of thing, and no backsies.
posted by IndigoJones at 3:56 PM on August 12, 2011 [1 favorite]


I might have missed something in the article - but why can't identical twins be selectively reduced?
posted by sawdustbear at 4:05 PM on August 12, 2011


They share a placenta, which you don't want contaminated with the remains of the reduced twin.
posted by bilabial at 4:07 PM on August 12, 2011


“The overwhelming majority of women carrying twins are going to be able to deliver two healthy babies.”

Well, since there's no way of tracking every pregnancy that spontaneously aborts, this is a hard assertion to prove or disprove.


Not to mention, "healthy baby" is a pretty mushy concept. As far as the delivery hospital is concerned, pretty much every baby that goes home without oxygen or a feeding tube or a diagnosed disorder of some kind is going to be considered "healthy". A lot of NICU kids develop their serious problems months or years down the line.
posted by gurple at 4:12 PM on August 12, 2011 [1 favorite]


I hope over the years she reminds them both of the inconvenience they caused her.

Yes, 4-5 weeks of basically never being able to leave her bed, filled almost exclusively with worries about the health alternately herself and her babies, was an "inconvenience". Not to mention the lost income of not being able to work, which was kind of a seriously big deal.

I'm not saying this happens with every twin pregnancy, but it definitely is more common with twins than with singletons. So to say that there's "no medical reason" to abort one fetus in a twin pregnancy is kind of... Silly. It astounds me that there's doctors who would seriously say that - and I'm not convinced there are, actually - the quoting in the article seems to conveniently sidestep the issue of complications, simply quoting doctors as saying "Sure, the babies will most likely come out healthy a majority of the time" - which is true. Usually, the babies come out fine. But that doesn't mean that the pregnancy isn't more risky.
posted by antifuse at 5:00 PM on August 12, 2011 [2 favorites]


But I also think changing/breastfeeding at the table should be illegal, so....

Excrement at the table, yes, is disgusting, and possibly a health hazard, but breastfeeding at the table should be illegal...? For fuck's sake, why? This must be a strictly American hang-up, but I grew up in America, and a woman breast-feeding her baby is just not an issue at all... does it disgust you, and why?
posted by Huck500 at 6:55 PM on August 12, 2011


they could actualloy adopt a child in desperate need of parents and a home?

Really? Why is this always put out there when any type of fertility issues are discussed. Try adopting. Come up with the money, deal with the stress, hope and pray someone chooses you, and that your home study is approved, then wait, and hope the woman won't change her mind after you have spent all that time, money, stress, and fear.

Adopting is not easy, it is expensive, it is hard on you, it takes time, and you don't always end up with a child in the end. I would love to adopt, we have wanted to adopt for years and years, yet here I sit at 36 years old, still childless. It isn't nearly as easy as people think it is.


As far as the original issue, I don't understand how anyone can be pro-choice and have the reactions many people are having here. I am pro-choice and believe it is the woman's right to decide whether or not she carries one, two, three, or no fetuses to term.
posted by SuzySmith at 7:04 PM on August 12, 2011


But I also think changing/breastfeeding at the table should be illegal, so....

Breastfeeding illegal at the table? Where should babies eat? We eat at the table, oftentimes there will be cow's milk in a glass, but, that is less disgusting than breastmilk?
posted by SuzySmith at 7:05 PM on August 12, 2011


I might have missed something in the article - but why can't identical twins be selectively reduced?

bilabial: They share a placenta, which you don't want contaminated with the remains of the reduced twin.

Further details: 75% of monozygotic (identical) twin pregnancies are monochorionic, meaning they share a placenta. The other 25% are mostly dichorionic diamniotic, which means the placenta split into two very early in the first trimester, and each twin has its own placenta and amniotic sac. MoMo twins are monochorionic and monoamniotic, meaning they share an amniotic sac and a placenta. MoMo's are a rarity.

The body typically reacts to the death of a fetus in utero by miscarrying. To prevent this, selective reduction involves removing the amniotic fluid that supported the reduced fetus in order to reduce decay. Interestingly enough, the higher in the uterus the selective reduction is, (the further away from the cervix it is) the less likely it is to cause a miscarriage.

