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Selective reduction  Selective fetal reduction: from three babies to one.

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Last night 60 Minutes aired a controversial report into selective reduction.

Selective reduction is the practice of aborting one or more fetuses in a multiple pregnancy for medical or ‘lifestyle’ reasons, if the parents do not wish to have more than one or two babies.

The reduction procedure is generally carried out during the first trimester of pregnancy and the most common method used is to inject potassium choloride into the fetus’s heart; the heart stops and the fetus dies as a result.

With IVF becoming increasingly common, the number of multiple pregnancies is increasing and the practice of selective reduction is becoming more widespread.

60 Minutes interviewed one mother with triplets who chose not to selectively reduce and another mother who was pregnant with triplets via IVF and decided to reduce down to one foetus because she only wanted one child.

There was also a mother who reduced for health reasons. Kass Hall writes:

The discussions around the water cooler across Australia today will be firey, no doubt, after the story on “selective reduction” on Sixty Minutes.  Twitter and Facebook are in meltdown, with a range of views from ‘murder’ right through to ‘it’s a woman’s right to choose’, and everything in between.

The story by Michael Usher looked at women who have chosen to take this course of action due to lifestyle or financial choices, as opposed to reasons of impaired health for either mother or child. Many (but not all) of the women have used IVF and other reproductive technology to get pregnant.

I’m 34 years old and have survived cancer four times in 21 years. It has not only ravaged my body through surgery and treatments, it has also left me unable to conceive my own child. Given the long term nature of my diagnosis, I also don’t meet the criteria for adopting or fostering.

Despite my inability to have a child, I am strongly pro-choice – in fact I believe both men and women should have complete control over their bodies and what they do with them. But it’s hard to get my head around the women in the Sixty Minutes story on Sunday night.

My problem with selective reduction is two-fold: first, the way it occurs. A needle containing poison being injected into the heart of the fetus, until it stops beating. I don’t think it matters whether you support or oppose the ethics or morality of selective reduction. Watching that needle being inserted on the sonogram was horrific. (Ed’s Note: One Mamamia reader has had to make this heartbreaking decision before – you can read about that story in full here)

However, the more pressing issue (to me) is that people assert their rights without following through on their responsibilities.

There are many theories on when life begins. Whether it’s upon conception, within the first three months of the fetal development or whether you believe a baby is not alive until its born, is really not the issue at hand. The issue is whether a mother has the right to abort that child for lifestyle reasons. When you choose to get pregnant through IVF, when you choose to implant more than one egg – do you then get to choose if that fetus continues to birth? At what stage do the rights of that baby kick in?

The two concepts cannot be mutually exclusive – you cannot have the freedom to make a decision without also being responsibility for the consequences of that decision.

Frankly, this is where I get really frustrated with the use of IVF and other reproductive technology in general. It’s a fabulous use of science to help people who can’t get pregnant naturally. But when it is used by people because of their lifestyle choices – this is where I believe it crosses into unsavory ground.

Having more than one baby doesn’t suit your lifestyle? Waiting until you can’t conceive naturally because you got busy career wise? Implanting three eggs with intention of terminating two – choosing the healthiest one or the gender your prefer this time around? Where do we draw the line? When do the corresponding responsibilities of being a parent kick in?

CNN, The Washington Post and other media outlets have reported on what the fertility world calls its “dirty little secret”. But there seems no-one in a position of leadership is willing to confront the issue head on and really open it up to public debate. This isn’t a pro-abortion vs anti-abortion debate. This is about using technological advances in a responsible way.

None of these women are responsible for my situation or the situation of other reproductively challenged women. But they do have a responsibility – as do doctors – to use the technology in an ethical, responsible way. It’s much like the development of nuclear and chemical weapons. We know how to, but does that mean we should?

Calling a fetus “tissue in my body” (as one of the American women in the Sixty Minutes story did) says to me that there is a serious gap in the way we monitor and regulate IVF use, and the hoops adoptive and foster parents have to go through. I just can’t get my head around it. I can’t be a mother through no fault of my own. Yet these women have access to wonderful technology and use it in a way that makes a mockery of what IVF is there for in the first place. IVF is not about choosing your child so they fit the mould you want them to. A natural conception doesn’t grant you this privilege and neither should IVF. IVF is about giving you an opportunity you would otherwise not have. Children are not shoes – you can’t just shop around until you find the pair that suits you best.

These women should take their responsibilities as parents a lot more seriously, or consider getting a pet rock instead.

Kass Hall is an artist and writer from Melbourne. You can follow her blog here or on Twitter here.

What do you think of selective reduction?

Comments

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378 Comments so far

  1. Erica

    What right do you have to judge women who undergo this procedure? First of all, you make the incorrect assumption that this done exclusively by women who undergo IVF. A Dailymail.co.uk report on the same issue showed that only 1/3 of selective reductions were for women who used reproduction assistance. The other 2/3 conceived multiples naturally, through no fault of their own. I would assume that the figures are similar in other countries so there’s no need to heap on IVF-blaming.

    Carrying and bearing multiples significantly increases the risk of DEATH to both the mother and the fetuses. Selective reduction is about maximizing the number of healthy people who survive birth — babies and mother.

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  2. Hannah

    Today I found out I am 6 weeks pregnant with triplets. Up until this day I have always been pro adoption, against abortion. I can now say I have lived both sides, and you have no idea what you are talking about until you are in a person’s shoes that has to make this decision. My husband and I have been trying for 3 years to get pregnant with no success. We both work, own a home, and know that for a life that we want together we do not want more than 2 kids. I saw the three sacs on the screen and immediately knew my decision. If they all three continue we will reduce to two. Yes, the procedure is terrible, injecting a needle in the heart. However, go online and read the stories of the women who didn’t reduce, carried their babies to 25 weeks and watched them die one by one. You don’t think that baby suffered more than it would have at 6 weeks in the womb? Do you think if that baby had a choice it would want to suffer as little as possible? You have no idea what you are talking about and unless you are in a position where you have been trying for years and fertility drugs were your last hope, shut your damn mouth.

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  3. Jwelch

    I agree with much of what TMH has said. Unless you have walked in these shoes, you really don’t have the right to an opinion. Most infertile women who have come to the point of using IVF, donor eggs, etc. would do about anything to have a child. There is a sense of desperation. Carrying multiples has many risks. When couples decide on a reduction, it usually isn’t an impulsive decision that wasn’t thought through weighing all the pros and cons first. It’s a very difficult, heart wrenching choice to have to make. It comes down to thinking about the well being and the life of the other babies.

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  4. Rose

    I’m sorry, you say ‘A needle containing poison being injected into the heart of the fetus, until it stops beating. … . Watching that needle being inserted on the sonogram was horrific. ‘
    THIS IS THE SAME WAY ABORTION IS PERFORMED!!!! I don’t understand how you can mourn over how they kill the baby with selective reduction but you are happily willing to express how abortion is ok! How else is abortion performed? Either way, it is still killing the baby in the womb.

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  5. TMH

    In relation to the story on fetal reduction: I am medically infertile as well and pro-choice. I want to say three things: I started trying to have a baby at age 32, and struggled for four years with multiple surgeries, infertility and miscarriages. Most people who use IVF have medical problems which mean they cannot conceive or cannot carry a baby to term. There are very few women who put off having children because it does not suit them. The stereotype of the woman who “forgot” to have a baby is generally untrue. The average age of women at my IVF clinic is just 36 years old. Secondly, some women conceive twins or triplets without IVF and some conceive them without implantation of multiple embryos. Thirdly, having twins or triplets is dangerous. More than half of all twins and triplets are born prematurely (before 37 weeks). More than 70% are low birth weight. Many more twins and triplets are born with lifelong disabilities than singletons. Twins and triplets are also much more likely to die soon after birth than singletons. I don’t agree with fetal reduction for lifestyle reasons, but just wanted to point out that sometimes women who are pregnant with more than 2 babies are advised to undergo the procedure for genuine medical reasons.

