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Unnatural Selection? The Selective Reduction of Twins After Fertility Treatment

To politically conservative and devoutly Christian people, the idea of terminating a pregnancy under any circumstances is simply unthinkable.  I respect that; having been raised Catholic, I’m happy I’ve never been in a position to need an abortion, because I think it would probably be a traumatic experience for me.  However, I’ve always believed that abortion should be legal and widely available, because just as it is one woman’s right to have 19 children (but who’s counting?), it’s another woman’s right to have none. 

But abortion isn’t just for women who don’t have or don’t want kids, and not everyone who identifies as pro-choice sees abortion as a black and white issue.  In fact, there is so much grey area, it’s hard to identify all the cloudy circumstances under which terminating a pregnancy becomes ethically questionable, a moral quandary for the people involved in the decision.  I think most people would find third trimester abortion ethically unsound – except in cases where the mother’s life is at stake.  Many pro-choice advocates could understand if a married woman who wasn’t yet ready to have kids ended an unplanned pregnancy, but what about a married woman who already has children?  Most feminists probably support or can at least sympathize with a desire to selectively reduce multiples beyond three, but what about the selective reduction of twins?  Twins who were not only conceived using fertility treatment - a process afforded by wealthy women who desperately want to be pregnant – but who are of differing genders, therefore forcing the mother to choose which fetus to keep, the girl or the boy.

That’s the story of Bettina Paige, who wrote a piece for Elle about her decision to abort the male fetus during her pregnancy with twins.  She doesn’t seem to have taken the decision lightly, saying, “I was horrified at the idea of terminating one of the fetuses growing inside me by injecting potassium chloride into his or her heart.”  (I shudder to think of it so grimly.)  Paige goes so far as to acknowledge the intense engineering going on in her reproductive life, describing selective reduction as “Orwellian,” adding, “I knew I was ending what could be a life.”

At this point, you’re probably wondering why Paige was even considering selective reduction.  Two kids really isn’t that many, she only had one other child at home, and she chose to become pregnant again using an expensive fertility treatment.  So why would she want to end what could have been a life?

Because her husband is a selfish jerk.

She writes:

My husband was convinced that twins would radically change our lives for the worse. We’d have to leave our beloved neighborhood for a place with cheaper rents and better public schools—there was no way we could afford private education for three kids. We’d kiss goodbye any hope of career advancement, at least for the foreseeable future. To his list, I added the loss of my income, necessary to meet our expenses. I couldn’t see how I’d be able to resume working after the birth since we could never afford full-time help, and—no matter how well they napped—two infants wouldn’t leave much time for anything else….  I know it sounds selfish, but I wanted to protect the well-being of the people already in my life—my son, my husband, and, yes, myself.

Yes, Paige’s husband pressured her to have the reduction surgery, but he is not entirely to blame, of course – that is, if you think there should be any “blame” involved.  Paige says, “All I knew was that ultimately, I didn’t think we could have twins and remain an intact, happy-enough family.” 

So why have another child at all?  And why try for another using IUI (intrauterine insemination, or artificial insemination), a treatment known to produce multiples?  It is a bit difficult for me not to look at this woman as someone who is trying to have her cake and eat it, too.  Some would argue there’s nothing wrong with that.  They might say, in fact, that is the whole purpose of science (and cake).  But what if Paige had conceived twins, or even one child, naturally?  I imagine she would have felt the same mixed feelings about adding to her family.  And that’s why I think people have a knee-jerk reaction to Paige, because she comes off, by virtue of her own description, as someone wrapped-up in and obsessed with her quality of life, her perfect neighborhood, her status.  That’s where the vitriol comes in.  It’s not so much that she’s aborting a baby that rubs even young, well-educated New York feminists the wrong way, it’s that Paige not only has the luxury to make these types of decisions, but that she makes the selfish one in the end.