For the 75% of monozygotic monochorionic twins:

With a shared placenta, it is more likely that the decay will still contaminate the shared placenta. This can cause placental tissue to die off, or it can contaminate the shared circulatory system within the placenta and affect the surviving fetus. It is also more likely that this will trigger a miscarriage.

For the 25% of dichorionic diamniotic monozygotic twins:

Selective reduction is typically no different than with fraternal twins.

My understanding is that you cannot reduce a MoMo pregnancy to a singleton. The amnion that supported the reduced fetus needs to be siphoned off lest it promote decay, and that cannot happen when another fetus is relying on it for survival. I may be wrong about this.
posted by zarq at 7:25 PM on August 12, 2011 [1 favorite]


But that doesn't mean that the pregnancy isn't more risky.

To an American OB/Gyn or a perinatologist, twin pregnancies are automatically considered high risk. They are usually given more scrutiny for that reason. .
posted by zarq at 7:29 PM on August 12, 2011


nanojath: "My growing suspicion is that pro-choice individuals who think the situation described in this article is ethically different than any elective abortion not made for medical necessity or because the pregnancy was the result of non-consensual sex are basing their opinions on emotional reactions to various conception/pregnancy/birth narratives and have no ability to logically defend their opinions. I've seen nothing so far here to make me doubt this suspicion."

And? So what? Ethics and logic are two different things. You could make a sound logical argument for Eugenics and forced sterilization of the mentally handicapped (and we did), but that doesn't make such an abhorrent practice morally ethical.

You seem very combative about this; really, you "insist" on explanations? No one here owes you an explanation. I am sure you'd be very upset if a woman had to defend why she made the choice to abort (and rightfully so). Why should anyone who doesn't feel exactly as you do have to defend their opinion?

Personally, I support a woman's right to choose, even when I don't agree with her choice. I also think I have the right to say how I feel, though*, and I don't give a damn whether you agree with me or not.

*For instance, I think a 40s-something woman with kids already who has to go through fertility treatments just to get pregnant again might want to consider that she had her chance already and maybe let it go.
posted by misha at 8:52 PM on August 12, 2011 [4 favorites]


Bilabial: "It's forced to me to consider something that I'd never really faced before: This could happen to me, and no matter what I chose, someone would insist that I had made the wrong choice. And some would say I was selfish, for choosing either way."

That description (could happen to me, people will be harshly morally judgmental whatever I choose) applies to just about every major decision in a woman's life, as the discussion of this article shows. Get married young, someone will say you're an undereducated golddigger looking to live off a man, get married later, someone will say you were a selfish slut who partied through her 'best motherhood years." Don't get married (or don't marry a man), and you're actually bringing society to it's knees for your own selfish desires.

Have kids young, you're a barefoot-and-preggers future welfare queen. Have them later, you're the above spoiled slut plus an unfit mother. Don't have them at all, you're a super-selfish slut and a sign that the society you're in is about to collapse solely because of empty-headed partygirls like you.

Have children the old-fashioned way at the old-fashioned time, and people will whisper that you can't possibly afford them, are therefore doing a bad job raising them, and should have at least waited until your 30s, or that you are wasting your education on drudgery and are an ungrateful daughter to the parents who provided it. Adopt children, and people will say you are an imperialist, praying on the poor or those of another ethnicity or those in other countries to get what you want, too lazy to find a man to knock you up, looking to buy a toy instead of a "real" child, setting the child up for a terrible trauma later, or are desperate to repent from the wasted time of your youth with a 'substitute baby." Have fertility treatments, people will say you waited too long (selfish slut again), spent too much energy on your career and are now trying to 'buy a baby' with the money you made, and...well...look upthread at how many posts devolved into what I will now, for the rest of eternity, recognise as Kal-el's Law (Thanks, griphus!)

Etc. etc. etc. The ridiculous judgements are all over the place. Natural delivery or Cesarian? painkillers or not? Breastfeeding or not? Sling or stroller? Leave a battering spouse or not? Leave a spouse you don't love or not? Get left by a spouse or not (taken to be your decision, don'tcha know?) and on and on and on. Most of this judgement, btw, comes from other women, often women who either had fewer choices or made different ones they are now trying to justify to themselves as the 'only right answer.'