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    • Shelby

      TMH, carrying triplets carries a variety of consequences…as you’ve pointed out. Amy & I both took those into consideration. Who knows, maybe we were handed medical information that we chose not to share. I support a woman reducing her pregnancy at anytime, for any reason. If we limit women, it becomes a slippery slope of what’s ok and what’s not. It’s imperative we ensure the choice is there for women to make, regardless of why.
      Great perspective! http://www.mother-to-one.com

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  6. anon

    Can I just say that until July I possibly would have agreed with many of your views and readers comments- all apart from your nasty final swipe about pet rocks. That was until I was confronted with this heart breaking decision on a personal level. Have you considered the multitude of other reasons why people have to make the horrendous decision to reduce a multiple pregnancy? It stems well beyond ‘lifestyle’ and convenience issues and often is due to matters of life and death for the mother and babies alike. I spontaneously conceived triplets with no fertility drugs or medical assistance. Not only did we conceive triplets but we had the devastating reality that the twin pair (we had two sacks – one with two babies and one with a single baby) shared both a placenta and an amniotic sac. The risks were horrendous and were faced with the terrifying reality that statistically we were very likely to birth three babies with significant health issues – stemming from the likely prematurity, twin-twin transfusion syndrome and the inherent risks of chromosomal issues with multiples. That was if I managed to sustain the pregnancy to viability. I am not a heartless woman. As soon as I saw these three babies I fell head over heels in love. However, the reality was that these babies would most likely have a very challenged quality of life and I would rather spare them of that. I saw it as the most selfless thing we could do – give up parenting three babies in the hope that we could offer one baby its best chances for health and happiness. Does that make me a murderer? a selfish nasty troll who thinks only of myself and the impact that triplets would have on our lovely family? I honestly don’t think so. I am resolute that we did the right thing. I am desperately sad that we ended up in this situation and were faced with the ‘choice’ that we were and I doubt a day will go by when I don’t think about these babies with such overwhelming love and heartbreak that I will never get to meet them. Why am I sharing my story? This situation was incredibly lonely and when I went to the web for information all I found so many abusive and judgemental posts and comments. I fully respect that this is a minefield and can appreciate that not everyone would make the decision we did, but does that give anyone the right to judge someone else? And do so so vehemently?. These are not decisions that are made lightly. I struggle to believe that any mother views life as disposable, and would make this decision based solely on lifestyle factors. All I am asking is that you maybe expand your view and recognise the multitude of reasons that this procedure is undertaken. I have never been through anything more confronting or challenging and heartbreaking all at once and all I can hope for is that the next person in my position (it will happen to someone else!) will be offered a slightly less judgemental audience who see the issue from a wider perspective. I too find the images of the procedure heart breaking and as someone who has been through it I can vouch that it is an experience that will stay with me for life.
    I am not posting so people can either support or bag our decision but to encourage broader consideration of the facts at hand. It is not as black and white as ‘disposing’ of a life for convenience. There is always more to a situation than you might ever imagine…. Please be generous enough in spirit to respect that at least

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    • Shelby

      Well put! I hope that this story makes a kinder, gentler Australia in the future.
      It isn’t easy, at all, is it? I don’t believe I ever said it was easy. But, it is life-saving & sparing.
      Lots of hugs! If you need support at all, email me: shelby@mother-to-one.com

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      • Anon

        Thanks Shelby for you offer of support. I am so sorry that you too had to got through this and I take my hat off to you for so courageously sharing your story (however they chose to edit it!).

        We are left in a precarious position now that I am sure you will understand- simultaneously grieving the loss of our babies and celebrating the life of our survivor.. A very tricky set of emotions to balance! All we can hope for is a good outcome but this really is a challenging and terrifying journey.

        In NZ this is not a well known procedure (I had never heard of it before becoming an unwilling ‘expert’) and this all contributes to it being somewhat cloak and dagger. This further complicates things and isolates those going through it. People like you are a lifeline to others all over the world. Thank you!

        Hopefully one day I will find the courage and strength to reach out and help others experiencing this devastating scenario.

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        • Shelby

          Dearest Anon, I know it’s hard to comprehend what *could* have been…all while you are excited about what is. It did take me 1 solid year to process all of this mess. Believe me, on the flip side you will realize how strong and courageous you were. You saved your future child. Lots of love and well wishes. Contact me anytime. I can share my own emotions and
          I truly hope that you drew solidarity from the 60 minutes program (no matter how it was edited), you are the furthest from alone in your choice!!!!

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  7. Just saying

    I feel sick!
    Thank god I didn’t see 60 minutes, WTF is the world coming to!!!!!!!!!

    Ps currently undergoing IVF due to unexplained infertility

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  8. georgiepie

    I just…ugh…I had no idea this even existed. I am in shock that you would about your own child because it didn’t fit in with your ‘lifestyle’. Yay Australia for only using selective reduction for medical reasons, which is completely fair enough. I cannot BELIEVE that the American woman referred to her child as ‘a piece f tissue’. What the actual fuck.

    I am pro choice. I support people’s right to choose. I would never consider an abortion, but that is my choice and not my belief to force onto others. But this – aborting a foetus for lifestyle reasons – makes me SICK. It is so much worse – you have two/three/four beautiful lives in there, and you’re planning to have one but not the others?! Because of lifestyle/wanting a certain gender?CHOOSING ONE LIFE OVER THE OTHER. Can you imagine growing up knowing that you had a brother or sister but they were aborted? A triplet without the trips..

    I want to cry.

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    • Claire

      Many abortions are for lifestyle reasons, why is this any different? The woman is technically correct in saying it’s a piece of tissue, I mean, you and I are pieces of tissue too.

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    • Shelby

      Fyi, Australia does it on demand. Varies state-to-state.

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  9. B

    Hi,

    This is a plea for help really. After losing both my tubes with ruptured ectopic pregnancies the only option I have to get pregnant is IVF. I have done 5 IVF attempts here in Australia, all without success. It appears that the most likely issue is my age which is making it impossible for the fertilised eggs to implant (I’m 42).

    After the Medicare rebates I have spent a little over $51,000 trying to have a baby (worth every penny to have the chance to try) and have now been told a donor egg is the best option for me.

    I spent about 7 months trying to find a donor in Australia and then heard about overseas clinics where there is much less red tape (but more expensive). I made contact with a wonderful clinic, they have found a donor for me and I am due to travel to Greece in September for the procedure.

    I am beyond excited and so thrilled to be able to try something different as maybe this will work?

    BUT here’s my dilemma:

    In Australia, despite the punishing amount of drugs, I only ever grew one egg. We would pray it fertilised, pray it lasted the 3 days and pray it would implant. My eggs never implanted.

    Now I have the chance to implant (probably) more than one egg and probably at day 5 (blasto stage) rather than all my other attempts (done at day 3).

    Implanting one embryo (or blasto) does not guarantee implantation and just on the law of averages my chances of one embryo taking seem slim, so to get a pregnancy should I implant more than one?

    I don’t want to be irresponsible, I just want a baby and want to implant whatever number is most likely to result in a pregnancy and live birth.

    So do I implant one, two or three?

    Three makes my eyes water but two is probably what I’ll do. Or should I do just one (which has never worked for me in the past but I always did day 3 transfers, not day 5).