As an unpretentious child of upstate, I’ve often stood aghast at the effete, urban masses and their sense of entitlement, especially pervasive in certain “beloved neighborhoods” in New York.  “I want another baby, but I’ve tried for a year – a whole year! – and I didn’t get pregnant – which is crazy because I’m only 43 – it’s not like I’m 60 – but anyway – so I’m gonna try IVF, but I don’t want twins, because my husband doesn’t want twins, I mean, actually neither one of us wants twins, because I want what my husband wants, right?, I do, and honestly how would all five of us fit at one table on trivia night?  Seriously!” 

And yet, for many years, I also tried to model myself after those very people.  I know what it feels like to face a crisis in a marriage, because I faced several.  Fortunately, I never had to choose between fetuses; one, we didn’t have enough money or a need for fertility treatment, and two, we hadn’t really discussed having a second child.  My marriage was already crumbling by the time my daughter was born, so in my own mind, I’d already decided that another pregnancy was not an option.  In fact, toward the end of my marriage, I was scared that I was pregnant, and I thought secretly in my heart that if I was, I wouldn’t keep it.  Or worse yet, that I would keep it and be trapped for the rest of my life, so in that sense, I relate to Paige’s struggle.  I remember thinking when my period was late, “I cannot be pregnant with a hate baby.”  So to find out, I bought a pregnancy test at a Duane Reade in the West Village and took it in the bathroom of the Comedy Cellar, the night I met the lead singer of the Spin Doctors.  (It’s kind of a long story.)

The difference between Paige and I, though, is that I wasn’t trying to have more children.  I didn’t want more children.  When it comes to choosing between twins, Paige herself admits, “I’d begun to realize that people viewed selective reduction in its own category: You weren’t terminating an unwanted accidental pregnancy; you were making a “Sophie’s Choice” between siblings, something a good mother would do only with a gun to her head.”

Since the Internet is an endless pile of commentary upon commentary, by the time Jezebel ran Paige’s story, it became less about the painful tale itself and more about my friend, fellow comedian and blogger Sara Benincasa’s reaction to Paige’s story.  Sara reacted unfavorably to Paige, via Twitter updates, saying:

“‘Oh, I’m well-off and I paid for IVF, but eww, my husband hates kids, so the boy has got to go.’ Convenient blame.”  Followed by, “I’d like to retroactively abort this woman and her husband.”

As I’ve disclosed, Sara is a friend – and a close friend at that.  Does that mean I totally agree with her response?  No.  First of all, Twitter is no place to be having a nuanced discussion about the shifty moral line in the abortion debate.  Obviously, 140 characters simply cannot do that type of argument any justice.  (Hell, I don’t even think 140 characters provide enough room to amply describe a delicious lunch.)  Nonetheless, I think Anna North’s ensuing comparison of Sara’s (perhaps ill-conceived) comments to Ann Coulter’s horrifying attempt at spinning last summer’s murder of abortion provider Dr. George Tiller into a “termination in the 203rd trimester” is a bit of a stretch.  Then again, I often find myself squirming when young, female comedians talk about abortion in such a glib manner – and I wonder, are you speaking from authority and experience, or are you just trying to be edgy?  I don’t want to speak for Sara, and she hasn’t really responded to the Coulter comparison, other than to say, “I am honored to be criticized by a group of my peers.  I get why some people don’t agree with me, but I’m not about to give a lady props for offing her boy twin because it was inconvenient and weirdsies.”

The moral of the story here is, really, we all have to be held accountable for what we say, and for our mistakes.  Paige, Benincasa, North, me and you.  In sharing her story, Paige opened herself up to judgement from the court of public opinion, something she surely anticipated while writing it.  Did she make a mistake getting IUI?  Did Sara put her foot in her mouth?  Should I not judge Paige for having the kind of problems run into by “sophisticated” urbanites who can’t keep up with themselves?  The kind of person I readily admit I once was.  I don’t even know that I am judging her – I just have trouble understanding why someone would undergo fertility treatment if they felt such a pressing need to control such a hard-to-control situation.

Everyone has a right to their opinion.  What’s yours?

Correction: I had originally stated Paige was impregnated using in vitro fertilization.  She was impregnated using intrauterine insemination, better known as artificial insemination, another popular fertility treatment.  My apologies.

Photo: craigCloutier via Flickr

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