The good news for all of us is that - armed with the knowledge that in certain people's eyes we can do no right, and that a good many people will feel free to condemn us, to our faces (or question us about intimate matters like the conception of our kids, with intent to judge) whatever we do...we can just choose to proceed as we see fit.

Tl;dr : There's no way to avoid this garbage, so it's best to make decisions as if it didn't exist.
posted by Wylla at 12:51 AM on August 13, 2011 [22 favorites]


yay, babies as consumer products!

nanoJath: I agree with misha. I'm pro choice and think that FelliniBlank raises a good point saying the reporter chose a pretty provocative and outlier "representative" example in Jenny.

I think the parents in this are selfish, and abhorrent. I don't think its reasonable(medical reasons excepted) that a couple going through IVF because they can't concieve would reject having two rather than one except in the case of "hey, we've got 4 already, we just wanted one more"

Comparing this with, the "lets have sex .. oops... abortion" ethic is illogical, both have an element of self in them, but thats not enough to draw the parallel. I am lucky enough not to know anyone who uses abortion as a frontline method of birth control - maybe there are, but I'm glad I don't know them.

So, everyone gets the choice, but I know its not a choice I could ever agree with.

but, hey isn't it great the iPhone now comes in white?
posted by fistynuts at 6:39 AM on August 13, 2011


Breeders gonna breed.
posted by sneebler at 7:26 AM on August 13, 2011 [1 favorite]


I was pro-choice before becoming pregnant. Every day I am pregnant I become more pro-choice, which I didn't think was possible.

My husband and I love our unborn fetus. We're excited. We had been trying for almost a year when we became pregnant with this child. We were ready and willing and trying to have a baby.

And yet, as ready as we thought we were; its hard. It is so fucking hard.

The 27/4 exhaustion. Nausea with certain smells. Inexhaustible hungry when absolutely nothing sounds good. Sex drive hitting an all time rock bottom. Mood swings like nothing I have ever felt before. Bawling my eyes out from utter depression, crying because I am so happy, screaming angry bitterness solely due to hormonal fluctuations.
Having to worry about all the things I can do to fuck up my baby before its even born. Have to remember to take vitamins and eat right. Everyone knows your supposed to avoid sushi and wine, but did you know you also are supposed to avoid lunchmeat, soft cheese, caffeine, too much tuna, sprouts and a million other things? And then you get into internet arguments with people about whether or not you actually need to avoid all those things. If you avoid them, you're overprotective and paranoid but if you have a glass of wine or a cold cut sandwich every now and then, you're ZOMG risking your baby's life!!!
And the judgements start way before you even give birth! Are you planning natural or medicated birthing plan? Breastfeed or formula? Cloth or disposable? Stay at home or daycare?
Just remember whatever you choose, everyone else thinks you're a terrible parent because of your choice!

From everything I've researched on twins, adding another fetus to the mix isn't a two for the price of one deal. The symptoms of pregnancy are often magnitudes stronger. In the US twins are automatically considered high risk. Often they are born early. Carrying multiples multiplies the risks!


To get to my point, we wanted our child. Its just one child and I have the world's best husband AND ITS STILL CRAZY HARD! No woman should ever have to be forced to stick with a pregnancy or multiple pregnancies if they choose not to.

The 16 year old who had no idea what she was getting into. The 23 year old who wants to be in a better position before having kids, the 34 year old with 3 kids already who doesn't have the financial/mental/physical resources for another kid, the 45 year old who's kids are all off in college already and didn't expect to get pregnant again. The ones trying for a baby with medical assistance who, for the health and safety of themselves and the baby they so desperately want, choose to reduce down to one so they can give that one the best chance possible. No woman should ever have to be forced to stick with a pregnancy or multiple pregnancies if they choose not to.
posted by HMSSM at 1:20 PM on August 13, 2011 [7 favorites]


I was pro-choice before becoming pregnant. Every day I am pregnant I become more pro-choice, which I didn't think was possible.

Same here. Pretty much echoing the whole comment.

Also: as for the sentiment upthread for people having kids because it's "trendy" - I was married to someone with the same idea that the world is too overpopulated as is and perhaps adding more kids is a bad idea. And I tried, so hard, to make that marriage work despite my own desire for kids. And it didn't work. At all. Trying to sublimate that part of myself literally drove me insane. I did crazy, crazy things to the point where I didn't even recognize myself. I felt wracked with grief over the children I would never have. The urge to be a mother was so strong that I would very often just weep when thinking about the fact that to make my marriage work, I wouldn't be able to have a child.