    My clinic in Australia said they would have implanted two but I never grew two.

    Does anyone here have any statistics on successful pregnancies correlated to the amount of embryos implanted?

    If it’s all about the environment of the uterus and the stage of the egg then I could assume that one day 5 blasto would implant just as much as if two or three were implanted. BUT I have a number of friends, both here and overseas, that had more than one embryo implanted and only one “took”.

    I don’t think that women, as a rule, get multiple embies implanted so they can end up with multiples (or have to face the decision of doing SR which must be the most heart-wrenching thing ever), they just want to maximise their chance of having one baby.

    A dear friend of mine had four day 5 blastos implanted (at the same clinic I’m going to) and only one took. She has just had a little boy but four embryos were implanted.

    I would love some opinions (particularly from people with experience) on embryo implantation stats as I just don’t know whether I should opt for one, two or three?

    I would hate to do SR but do respect that it’s a choice. Just not a choice I would make (I don’t think). However, I understand how it gets to that point. Sometimes people just get so desperate for a positive reult that they perhaps get too many embies in. But sometimes getting multiple embies in only results in one baby, or none at all.

    After years of the most profound emotional battles and pain I may be at a point where things change but jeez, I really want to make the right decision and am so confused.

    Thanks!

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  10. Angela

    Bear in mind that, in Australia, selective reduction is done only for medical reasons – ie. either because the mother’s or the foetus is at risk. Also, in Australia, IVF usually now involves the transfer of one embryo, thereby lessening the chance of a multiple birth. In America, neither of these hold true.

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  11. Me

    So you are saying that you don’t agree with IVF for women who have been focusing on their career and then find themselves unable to conceive naturally? I don’t get it. You can’t pick and choose who is “worthy” to use IVF and who isn’t.

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    • Kym

      I think she is saying she doesn’t agree with women who have IVF because they have been putting off children for ‘lifestyle’ reasons who then go and get multiples implanted and then use SR to get rid of some of those babies because of ‘lifestyle’ reasons.

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  12. Shelby

    Just one more tidbit…

    I fully accept responsibility for my choices, all of them. I think the one of the biggest issues women facing fertility face is INFORMED CONSENT. I was told I had two eggs, possibly. After all was done with my selective reduction, I was then informed by my fertility doctor’s nurse that 4 eggs were dropping. Since I wasn’t given all of the facts about what my body was doing, I feel that the blame for HOW many embryos implanted is something I am absolved from.

    Please, encourage readers to check this and tell anyone you know…ask, ask, ask. Then, ask again.

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  13. Bo

    I am pro choice because research shows that regardless of abortion laws worldwide, the rate of abortion doesn’t vary all that much. I believe that any form of abortion at any stage of pregnancy is killing a human being, but my opinion doesn’t matter in the slightest because women terminate their pregnancies around the world, up to full term, regardless of my opinion or their legal right to do so. The only difference is that terminations performed illegally under unsafe conditions pose a greater threat to women’s health. I think legalising abortion worldwide can at least prevent two deaths in many occasions.

    On the numbers alone, I argue, that women should have the right to choose. On selective abortion when there is more than one fetus, I’m speechless. How can any parent make that decision? What gives them the right to do so? And more importantly, if this is allowed, what the hell is next?

    On the subject of aborting babies with disabilities, which I consider to fall in the same category as “selective abortions”, I really do wonder whether people who do so have ever spent time with a disabled child or adult. My wife’s younger brother had Down Syndrome and was the most adored person in his family (of 12). When we enter the realm of aborting because the baby is not the right number or doesn’t have the right ability or is the wrong sex we cross a line.

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    • Anonymous

      But you are comfortable with abortion, in cases where the fetus is healthy? What is the difference (to you)? The medical community sees the procedure as a different method, but still a part of CHOICE. Can’t have your cake and eat it too.

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      • georgiepie

        this is different anon – I’m with Bo. Abortion is abortion, getting rid of your child because it’s impossible to have it in your life at that time. That baby and life ceases to be. selective reduction involves choosing ONE life over another. it’s giving one baby life and killing the other one. the parent makes a CHOICE to kill one of their children and keep the other.That is the upsetting part.

        These are different things, the morals of it are completely different. I’m like Bo, I wouldn’t have an abortion but support other womens’ right to have one. But this? This is too far, you can’t choose one of your children over the other!! Ugh!

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  14. Shelby

    and Kass, we have a pet rock…his name is Fred. We like him a great deal. Thanks for the suggestion, we’ve already got that covered.

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    • Kass Hall

      Pleased your pet rock is loved. Rocks should be loved.

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      • Shelby

        Does my story at all change your own view? Your story is wrong, stating I had IVF is absolutely untrue.

        In the states for such things, we print “retractions”.

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        • Kass Hall

          Shelby,

          No it doesn’t. I acknowledged in the story that not all of the women interviewed used reproductive technology. If you look at the second paragraph of my story (not the introduction), you will see that.

          You’ll also see that at no stage did I ever say that you should not have the right to make your choice.

          What I do say, and I maintain – as a woman who is infertile – is that I do not understand why a woman would CHOOSE to implant several embryos and then CHOOSE to selectively reduce when they then get more babies than they wanted. I strongly believe – which I think is getting a bit lost in the arguments of those who have howled me down for holding a contrary opinion – that you do have the RIGHT to CHOOSE. But I ALSO think that every right we hold, every CHOICE we make, has equal RESPONSIBILITY and I do not believe that implanting multiple embryos and then aborting them when they take is responsible.

          Sometimes, multiple pregnancies happen naturally. Sometimes, they come about through technological intervention. Sometimes, the lives of one or more babies is at risk by continuing with the pregnancy as is. Sometimes Mum’s life is at risk. Where there is a significant risk to Mum or bub(s) then of course a difficult decision has to be made. That is an ENTIRELY different scenario. My feelings about this do not extend to where there is significant RISK involved.

          But when women undertake IVF, IUI or whatever they choose, they have to look at the possible outcomes and multiple births are one of those. You make that choice and there are consequences for it. It is just too easy for you to say “well I didn’t want three babies” or some of the other comments made “it didn’t suit my lifestyle in New York”, “I only wanted one baby”. If you only want one baby, only implant one egg. Make SURE you only get one baby.

          I am absolutely pro-choice and the choice you made is yours and I don’t say you shouldn’t have it. What I DO say is that you made a decision use IUI and you made it KNOWING a multiple birth was a possibility. You proceeded anyway and then destroyed embryos for no reason other than it didn’t suit you. I’m sorry if you don’t share my opinion, that’s fine and I maintain you have the right to do whatever you like, but you also took your story public and thus open yourself to people having contrary opinions to yours and have the freedom to express those feelings.

          On that note, there will be no retraction from me as I do NOT believe anything I have said in my article is factually incorrect nor do I back away from how I feel about selectively reducing a pregnancy based on “lifestyle” reasons.

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          • Shelby

            Ok, I’ll take that. And, I fully respect your opinion on this. I just hope that you continue to explore what CHOICE means to you.

            Also, I made clear in my comments that I did have a medical issue, that I choose not to discuss further. I don’t want this discuss to be given the footnote of “oh, well, she was sick”. I wanted the discussion to go in the direction of: every woman has the right to choose what’s best for her. I did have a few economic concerns in the days after I found out, but then kept getting bad, bad, bad news and that sort of escaped my mind.

            Look, we only have a short time to really make this decision, I had all of 3 weeks. So, we (every woman who undergoes selective reduction) make the best decision with the information that is presented to us. Amy’s story is slightly different from mine, but nonetheless, we made the same CHOICE–the why’s to both of us do not matter.

