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Thoughts On Reducing A Twin Pregnancy To A Single Pregnancy

Should women have the choice to reduce a pregnancy to a singleton?

As a result of more IVF treatments women have been getting pregnant with multiples more and more often. As a pregnancy with three or more babies does present some additional medical risks for mothers and babies, doctors developed a way of reducing the pregnancy to just twins. In the first trimester at around 12 weeks of pregnancy, a needle containing potassium chloride is injected into the fetal heart, which then stops beating.

More recently women who become pregnant with twins are deciding to reduce to one for reasons that have a little bit to with added risks of twin pregnancies, but more often relate to the concern that they do not have the resources to care for twins. Two might throw the family into too much stress– financial or otherwise.

But should women be able to opt for twin reduction for non-medical reasons?

This is the topic of The New York Times magazine cover story this week. The story runs through the doctors who have chosen to do this procedure and those who have not. Women who have opted to reduce a twin pregnancy are interviewed about their choice. The circumstance of wanting and not wanting a baby (at the same time) is emotionally wrenching. A woman’s mind must be pretty well torn in two directions to make this choice. And nevertheless women sometimes–not often– make it. And I think they should be able to. How is this different from a first trimester abortion? And why should anyone else have any say in it? A woman has the right to decide whether to continue a pregnancy.

Reading this story reminded my of an interesting section in Sarah Hrdy’s fascinating book about evolution and motherhood, Mother Nature on infanticide and postpartum depression. A long, long time ago, if mom realized she didn’t have the resources to care for both herself and her baby, she would abandon her infant moments after birth. From an evolutionary point of view it makes more sense that she go off and survive and make more babies, once resources become plentiful, than suffer– and possibly die–caring for the one. The theory goes on to say that women who feel they have too few resources actually shut down maternal hormones in order to follow the evolutionary path. Linked to this is an infanticide theory of postpartum depression. A mother who is overwhelmed and has no support may have the evolutionary response of shutting her emotions down.

Now, of course, things have changed. And what constitutes the “necessary resources” to care for oneself and one’s baby is a tougher question to answer. (The US ranks #31 of 43 developed countries when it comes to how we care for our mothers and babies.) We also have technology– the multiple pregnancies are orchestrated by technology. As reproductive possibilities open up, women certainly have more choices. But these are not necessarily easy ones to make. Bio-ethicist Josephine Johnston tells The Times, “In an odd way, having more choices actually places a much greater burden on women, because we become the creators of our circumstance, whereas, before, we were the recipients of them.”

A military mother interviewed in The Times story says, about her decision to reduce after IVF, “My No. 1 priority was to be the best mom I could be, but how was I supposed to juggle two newborns or two screaming infants while my husband was away being shot at? We don’t have family just sitting around waiting to get called to help me with a baby.”

Not an easy choice. But it should be hers to make.

What will you do to guarantee your pick? Pick a Sex, Any Sex

 

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