Please read The Two-Minus-One Pregnancy, a New York Times article by Ruth Padawer, before reading my commentary below. It is an excellent, thought-provoking article and my post is incomplete without it. All quotations below are from the above mentioned article.
In vitro fertilization and fertility drugs greatly increase the chances of a multiple pregnancy. Carrying multiples (especially more than three), increases the health risks for both mother and babies. The accepted solution is “reduction,” eliminating some of the fetuses to increase the likelihood of health for the mother and surviving child(ren).
“The procedure, which is usually performed around Week 12 of a pregnancy, involves a fatal injection of potassium chloride into the fetal chest. The dead fetus shrivels over time and remains in the womb until delivery.”
Reductions used to only be done in pregnancies of triplets or higher, reducing the number remaining to twins. But recently, more women are pushing to have their twin pregnancies reduced to a “singleton.” Most doctors agree there is little to no medical justification for such reductions; they are done simply for the preference of the mother. While some doctors are willing to do these two-to-one reductions, many refuse.
The article examines the issue in depth. It offers the perspective of several mothers who chose to reduce, one mother who didn’t want twins but kept them both, a father, doctors both for and against the procedure including some who have changed views, and experts in fertility treatment, social and clinical psychology, bioethics, and philosophy. (If you haven’t yet, please read the article.)
Some doctors will only reduce twins if there is a significant medical complication. Many won’t do it at all. Even many supporters of abortion rights are uncomfortable with two-to-one reductions. Why?
It would seem to revolve around the reason for the choice. One might assume that most seeking elective abortions never intended to get pregnant in the first place. It’s assumed these women had no choice in the matter, or that pregnancy was an unintended, unforeseen consequence of their actions.
Women seeking pregnancy reductions are a different matter entirely. These women wanted to get pregnant. Fertility treatments cost thousands of dollars, often involve years of trying and can be physically and emotionally strenuous. Women invest a lot to get pregnant with fertility treatments. The likelihood of multiples is high and is well known. Women make the choice to undergo the treatments, knowing that a pregnancy of twins or more is a very real possibility. They choose this and then want to eliminate some of the children they worked so hard to produce. To many, this course is blatantly irresponsible and therefore, morally wrong.
“Society judges reproductive choices based on the motives behind them…Think about the common reaction to a woman who aborts because contraception failed versus a woman (and her partner) who took no precaution at all…Likewise, people may judge two-to-one reductions more harshly because the fertility treatment that yielded the pregnancy significantly increased the chance of multiples. “People may think, You brought this about yourself, so you should be willing to take some of the risk,” Steinbock says.
The Endless Gray Area
Though Berkowitz insists that there is no clear medical benefit to reducing below twins, he will do it at a patient’s request. “In a society where women can terminate a single pregnancy for any reason — financial, social, emotional — if we have a way to reduce a twin pregnancy with very little risk, isn’t it legitimate to offer that service to women with twins who want to reduce to a singleton?”
“What is it about terminating half a twin pregnancy that seems more controversial than reducing triplets to twins or aborting a single fetus? After all, the math’s the same either way: one fewer fetus.”
Indeed, what is the difference between a reduction and an elective abortion? According to Merriam Webster’s Dictionary, abortion is defined as the termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus. So? Reduction is abortion. There is no difference, technically speaking.
What about morally speaking? Legally, a woman can abort in the U.S. for any reason. Polls show that many who identify as pro-choice prefer abortion only be an option under certain circumstances. It seems that many feel the same way about reductions. This is OK if (fill in the blank) but it’s really not OK if… We get bogged down in what-if scenarios, complex nuances and endless gray areas. Trying to make specific hard and fast rules becomes a nightmare. Frustrated, people conclude that we can never legislate morality and despite personal beliefs, we must be pro-choice.
“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.”