            I am sorry you’ve struggled with cancer, never and easy battle. My sibling had a brain tumor and fought it for many years. I, unfortunately, carry the gene. This played a factor into Dr. Evans choice for which fetus to maintain (also, he didn’t really have a choice because their was an issue with one of them and after genetic testing, he knew which to maintain). I really wish they had shown more of my interview…we had some solid discussions about the process Dr. Evans and I went through in choosing–which was all of a 24 hour time frame to decide. It’s really tough, and not as easy as “shopping for a Prada bag” by any means, which I do NOT own one!

            I understand from the producer that the only woman who underwent IVF was the woman who maintained all three fetuses and gave birth to healthy triplets. Again, can you explain your issue with IVF? Did you gather something from her interview that rubbed you wrong too? I didn’t see it, nor will I, just trying to understand.

            Also, I decided to do the interview for a variety of reasons. My #1 reason was this: I became very, very depressed first trimester and into 2nd trimester (following the procedure). I felt alone and isolated (especially because my husband was still gone). I never want another woman who goes through this to feel as intensely bad and hopeless as I did.

            I don’t mind the criticism one bit either… I’m so far out from the procedure I rarely think of it (as of late, quite a lot). In fact, a bit of a side note…in labor, I was called a murderer and criminal by the nurses treating me…it made for a very difficult experience. I hope that my story can open australians minds to the fact this happens…some people don’t discuss it, others do. Their reasons are theirs alone, and they should not have to be silent or endure the structural violence I experienced.

            What’s your cancer status now? I truly wish you the best.

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            • Kass Hall

              Thanks Shelby for your response – although we may disagree I think we are reaching a point of understanding where the other is coming from and recognising there are not hard and fast rules on this. Also these things are regulated differently in our countries which complicates things a little. By the by.

              I definitely have NO issue with IVF – my sister used it, both my best friends used it as have other friends a long the way. If it were an option for me, I too would definitely use it. Absolutely no problem with the technology at all. What I do have some problem with is people using it to get pregnant and then aborting their foetus for the afore discussed ‘lifestyle’ reasons. Health/psychological reasons are completely different and I recognise that selective reduction usually happens in those circumstances as opposed to ‘lifestyle’. In those cases, I have no doubt that the decision to reduce is difficult and heartbreaking. That was NEVER my criticism.

              Re: current status. I am 7 months out of major surgery. The surgery was successful but given my genetic defect that causes these cancers, there is little doubt that at some stage it will return – we dont know where or when, hopefully a very long time into the future! There is only one form of treatment available for my cancer type but, as mine is a rare subset of the cancer itself, that treatment is less effective and my body is likely to develop resistance to it before the cancer reappears anyway. So it’s a pointless exercise at this stage and frankly, the less chemicals and crap I have to put into my body on a daily basis the better! There are day to day medications I have to take, I am critically anaemic at the moment and all the usual methods of raising my levels are proving futile so it’s quite frustrating. I can’t work – probably will never work full time again – and life is still a bit of a week by week proposition. However: I am alive and, despite everything and all the battles, I consider myself VERY lucky to have had excellent doctors and the best medical care possible. One of the “upsides” (if you like) of infertility is that there are not innocent kids caught up in it all, watching Mum be sick and not able to be the Mum I would want to be. I also have an incredible, generous, loving husband who has sacrificed so much to love me and does so unconditionally. There is no possible value I can place on that, that does it justice.

              By the way – that nurse who called you a murderer? Horrendous. Disgraceful. Incomprehensible. Entirely unprofessional and someone who should be reconsidering the area they nurse in. There is no excuse for that behaviour and I am genuinely sorry you experienced that. I havent had a smooth experience with the judgments of others either, although thankfully not nursing staff. I HAVE been told that life would have been easier for my family had I just died….and that’s not even the worst of it. We all have our critics!

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          • Triplet mum

            Kass – I’m afraid you’re wrong when you say “If you only want one baby, only implant one egg. Make SURE you only get one baby.”

            It doesn’t always work that way. Despite previously having a twin IVF pregnancy (and losing both), I went ahead and implanted two embryos. I knew I could have twins and I accepted that. However, at no time did anyone raise the prospect of one of the embryos splitting. It didn’t even occur to me that it could happen – just as it doesn’t occur to most people who try to get pregnant every day. My embryos were five days old when implanted. In my ignorance, I assumed that I was implanting two babies – and I also assumed that at least one wouldn’t ‘take’. And if they both ‘took’ I assumed at least one wouldn’t live. They were the assumptions I was working on, not triplets.

            There are so many factors that go in to this issue that it’s a shame to see you so closed minded about what actually goes on. The truth is a lot more grey than the black and white reality you are trying to portray.

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            • Kass Hall

              Please don’t insult my intelligence and assume that I know nothing about IVF, triplet mum. As I have stated in other comments, my sister and both my best friends have undertaken the procedure. I fully support the use of IVF and reproductive techology. You and others are not reading what I have written carefully and in context – you’re coming at me with a preconceived idea of what I think about it, despite me making it quite clear.

              Of course after implantation an embryo can split. That is NOT what we are talking about. We are talking about women who implant multiple embryos under the assumption they wont have a multiple birth, or if they do, reducing their pregnancy for ‘lifestyle reasons’. I am not talking about health reasons and I am OF COURSE aware that embryos split after implantation. If it can happen naturally, it can happen after IVF too. It is certainly not my fault that your doctors did not give you all the information they should have before you implanted. It is not my fault that you made assumptions and didn’t really think through the possibilities. I stated in my article as well that I think DOCTORS need to take more responsibility for what they do too, in implanting more than one embryo and explaining ALL the possibilities. And sure, you may have only implanted one embryo, it split and you get twins. That is indeed a possibility for anyone who falls pregnant, naturally or not.

              NOTHING in health is black and white, I need no reminder of that. And if you HAD read my other comments throughout this thread I’ve said quite clearly that that is an important part of the discussion, that there is no black and white response. I am responding to the specific situation raised in the 60 Minutes story. My objection is and remains women who implant several embryos and then reduce their pregnancy for non medical reasons. You don’t have to agree with me but please do not treat me like I am stupid.

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            • Shelby

              as always, late to the table on this one! Thanks to a dear friend…I started a website. Honestly, I haven’t a clue what I’m doing… But, here it is: http://www.mother-to-one.com/
              Tripletmum, I gave you a little shout-out today in my blog. renewed my faith that people are good.

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          • Shelby

            Sorry I have to reply in a jacked-order, but I can’t reply to your last comment Kass.

            I feel very strongly that CHOICE is CHOICE. I don’t know how else to say it. A woman who puts 5 embryos in and gets 4 fetuses, I support her in her choice to selectively reduce. I also support the careless 17 year old who didn’t use birth control. I also support Amy, who had SR after a naturally conceived triplet pregnancy. Whether there is intent behind it…we all have to make the choice that is right for us.

            I worked at an abortion clinic here in the USA through graduate school. I have seen every reason under the sun WHY people choose abortion, and I fully support them all. My own feelings on this are irrelevant because, it’s not my body. The CHOICE movement, in both the USA and in Europe is of the same ilk: CHOICE, is CHOICE is CHOICE. We obviously disagree on this, but keep reading and keep evolving…that’s what life is about! My views changed (towards the liberal end) after my procedure…I couldn’t not support a woman for whatever reason, who made a choice to terminate a fetus/pregnancy. Because, I too was now in that boat.