I have a son now. Perhaps it's selfish. Perhaps it's fulfilling the mammalian impulse to continue the species. In any case, I finally feel complete for the first time in my adult life. I'd like to have more kids some day, but even if I don't, I'm ok with that. Being a mother was the only thing that I wanted to do with my life and actually being able to do it feels like an incredible gift.

You may not understand it, but some people do indeed feel an urge to be a parent that simply can't be ignored or quenched with any number of "rational" arguments to the contrary. I respect anyone's rights not to have kids and I would appreciate it if my own rights to have a family in the way that makes sense for me weren't rejected out of hand as "trendy."

I will, however, admit that sometimes my child is an adorable banshee.
posted by sonika at 4:24 PM on August 13, 2011 [6 favorites]


I will, however, admit that sometimes my child is an adorable banshee.

That's the best kind of banshee.
posted by madcaptenor at 6:10 PM on August 13, 2011


I was pro-choice before becoming pregnant. Every day I am pregnant I become more pro-choice, which I didn't think was possible.

Yes, yes, yes! I thought the same thing a thousand times while pregnant.
posted by banjo_and_the_pork at 6:37 AM on August 14, 2011 [3 favorites]


I was pro-choice before becoming pregnant. Every day I am pregnant I become more pro-choice, which I didn't think was possible.

FWIW, my wife and I are currently having the opposite experience.
posted by BobbyVan at 3:01 PM on August 14, 2011


To explain, we were squishy pro-choicers before my wife became pregnant... We're still pro-choice (barely), but I can't tell you the number of times we've looked at each other and said, "I can't imagine anyone wanting an abortion." Obviously our views are colored by the fact that our child is going to be born into a loving family... but when you look beyond the pro-life/pro-choice battle over language and politics, there's something that we find more than a little repulsive when it comes to the cavalier and selfish reasoning behind some people's decisions to abort.
posted by BobbyVan at 3:08 PM on August 14, 2011


It's also possible that you and your wife suffer from a dearth of imagination.
posted by muddgirl at 4:03 PM on August 14, 2011 [3 favorites]


We're still pro-choice (barely), but I can't tell you the number of times we've looked at each other and said, "I can't imagine anyone wanting an abortion." Obviously our views are colored by the fact that our child is going to be born into a loving family...

Well, yeah. My child was born into a loving family, too. Couldn't BE more loving. We could out love you any day of the week.

Which is part of what colors my own views. Pregnancy is HARD. Taking care of an infant is HARD. And we were prepared. We were as prepared as people get. There were spreadsheets detailing how we would pay for baby related expenses and how long I would have to work to save up enough to *stop* working when the baby was born. We had our own mothers help us for two solid months.

And, guess what. STILL HARD.

How hard must it be for someone to be pregnant unexpectedly? How hard must it be to be pregnant without a partner? How hard must it be to be pregnant without health insurance? How hard must it be to be pregnant without a job? How hard must it be to be pregnant without a partner, without health insurance, AND without a job? How hard must it be to be pregnant with other children to take care of and no extra resources for another one?

Yeah, I love my son more than life itself and can TOTALLY imagine why someone might not feel like going through pregnancy is the best choice.
posted by sonika at 5:30 PM on August 14, 2011 [5 favorites]


... can TOTALLY imagine why someone might not feel like going through pregnancy is the best choice.

after IVF?

I don't see many above who are not pro choice, I don't think that is what we are discussing, is it?

But I guess these are the same kind of people who order a 700 gram steak and then eat half - spoilt and priveledged.

I think thats what bothers me most - the lack of respect and humility
posted by fistynuts at 5:05 AM on August 15, 2011 [1 favorite]


after IVF?

I don't have kids, have never been pregnant. But I think this is pretty easy to answer! Partner leaves you. Job loss. Health insurance evaporates. Illness. Death of partner. The fetus(es) aren't viable. Severe birth defects. The child you already have develops problems. Somebody gets maimed.

And because I'm so rabidly pro-choice, the simple words "I changed my mind" would be sufficient. In fact, I wouldn't have the balls to ask why, because frankly, it's none of our business.

