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Is the Rise in Terminating Half of a Twin Pregnancy OK?

twin pregnancy, triplets

Is it OK to only carry one twin full term?

For women who have had trouble conceiving, finally getting pregnant can feel like their one shot at having kids. Their friends and family secretly feel that, too. So when the news comes that its twins, it feels like a bonus. Perfect even, since if one kid for a woman or couple desperate to make a family is good, then two is even better.

But two isn’t always better, as readers of The New York Times Magazine learned. There are people who have gone to great expense and discomfort, both physical and emotional, to get pregnant and when the wound up with twins decided to go through with one and terminate the other.

As with any discussion surrounding abortion, the article caused quite a stir. But what has been interesting is that many of the commenters who disapprove of so-called “selective reduction,” which is aborting some but not all fetuses in a multiples pregnancy, describe themselves as “totally pro-choice” or “adamantly pro-abortion.” In other words, it should be legal to terminate an unwanted pregnancy wherever they occur except when there’s also a wanted pregnancy sitting in the very same womb.

Babble’s own Baby Squared, Jane Roper, mother of twins conceived with the help of fertility drugs, gave her take on selective reduction in twin pregnancies. She’s hardly telling other women what to do, but says this:

It was, naturally, difficult not to project my feelings and experiences as a mother of twins onto the women I read about in the article. (Who, let’s remember, weren’t mothers of twins when they made their decisions; they were women carrying two fetuses). I had a hard time sympathizing with their decisions. I found it especially difficult to understand how people who entered willingly into fertility treatments  could justify reducing a twin pregnancy. To me, that’s one of the chances you take. And, assuming it’s not a major risk to your health or the children’s, then you should go ahead and have those two babies.

Both Jane and the NYT piece point out that few people argue with women who reduce triplet, quadruplet and more pregnancies. Health risks to both mother and child are much greater in higher order multiples. It’s the same math when reducing a triplet pregnancy to a twin one, and a twin pregnancy to a singleton. So why all the moral hand-wringing?

But it’s not the same math when a triplet or higher pregnancy is reduced to a singleton one. I wonder how people feel about that?

I’m inclined to trust the woman who has to carry the fetuses full-term, raise the kids, etc. It wouldn’t be my choice, but there’s a reason legalized abortion is argued for in terms of rights to privacy and that we call it a choice. However, I’m not at all in favor of selectively reducing based on the sex of the fetus. I think gender selection both in conception and pregnancy termination goes too far.

The number of twin reductions is on the rise. There’s no national data but at Mount Sinai Medical Center in New York, more than half of their reductions are to singleton pregnancies, and more than half of those started as twin pregnancies. A little over 10 years ago, that number was more like 15 percent.

What did you think  of The New York Times piece? What about what Jane says? Should medical ethics allow twin reductions?

Photo: sirlygirl via flickr

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