            And Triplet Mum is right…IVF is not steadfast in the numbers produced. Recently, the American Fertility Assn. published a report on embryos twinning and triplet-ing. The numbers for this were in the 20% range. That’s frightening! What would you say to a mama carrying triplets, after a single egg transfer? (just trying to understand, no criticism here). She did fully intend to get pregnant…would that be an acceptable use of selective reduction?

            I’m so sorry about your health situation…I cannot imagine battle after battle. Cancer is a HORRID thing… HUGS.

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          • Shelby

            But who wrote the first bit? Was there another woman interviewed who had IVF, wound up with a triplet pregnancy and reduced???
            And, can you explain how my comment about a fetus being tissue correlates to the regulation of IVF?
            Just curious, no sarcasm, no “tone” here…
            I fully agree with regulation of the fertility industry. You haven’t seen a crazy pregnant lady until I was at the fertility doctor’s office being told by the nurse (purely by accident), well kid, you had 4 eggs drop… I screamed “WHAT?!?! He said I only had two if I was lucky…” Informed consent is a real issue in the United States…if I could have sued that doctor, I would have.

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        • Shelby

          I failed to mention…those nurses… Well, here’s what happened.
          I go into labor at 36 weeks…walk into the L&D (labor and delivery ward) and the nurses refuse to call the doctor, suggest I’m not in labor…then proceeded to ignore me and whispered I was a murderer and they wouldn’t deal with me. one kind nurse finally came in and said “ignore those bitches and I’m going to give you the number to the hospital director so you can report them”. That poor nurse (the kind one, we’ll call her Sally) was racing between patients as the other nurses sat at the station gossiping about me and swapping breaks to smoke (which I could smell all over them!). After about 4 hours, I was in the bathroom and realized my water had broken…and I began vomiting. When I buzzed for the nurse, no one came. Sally was in a c-section…at that point, I was pushing (or my body was forcing it, I don’t think I was doing it). I was standing in the middle of the room and realized I was tearing, and all sorts of “stuff” was dripping on the floor…my husband ran out, screamed for someone…finally an intern (doctor) responded and pulled two nurses from the NICU in…by that point, the head was already out. 5 pushes and she arrived! Although she was tiny, her APGAR was 9, her weight was the only thing that prevented a 10. In anycase, we were SUPER lucky she was in the right position…if she wasn’t, I shudder to think what the result could have been.
          As for those nurses… I reported them to the director of the hospital, both of which admitted (since Sally backed me up and stated they had said what I was claiming they said) they had called me some fairly nasty names. Both were suspended from nursing in the state for 6 months and placed on 1 year probations thereafter. Both are not working in L&D any longer and both have a record of their behavior on their licenses.

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          • Faybian

            Good for you. I’m a nurse/midwife and that was what got to me the most in your story.

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            • Shelby

              Ok, I’m going to sound clueless here… But, what parts of my story did they air??? What did I say? I know what I said during the interviews, but I haven’t a clue what they did and did not use. I have the DVD, but I’m refusing to watch it. I am NO celebrity and have zero interest in being upset by seeing the procedure, seeing a pro-life slant and/or critiquing myself on things I said in February. I’m a mom, a public health consultant, a wife…and furthest from what I’m sure people envision. Also, I hope that any patients you have/will have can find some solidarity in my choice and know they are not alone. I experienced the worst depression of my life first and second trimester. It was my midwife who made daily calls talking me through it… Without her, without Doc Evans…not sure where I’d be?!?!
              As I pointed out before, it was 6 total hours of interviews…it’s a very long, long process. Also, regarding the life question: I think I answered that 10 (maybe 11) times already, I was starting to get a little frustrated! I think that was starting to come across in the way I said things (or so I’m reading via people’s comments).
              How I LOVED my midwife/NP! She was a total godsend for me…she was my touchstone going through this process (as was Doc Evans). Getting a little teary thinking about the support they gave me during my pregnancy and thereafter.

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  15. Shelby

    PS: I challenge each and every person who writes “I am pro-choice, but…” to rethink their views of what CHOICE is. That’s the point of this story…to challenge you, the producer went into this wanting to challenge what CHOICE means. CHOICE means supporting women in their rights to control their bodies, in every way.
    Also, Dr. Evans platform, which I am also a fan, is this: economic, mental health, and relationship concerns are JUST as valid as medical. I agree with this and fully support any/all women who choose to continue (yes, even Octomom) and women who choose to abort/SR.
    I do not believe this procedure is for everyone and I do not believe that this process is without consequences. Believe me, I did suffer with this–the process of talking about this with 60 minutes as been cathartic.

    And, for those that want to explain away selective reduction stating “if it were medically necessary, I get that…but for lifestyle”…a high order multiples pregnancy is NOT without risk. The risks are EXTREMELY high, to both the fetuses and the mother. There is very little statistical difference between a triplet pregnancy and quads.
    At my fertility clinic, there was little to no discussion with me about the risk of high order multiples, since we were facing a litany of fertility issues. I was angry at my doctor for a while, but, without this procedure selective reduction, I wouldn’t have this amazing little person. I am SO LUCKY!

    I think the issue of intent is bleeding into the bioethics side of the house (or so to speak). There are a variety of interesting bioethical papers out there on abortion, both for and against. This area is fuzzy for me…I did FULLY intend to get pregnant, but the information I was armed with via my doctor, I didn’t expect to.

    Also, I hope that this starts a conversation in australia prior to entering into fertility. My husband and I had discussed this early on and…on a clear day, I had decided that any more than 2 (which, I would have been elated to have twins), we would reduce the pregnancy. This discussion, back in 2006, made it easier for me when it actually happened.
    I will be discussing this with my daughter. If I raise her right, she’ll understand (rose colored goggles on here!), and if I’m completely honest. I believe she’s the only one that needs to know (besides my husband) the medical issues I was facing. I’m fairly sure this will happen when she’s older, right now all she wants to discuss are princesses and ballerinas.

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  16. Shelby

    I have read some of this discussion and feel like it’s an appropriate venue (your respect for the subject astounds me!) for me to address some of the questions & concerns people seem to have.

    We had *zero* part in the editing, voice over, and such associated with the story. I have the highest respect for the journalists & producer who treated myself and my daughter with a great deal of kindness. Even Mr. Usher does not have control over the final editing…. With that said, I have NOT seen the piece, nor do I believe I will. Even if we were demonized–I would think any intelligent person could conclude that the interviews we did were 1 or more hours. I believe I spent 6 full hours with the 60 minutes team…and I’m guessing my portion was, 5 minutes? Less than 5% of what I said was included in the interview.

    In the USA, artificial insemination (IUI) is quite inexpensive (a few hundred dollars, US), so all those who had stated “she spent thousands on IVF” are assuming. When I went in for IUI, I was told two things: a) you will not get pregnant, b) I did not take enough hormones to stimulate my ovaries (subsequently, accused of not taking the medication at all). So, my hopes were, low, to say the least. When I received the news at 6 weeks I was pregnant with triplets, I was in shock. When I received further news that I needed to be hospitalized, I was shocked. I spent another month, reeling from shock. But, I persevered and survived this ordeal…as did my wonderful daughter. At the time, my husband was away–so, we discussed (as did my doctors) all of this by phone. We flip-flopped between maintaining 2 vs. 1 fetus. In the end, we received even more news from my perinatologist that helped us make the decision to reduce to one fetus.