If I support abortion for victims of rape, incest, poverty, or any other verifiable hardship, then I am unable to support forcing a woman to birth a baby she does not want. There is a growing body of evidence to support the notion that adoption is very very hard on birth mothers. Harder, it seems, than abortion. (as a generalization and statistically! Of course there are some mothers who have blissful birth and adoption stories, and abortions that are fraught with emotional turmoil and lead to decades long grieving)

But I guess these are the same kind of people who order a 700 gram steak and then eat half - spoilt and priveledged.

What? Sure, if the steak turns out to be rotten (well, that's a terrible analogy, I know.) Or if the my dining companions leave me at the table telling me they'll never dine with me again, whether I finish the steak or not. Or if I'm suddenly, you know, sick to my stomach, get a migraine or start having seizures. Or if finishing that 700 gram steak could kill me. Or if it turns out that the 3 or 4 appetizers I ate before I got the steak turn out to have taken up more of my energy and resources than I expected. Ya, I might not finish a 700 gram steak.

Really. You just compared a baby to a steak. I had to take that into the absurd. Listen, there is little evidence that anything like a majority of abortions are performed for frivolous reasons, and somewhere between 30 and 60% of women who have an abortion already have a child at home. So, if allocating the resources of your family to adequately care for yourself and your loved ones is a sign of being spoilt, I'm all for it. Are you aware of the dearth of prenatal care in America? Aware of the infant and maternal mortality rates that we boast here? This is a pretty terrible place, actually, to be having a baby. But regardless of where a woman lives, if she doesn't want to have a baby, I don't give a rat's ass how she got pregnant, she should be able to safely and legally terminate a pregnancy with dignity.
posted by bilabial at 11:35 AM on August 15, 2011 [5 favorites]


Who cares if it's frivolous? A fertilized egg is not a baby. A woman can do whatever she wants with her body, frivolity included.
posted by ODiV at 12:30 PM on August 15, 2011


Since we're arguing semantics, at 14 weeks you've got a fetus, not a fertilized egg.
posted by litnerd at 1:49 PM on August 15, 2011


Right, sorry. Didn't connect it back to the original timeline obviously.

Still not a baby (or a steak).
posted by ODiV at 2:28 PM on August 15, 2011


I compared the people ... not the baby/steak.

I don't see many above who are not pro choice, I don't think that is what we are discussing, is it?

Partner leaves you. Job loss. Health insurance evaporates. Illness. Death of partner

was having IVF to have children ...but yet you still want to have 1 ...

The fetus(es) aren't viable. Severe birth defects.

medical

The child you already have develops problems.

in the 20 week window between you having ivf and the abortion ... and you are still deciding to keep one?

You can't keep a consistent goal in your head for 30 weeks and think it is a good idea to try to have a child in the first place?

Somebody gets maimed.

but yet you still want to have 1 ...

Besides, none of this is what is addressed in the original article, which is specifically about selective, and is what we were trying to discuss until the "you can't tell me what to do" party turned up

In fact an abortion is probably the best thing for the cells given the future crap they would have to put up with, with parents like this.

You know, you've made me reconsider my viewpoint, maybe it's the one they decide not to abort that I should be feeling sorry for.
posted by fistynuts at 3:59 PM on August 15, 2011


but I can't tell you the number of times we've looked at each other and said, "I can't imagine anyone wanting an abortion."

You, you, you, it's all about you. I really hope there is somebody else in your child's life to teach them empathy.
posted by Secret Life of Gravy at 4:23 PM on August 15, 2011 [2 favorites]


[Couple comments removed, I know this is a difficult subject but we need to stop short of just saying "fuck you" to each other.]
posted by cortex at 6:53 AM on August 16, 2011



Slate: Why do "reductions" of twin pregnancies trouble pro-choicers?
Across the pro-choice blogosphere, including Slate, the article has provoked discomfort. RH Reality Check, a Web site dedicated to abortion rights, ran an item voicing qualms with one woman's reduction decision. Jezebel, another pro-choice site, acknowledged the "complicated ethics" of reduction. Frances Kissling, a longtime reproductive rights leader, wrote a Washington Post essay asking whether women should forego fertility treatment rather than risk a twin pregnancy they'd end up half-aborting.

posted by zarq at 8:09 AM on August 16, 2011


fistynuts: " You can't keep a consistent goal in your head for 30 weeks and think it is a good idea to try to have a child in the first place?"