The Real Question
If we want any answers, we must step back and look at the fundamental question. What is at stake here? When life begins is the only relevant question. If the embryo or fetus is not alive, then the debate is silly. Who cares what reasons the mother has for her decision? It’s her body, it’s her life, it’s rightfully her choice. If the embryo or fetus is alive, the debate is absurd and terrifying. What reason is good enough to justify the killing of an innocent, helpless person?
I contend that life begins at fertilization. This is a reasonable statement that is supported by science. For a very thorough explanation of life’s beginning, read this page on medical testimony and this one on prenatal development.
If science is correct that life begins at fertilization, then every abortion at any stage for any reason takes a human life. The same is true of reduction, whether two-to-one or any other reduction of a pregnancy. Can this ever be justified?
The only argument worth considering is the argument for health. If the life of the baby will end the life of the mother, it is quite a quandary. In the case of higher numbered reductions (reducing quintuplets or quadruplets, for example), the act may increase the likelihood of life or health for both the mother and the surviving children. Is this then justified? Most would agree it’s a tragic situation to begin with, if we find ourselves having to choose one life over another. The best possible solution would be to avoid the situation in the first place.
Since it’s known that fertility drugs and in vitro fertilization significantly increase the chance of multiples, and it’s known that having multiples increases medical risks, isn’t it logical to conclude that such drastic measures are morally irresponsible? Even if a fertility specialist only fertilizes one egg in vitro and only inserts that one resulting embryo into the woman’s uterus, there is a high risk that the embryo will fail to implant. In other words, it’s quite likely that the baby will die. That’s why in vitro fertilization so often leads to multiples: they insert several embryos, hoping that at least one of them will “take.” All those who don’t implant are lost without a thought and considered collateral damage. If unwanted “extras” implant, they may be killed by reduction. Often, “extras” are produced in vitro but never inserted into the woman if they aren’t needed. These extra embryos are discarded or used for embryonic stem cell research. In other words, all the unneeded living humans are killed.
How did we get to the point where any of this became acceptable?
Defining Persons and Non-Persons
When faced with the evidence, honest people usually concede that “some sort” of life does begin developing at fertilization. The next argument is that while a zygote, embryo or fetus is alive, it is not yet a person and therefore does not deserve human rights.
How do we define whether a living human being is a human person worthy of rights? We’ve tried to do it many times before, with horrific consequences.
America defined Blacks as non-persons to justify slavery. In the Three-Fifths Compromise, a slave was defined as three-fifths of a person, obviously not for any rational reasons, but for political reasons of power and money. Even after abolition, Jim Crow laws ensured Blacks could not have the same rights as other people. We defined Native Americans as non-persons to force them off their land. Women were thought of as non-persons to keep them from voting and to keep them out of the workforce. A woman was considered her parents’ property until she married and became her husband’s property. If we say a human isn’t a person, we can justify horrible treatment and even killing them for our own personal gain.
Unborn babies are treated as people when society considers them “wanted.” Every alcoholic beverage and cigarette pack is required to carry a Surgeon General’s warning about the risk of use during pregnancy – this is risk to the unborn baby and not to the mother. Women can be prosecuted for child abuse if caught using illegal drugs while pregnant. A person who kills a pregnant woman can be charged with double homicide in some states.
If we’re honest, these issues aren’t about when life begins. They aren’t about when personhood begins. They are about the fact that we are more powerful than another group of people, and that group of people is in the way of what we want: absolute control over life.
America’s selfish demand for limitless choice has driven us to treat our fellow humans, even our own children, as yet another product to be bought, sold, or thrown away as we please.
“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.” -Woman identified as “Jenny” in the article
We must recognize that human life has intrinsic value, regardless of perceived usefulness or inconvenience to others. We must recognize that all humans are persons equally deserving rights. We must recognize that if people are weaker, vulnerable, or unable to speak for themselves, it is our moral obligation to defend their rights. These are universal values of human decency that we should all hold, regardless of our religion, philosophy or political leaning.