    With that said, I must emphasize that this process was NOT easy, nor was it without emotion. I was not callus about anything, whatsoever. I believe that during the interview, I came off as callus because I had been asked the “what is life” question 10 times…by that point, I was starting to get a little frustrated. Plus, I had an angry toddler in the background wanting a hot dog (no joke). I am also 4 full years out from the procedure, which was at 11 weeks for me…so, the emotions surrounding the procedure have long faded. Oh, and whatever procedure they showed on the news program was not mine or Amy’s procedure.

    I also have to mention to you my background. I have a master in Public Health. I have worked in women’s reproductive rights for a decade. My education was the key to understanding the statistics (I read quite a lot of the papers the WHO had produced at the time). I processed the statistics of triplet pregnancy outcomes and…and spoke extensively with Dr. Evans. My husband and I concluded that a singleton pregnancy would give us the best shot at having a healthy baby. We had only wanted one child, and then to go on and foster/adopt later. I have some genetic concerns and didn’t want to further those–plus, as a pro-choice woman, I feel I need to walk the walk and talk the talk. So, adoption is (hopefully) in our future.

    I did 60 minutes because I (and my friends who have also had selective reduction) are not wanting to hide this subject any longer. When sitting around discussing pregnancy with friends/coworkers/family, I shrink back thinking back to that difficult, dark time for us. I don’t want that to be the case. I don’t want my child to have to face a world where her reproductive choices cause her to dodge questions, as I currently do. As parents, don’t we all just want to make this a better place for our kids to live?

    Dr. Evans was my hero. He saved me, he saved my pregnancy and he saved my child. He cares very deeply about ensuring the health and welfare of mothers/fetuses. He even performs fetal surgery… This isn’t his only “gig”. He’s a very kind soul and I think the world of him…he rescued us at a very dark time.

    Finally, seems that folks don’t like my choice of words. I shoot from the hip, which isn’t always the best way to be…I get that. Again, you’re seeing a very small chunk of my discussion with Mr. Usher. Who was, again, very professional, warm and understanding.

    I fully support EVERY single woman in her choice…whether that’s NOT having kids, aborting, adoption, etc. Selective reduction is another aspect of choice that myself and Amy felt needed to be discussed…I am PLEASED to see a discussion has begun and thank all of you for the intelligent, thought-provoking discussion that’s occurring here. You will all help shape this world into a better place, whether you agree or disagree with my choice…you are now armed with the facts. Again, this is an amazing discussion and forum…

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  17. ivf-er

    regardless of whether ‘selective reduction’ is right/wrong – i think the way 60 minutes handled the story was rough.

    in no-one’s defence – the first woman on the 60 minutes story said she did not go through IVF or artificial insemination (iui) – she conceived 3 naturally. the second woman went through iui – in which she had no control of how many of her eggs fertilised – however should/would have been made well aware of the risks of multiple pregnancy.

    the judgements on ivf and the amount of embryos transferred in the comments of this post are mostly uneducated and plain wrong. nobody in their right mind would choose to go through the heartache and grief of infertility and ivf – and how many embryos to transfer is one of the TOUGHEST decisions i’ve had to make. if you have been through multiple failed ivf cycles – and you have to make a decision on as to whether you transfer one – or both of your embryos is a tough call.

    in australia – generally there is a one transfer policy – unless you’ve been through multiple failed ivf cycles – or you’re older and have a lower potential success rate.

    i am made WELL aware of the risks of a multiple pregnancy for both myself, and my potential babies… but there’s a whirlwind of hope, risk and emotion involved in making that decision. i sometimes wonder if i could live with myself if my choice to transfer 2 embryos resulted in something that ‘went wrong’ with my children…

    i guess my point is – don’t judge someone’s (very tough, personal decision) before you’ve walked in their shoes.

    personally, i could not live with myself if i chose ‘selective reduction’ as an option.

    L

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    • Shelby

      All great points. I believe that it’s imperative that we all respect one another’s choices, and remain open-minded and ever-evolving. If you don’t believe selective reduction is for you, please do not consider it! My own philosophy: do what’s best for you, I’ll do what’s best for me–and somehow, we’re all just human at the end of the day. I wish you TONS of luck…fingers crossed you get pregnant soon and that pregnancy is easy and UNEVENTFUL! I wouldn’t wish my situation on anyone!

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  18. neola

    I was told by my doctor that, in Australia, most IVF clinics now have a ‘one embryo implanted at a time’ policy for all patients. I can’t understand the reason why anyone who wasn’t prepared for multiples wouldn’t try one at a time? Apparently the rates for frozen transfers are as good as fresh anyway and the transfer process is fairly straightforward for most women (as opposed to the egg harvesting!)

    I say this as someone who currently has one in me and some on ice and was told that a multiple pregnancy would be very high risk for me, anyway.

    If I were lucky enough to have a multiple pregnancy, I would only ever consider terminating one if the strong likelihood was that none would survive otherwise. I hope I would never have to make that choice.

    Sure, twins and triplets would be incredibly hard, but I’d be absolutely thrilled to bits to have them.

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    • Triplet mum

      Unfortunately there’s a lot of misinformation surrounding this topic. You can’t always choose whether you terminate one or two. In my case, I would have had to abort my identical twins as the risks associated with those are much greater than a singleton – and you can’t just abort one twin.

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  19. Amy

    Very well written, Kas. Thank you for your courage in expressing your opinion as I’m sure there’ll be a lot of woman who disagree.

    I didn’t see the show but the thought of a poisonous needle being injected into a living creature like that, a human no less, horrifies me.

    Women need to take responsibility for their outcome of their decisions knowing that a multiple pregnancy can be the result of IVF. This is about the creation of life not a trip to the shopping mall.

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    • Kass Hall

      Thanks Amy. Lots of disagreement, which is fine. As long as everyone is respectful it’s all good. :)

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  20. Mums Advice

    Well written article Kass on a heart wrenching topic.

    I believe that IVF is a choice that people make to conceive their children and that in making this choice people should take responsibility for the outcome, one or 3.

    Having said that, I also believe that the universe/God/Allah, whom ever you subscribe to, gives us what we can handle, even if we think we can’t. Maybe the universe put these women in this situation so they can stand up and shout for what they believe. Maybe to them, selecting to have only one of 3 children was taking responsibility for their actions.

    These women stand up for choice and it can be their choice only as it’s their lives and beliefs.

    We all believe different things, we all take responsibility differently & we all live differently. Thank goodness!!

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    • Shelby

      WELL SAID. I firmly believe I took my child’s well-being into my hands and made the best choice for my family (with full support of my husband, my parents, and my friends). I feel that this is a slippery slope and when regulation is placed on selective reduction (ie, only when it’s medical, only to twins, etc), we’re looking at further regulation of our bodies, a road my mother and grandmother already went down and fought for.
      Thanks for your open-minded and thoughtful comments…
      Decided to comment to some comments on here because I hear my interview was all of 5 minutes, and well…didn’t give the clearest picture on my feelings or thoughts.

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  21. Shelby

    Ok, just to clarify…I ( Shelby from 60 minutes ) had IUI.
    I also had health issues that I opted NOT to discuss because whether it’s medical/social/mental health…it is still CHOICE!

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  22. Em

    In America, you can’t just choose to have one embryo inserted. They have to insert more than one. You’d think people would know what happens in a country whose citizens they choose to discuss. Anyone here know what’s legal in Afghanistan and have a problem with it?

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    • Lil

      Hi Em

      You can choose to insert a single embryo in the States. Friends of ours recently had a baby girl after a single embryo transfer in California and they froze four embryos from the same cycle.

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    • jb expat

      Wrong – absolutely wrong. In America you absolutely can choose to do an eSet (Elective Single Embryo Transfer). See my post below as to why this isn’t an option for many.