You get that this isn't at all an easy decision for most parents, yes? That it's not something most parents take casually and that there are a lot more risks involved than having an outright abortion, both to the mother and the remaining fetus? That selective reduction can quite literally cause a miscarriage, either during the procedure or during the weeks after. And that most of the time, women who have this procedure have already had several needles in their uterus to check for genetic disorders -- each puncture from which carries a certain amount of risk.

I've interviewed a number of women who went through selective reduction because they were pregnant with triplets or quadruplets and were required to reduce for medical reasons. It was an agonizing, guilt-ridden decision for them. One that many of them did not get over easily. Especially if the reduction had caused a complete miscarriage.

We are a culture that worships motherhood, parents and families. When one is told that they are infertile, it can be a pschological blow. Some handle it better than others. But in a culture where jokes are made routinely about barren women and impotent men, there's often a great deal of humiliation that goes with learning that one can't have children.

People who go through infertility treatments to get pregnant are invested to a far greater degree than those who haven't required intervention. Infertility treatment requires more than simply making a medical appointment. They have often gone to multiple doctors, been poked, prodded and subjected to invasive and possibly even embarrassing medical procedures and diagnoses. They have self-injected hormones in order to counter their own body chemistry, and then perhaps have endured repeated attempts and failures.

Imagine then for a moment how conflicted someone who has dealt with all of that might feel about reducing a pregnancy. Either for economic reasons or medical ones. How agonizing such a decision might be for them to have to make. Ask their OB's and perinatologists how many of them weep while having their hard-won pregnancy reduced. And how many of them require therapy afterwards to come to terms with what they've done.

Feel free to have no compassion for their situation. Personally, I think they deserve as much as we can give them.
posted by zarq at 8:32 AM on August 16, 2011 [1 favorite]


Slate: Why do "reductions" of twin pregnancies trouble pro-choicers?

I think it's fine to be "troubled" about a decision someone you know might make, even though it only affects them. Just like it's okay to be "troubled" about the extensive cosmetic surgery some choose to undertake. But in the end, it is a personal decision that should be recognized as such and never, ever should strangers undertake to scold or cajole an individual regarding her choices in such personal matters.
posted by Mental Wimp at 8:37 AM on August 16, 2011 [2 favorites]


Zarq:

I don't disagree, it was noted that the original article chose a pretty atypical example.
My feeliing is the time for making these decisions is before having IVF, not after, this is after all a probable consequence.

Like the question, "What if we get pregnant?" changes behaviour of even the drunkest couples, so the risk of "IVF might mean twins" means "we need to decide about selective reductions now." If my partners response to the drunken question is "Oh, I'll just have an abortion", rather than "I'm on the pill/I have protection/etc" then I'm pretty sure I'd balk. I get that not everybody would ... that wouldn't make me respect or feel compassion for them, there are plenty of stupid people in the world.

All the post IVF success hand wringing you portray, makes me think nobody had thought this might happen to them.

My comments been drawn into something more confrontational by some elements, so I apologise for that.

I feel compassion for anyone who doesn't have children who needs to go through IVF to have them - I feel much less for anyone who already has a child/children, and still *wants* IVF (although there is always room for exceptions)
posted by fistynuts at 9:05 AM on August 16, 2011


Like the question, "What if we get pregnant?" changes behaviour of even the drunkest couples

Not always, unfortunately. :(
posted by ODiV at 11:57 AM on August 16, 2011


I think the parents in this are selfish, and abhorrent. I don't think its reasonable(medical reasons excepted) that a couple going through IVF because they can't concieve would reject having two rather than one except in the case of "hey, we've got 4 already, we just wanted one more"

Well, in the case of this couple, their reason was "We don't think we can give the amount of attention that two infants require, and still be good, attentive parents to our current children" - is that selfish? Or realistic? Infants are a LOT OF WORK. Trying to care for TWO infants, at the same time, while trying to keep up with multiple school aged children? If you KNOW that this is something that you're not capable of, why not reduce? It's win-win for everybody, except the reduced fetus of course.
posted by antifuse at 10:49 AM on August 17, 2011


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