September 25, 2022

The gut-wrenching dilemmas of “foetal reduction”

Foetal reduction is the dark side of the moon of fertility treatment. All too often women who become pregnant have twins or triplets. Since this involves medical and social risks, one or more of the foetuses are “reduced”, ie, aborted. It is a procedure which few outside the industry are aware of. Freelance journalist Ruth Padawer has just written a feature in the New York Times Magazine shedding light on its bioethical dilemmas.

Foetal reduction is the dark side of the moon of fertility treatment. All too often women who become pregnant have twins or triplets. Since this involves medical and social risks, one or more of the foetuses are “reduced”, ie, aborted. It is a procedure which few outside the industry are aware of. Freelance journalist Ruth Padawer has just written a feature in the New York Times Magazine shedding light on its bioethical dilemmas.

About 5-20% of pregnancies from fertility drugs are twins or higher, according to the American Society for Reproductive Medicine, and half of babies conceived using through IVF are part of a multiple pregnancy.

“For all its successes,” writes Padawer, “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 mega-pregnancies, terminating all but two or three fetuses to lower the risks to women and the babies they took home.”

But now foetal reduction is being offered for social reasons — as an option for women who could not stand the stress of having twins.

 “…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.”

William Saletan, who writes in the online magazine Slate comments on the “queasiness” and “misgivings” of doctors and patients over foetal reduction, which raises weighty questions about abortion itself.

“It combines, in a single pregnancy, a wanted and an unwanted fetus. In the case of identical twins, even their genomes are indistinguishable. You can’t pretend that one is precious and the other is just tissue. You’re killing the same creature to which you’re dedicating your life.

“Sophie’s Choice is a common theme in abortion decisions. To give your existing kids the attention and resources they’ll need, you have to terminate your fetus. This rationale fits the pro-choice calculus that born children are worth more than unborn ones. But in the case of reduction, the child for whom you’re reserving attention and resources is equally unborn. She is, and will always be, a living reminder of what you exterminated.” ~ New York Times, Aug 10; Slate, Aug 1 

Jared Yee
abortion
fetal reduction
IVF
US