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    • Shelby

      Yes, you can opt to have one embryo “put back” (I’m fairly sure that’s how it’s referred to up here). However, the cost of this procedure is 10000 US dollars, so many couples choose to have 2 “put back” to increase their chances of getting pregnant. My friend, case in point, decided on two, both split, causing quads. She terminated 2 and has two healthy boys now, 2 years old.
      I fully agree with more regulation in the fertility industry.

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  23. ameliastclair

    Hurrah! I love a bit of reproductive health and ethics debate to kick off the week! Bravo Kass, well done for generating both interest and discussion :)

    I can understand the arguments from both sides – pregnancy with multiples has higher risks to the mother and foetuses, IVF is expensive so more embryos are implanted incase they don’t take, additional babies put so much emotional and financial strain on a family, IVF is a voluntary procedure as is choosing the number (1 or 2) to implant… each side of this argument is valid.

    Ultimately though, I believe in reproductive choice. Who are we to judge another’s choice until we have been in their position?

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  24. Nic

    **warning, this is off topic!!**

    It seems to me that if an author submits a piece for Mamamia at the moment, they have to be prepared to endure the extraordinary wrath of its audience. I’m sort of shocked at how many of the comments thus far have attacked Kass despite the article being very well written and particularly heartfelt. Also surprised to see how many people have rushed to the defence of the women in the 60 minutes story and then finished off their post with the statement – by the way, I didn’t actually see the show last night… For the record, I found absolutely nothing in Kass’s story to be hypocritical, I thought it was well thought out and it was straight from the heart.

    Kass, I don’t know whether the negative comments would actually be upsetting you or not – could be your have thicker skin than me! But if I knew you, I’d be buying you a cup of coffee. x

    p.s. this isn’t about comments where people are simply putting forward their opinion – obviously that’s fine, everyone is entitled to their own opinion, I’m just talking about the cases where people are being a bit harsh in their retorts.

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    • ameliastclair

      Totally, Nic! I hope you’re holding up, Kass! To be fair, most people have been respectful in these comments which is nice (the ones I have read at least). Pregnancy, babies and reproductive choices are always going to be hot and emotive topics on this site purely from the varying experiences and passion of the readers – everyone just needs to remember their manners and that the writers/Mamamia team are people with feelings and have the very best intentions :)

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    • Kass Hall

      thanks Nic I’m just fine!!! I am absolutely up for any differences in opinion where the commenter is respectful and puts forward a thought out point of view. Agreeing with me isn’t a prerequisite! Im pretty tough – and those who do resort to name calling…well that’s more a reflection on them than me. :)

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      • Kass Hall

        Thanks Amelia too!

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    • oopsyboops

      lol I’m one who didn’t see the show (chose not to) however I saw enough of the ads, and enough generated discussion and read this article, to feel able to comment. It’s just some of the finer points I may have missed. However it also means I can comment without the sensationalism that surrounded the piece (and the emotions it could bring up).

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      • Kass Hall

        nothing for you to worry about Oopsyboopsy. ;)

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  25. melmills

    Aside from the decisions made, no one should have to see that footage of “the injection” unless they choose to. We chose to farewell our baby girl mid-pregnancy due to chromosome issues. Re-living that moment/that hour/that day/that needle absolutely breaks my heart every single time I think about it. When I remember that time, it feels like my heart is being ripped out of my chest and I (like right now) bawl my eyes out. We know the reasons why we made that decision and we stand by those decisions, but, in my opinion, that footage is not something that should be shared on a news story.

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    • Shelby

      I am so sorry you had to terminate too. My heart goes out to you.

      Again, I had no part in the production of the piece, nor was it my own procedure shown.

      I NEVER watched the screen during my own selective reduction, nor have I ever watched one. Won’t start now. Prefer not to… Try “thought stopping techniques”…like, every time your mind goes there, force yourself to think about something happy! Puppies (frenchie puppies) do it for me…

      HUGS, and I’m sorry it impacted you so much.

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  26. sundress

    Why aren’t lifestyle and financial reasons considered good enough? Personally I think taking them into consideration shows that you’re actually thinking about the reality of raising children.

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    • Me

      Yes! Agree!

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    • Guest

      Absolutely agree!!! “Lifestyle” is what kind of car you drive or whether you eat out in restuarants a lot. Having 3 children at once is not about lifestyle but quality of life (theirs and yours). If you can’t cope with them physically and mentally then everyone will suffer.

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      • Monica

        I am pro choice generally, but what people don’t seem to consider is that aborting the baby is not the only option if you dont want to raise multiples. Adoption is available and there are so many loving families that are desperate for a baby!
        That said, I do believe that women have the right to decide what happens in their bod and I would never take that choice away from a women. But I do think it is sad when people think termination is the only option.

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        • Shelby

          Adoption was not an option for us (although, I am in the process of adopting now!). High-order multiples pregnancies have EXTREMELY high rates of loss of life (for the babies) and even further developmental/neurological issues. I felt it was the most responsible choice for myself and my family to give our future child the BEST possible shot at a healthy and productive life.

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  27. Kaz

    I think we need to realize that if a woman decides to abort or reduce her fetuses that her decision isn’t made lightly. Personally I wouldn’t even contemplate either but that’s me and my decision may change if my circumstances changed.
    I was disturbed by the image of the fetus being killed and initially didn’t agree with the whole concept but I’ve realized that the world would be a better place if we understood and supported each other rather than judged and alienated each other.
    People do things on a weekly basis that I personally would never do but who am I to try to change who they are just because they’re not like me?

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    • Shelby

      LOVE your comment. I agree, and virtual ((hugs)) from the USA!

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  28. KatK

    What happens to the baby that is killed? Does it come out? Or does it stay there till birth?

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    • Anonymous

      Depends what gestation the procedure is done at. Generally the reduced fetus remains in the uterus but they become smaller and may or may not be totally reabsorbed. At delivery they will be passed as part of the placenta and will appear as another blood clot.

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    • jb expat

      It is not a baby, it is a fetus and it is incapable of surviving on its own at the time in the pregnancy when this would happen. I miscarried a twin at 11 weeks (yes, the result of ivf and the full truth is we only wanted a single pregnancy but we put back 2 on the advice of our ivf doctor – this was not an aeasy decision to make AFTER 5 miscarriages) – ended up with a single pregnancy that resulted in our now 17 month old.

      The tissue that was formerly the fetus stays in your body (hopefully, as you can have serious issues if your body tries to expel it and you are still carrying a potentially viable fetus). When you deliver – whether it be via c-section or vaginally, they make sure that all that remains of the former fetus is removed from your body.

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      • KatK

        Yes thanks for the clarification jb that it is a foetus and not a baby. I don’t know why I said ‘baby’. My concern was whether or not killing one foetus would affect the other foetus at all. But sounds like the pregnancy can progress as normal for any remaining foetuses.

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    • Shelby

      The fetus is then absorbed into the placenta. After birth of the remaining baby, the placenta looks like any other placenta (sometimes larger due to the nature of a high-order multiple pregnancy).

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      • KatK

        Thanks for the responses. My concern was whether or not killing one foetus would affect the other foetus at all. But sounds like the pregnancy can progress as normal for any remaining foetuses.

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        • Shelby

          Yep, the pregnancy continues as normal. Finding a provider that is well-versed in this procedure is half the battle. Someone who’s done this time and again is highly skilled, vs. someone that’s done it once. Dr. Evans results are that the same number of pregnancies miscarry after the procedure as they would have, naturally. Sometimes, the fetuses aren’t in the right place, the uterus gives way, and you wind up with spontaneous abortion (miscarriage).

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  29. Lil

    We had twin girls with the help of a generous surrogate. Our goal was a singleton but after four IVF cycles that produced not even one viable embryo we suddenly found ourselves with three. Two were considered of reasonable quality with eight cells and one poor with only four cells. We took the doctors advice of implanting all three. We had a thirty percent chance of getting pregnant and of that thirty only ten percent chance of a twin pregnancy. The day I found out we were pregnant I was elated but when news of a twin pregnancy arrived I was horrified. I cried tears of desperation and heartache not knowing how I would cope with twins.

    I had always planned on an amino and had the surrogate in the doctors office ready to go ahead with the procedure. The doctor then explained to me how they would terminate if one of the twins had an abnormality. I had always thought I would abort an unhealthy foetus. However the idea of injecting poison into my baby’s heart and putting its twin at risk of miscarriage was just too much to bare. So we decided not to go ahead with the amino because we knew we couldn’t go through with a termination or reduction as it was referred to if something was wrong. It was a heart wrenching decision but it didnt feel like we had an alternative.

    So the surrogate went home without the procedure. She then endured the most difficult pregnancy of her life while my girls fought to live her body broke down and became a mess. She was hospitalised from 27 weeks when her waters broke and isolated from her family until the girls were born at 31 weeks. She endured hardship, pain and emotional anxiety throughout the process.

    Thank god we have two healthy girls who despite a rocky start to life are doing very well. I am glad we made the decision we did but I still feel bad for our surrogate who got far more than she signed up for. Further, the stress of adding twins to our family has been overwhelming both emotionally and financially. I have no regrets but I do empathise with women confronted with the difficult choice of reduction. There are so many issues to consider and so much potential pain and hardship.

    I beg everyone to be less judgemental and to consider the needs and impact of all involved.

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    • Shelby

      Thank you for your kind words. Congrats on your twins! And, finally, no one knows what they will do until they are placed in that situation…

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  30. Loz201

    I’m perplexed as to how selective reduction is seen differently to any other abortion. Women choose abortion for a whole range of reasons. In some cases I am very sympathetic, in other cases find it hard to rationalise. Why is selective reduction different?

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    • Anonymous

      You’re right, it’s not! I think perhaps the method of potassium chloride injection seems to upset certain people.I find that hilarious…I mean, have you seen a d&c?!?! Also it can be wrongly portrayed as ‘just a lifestyle issue’. Which is also a moot argument, because most singleton abortions are done for social reasons.

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    • georgiepie

      I see it differently because you’re choosing one life over another. At least with an abortion you kill the foetus and you’re done with it, kaput, no more baby. But with selective reduction you’re choosing one baby over another…it just unsettles me. How is one life more viable than the other? If one is going to die anyway, danger to the mother, huge birth defects etc. I understand. But aborting one child because you don’t want twins?! That’s what mother nature dishes out!

      I’m a type 1 diabetic, and my mother knows people who would have had an abortion if they could find out their child had a disease like mine. What if I’d been a twin – how is my life less valid than the other baby? Selective reduction really bothers me – you’re choosing one life over another, a kid will never meet their sibling. If I found out my mum had done that for the reason that she didn’t want wins, I would be FURIOUS.

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  31. oopsyboops

    I’m not sure I can adequately express my feelings here, so bear with me. Kass I can feel your pain all through this story. And yes you are right, women having abortions for lifestyle reasons is distasteful. However I am pro-choice, no matter the circumstances.

    But to call for greater control over IVF becuase of a few women in America, isn’t right either. It tars those of us who have used IVF. It stirs up anti-IVF sentiment (which does exist already on so many levels) and it highlights how little people understand about the IVF process in Australia.

    Rudyroo wrote a great comment below about the reasons behind how many embryo’s one decides to transfer. In Australia, the maximum limit is two, and we had to sign something to authorise that. For our first cycle, with all the hopes and good stats to go with it, we transfered one. After the pain of a negative, where we had two to transfer, we did. Knowing we may have twins, but never expecting it. It took 6 cycles to have our daughter. I never expected to even get pregnant by then so the thought of twins was far from our mind. And ditto for our son (two incredibly draining cycles later). Had we conceived twins we would have been elated, however that is my own personal choice. I had many health issues with my second pregnancy. Had we conceived multiples and then been adivsed to reduce because of the health issues would that still be so distasteful?

    We also made the incredibly painful decision to discard our last frozen embryo. Is that too considered irresponsible because I didn’t donate it?

    This story is complex on many levels, and I don’t think it’s fair to tar one side because of one persons decision.

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    • Kass Hall

      Thanks, Oopsyboops.

      In case I have been unclear in ANY way – I fully and wholeheartedly support the use of IVF. My sister used it. My two best friends both used it. If it were at ALL possible, I would use it.

      What I do object to is the use of it by people I think abuse the process by having it “both ways” – using the technology to both reproduce and abort. I can’t reconcile that for lifestyle reasons. Health reasons – YES. Psychological reasons – YES. But because it doesn’t suit a person’s “New York lifestyle” – that I can’t stomach.

      If that makes me judgmental, hypocritical or whatever…. well I can wear that.
      :)

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      • oopsyboops

        I will confess I didn’t watch the show, so I haven’t seen this women’s reactions. And I don’t know what her reason for using IVF was, I’m presuming she was actually infertile. And yes, I read most of the comments and I see that you are supportive of IVF.

        However you weren’t in her head when started IVF. When she injected herself daily, had numerous blood test, underwent a painful egg collection procedure. Or when she decided to transfer more than one embryo. I can’t believe that she did all of that for lifestyle reasons. She clearly wanted a child; one child. Whatever decisions she makes after that is her choice.

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        • Kass Hall

          Yup, and thanks for keeping it civil and not resorting to name calling ;)

          I was and am not in anyone else’s head. But I am in my own – the heart and mind of someone who has known since age 12 she wouldn’t be a mother, that no matter WHAT I did, I could not be a mother – naturally, through technology, adoptive or foster. Being a mother is still a choice though, for most!

          I think – and on this note I need to attempt sleep (long day!) – my main concern is that in the fight for the rights of the mother, there seems to be very little scrutiny or concern for the associated responsibilities to those rights. The women in the story had, in my personal opinion, very little concern for their responsibilities to their unborn child. The wider concern is the responsible use of IVF and that the technology is being used for the right reasons – the create life.

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          • oopsyboops

            Oh gosh I would hope I could always keep it civil, any interpretation otherwise is my dodgy grammar and brain ;) and you are doing a fantastic job at defending your position.

            I’ve thought about this all night though. Yes you absolutely have the right to judge this woman and her choices. But what you are also doing is calling for tighter controls for IVF. I have to presume you mean in Australia since you are discussing this here. And that affects people like me. Since the guidelines in Australia are already pretty tight, the only way they can get tighter is by banning two embryo transfers completely. For everybody.

            In my case, I had a total of 14 embryos transferred (a mixture of fresh and frozen) in 8 cycles. But one at a time only would have meant 14 cyles. Not counting the cost, the extra emotional and physical cost would have been extreme for me.

            So when you call for more regulation, tighter controls, women to take accountability for their actions etc etc it directly impacts people like me and the decisions we have made. I’m not going to play a hypothetical “what if” game about if we had conceived multiples as it didn’t happen. But to subject women to such strict guidelines, just in case I get multiples and then decide I can’t continue with a pregnancy, is cruel.

            I don’t see this as an IVF discussion, I see it as an abortion one. The woman chose to terminate a pregnancy based on her personal decision. How she actually got pregnant is irrelevant.

            I know that life isn’t fair (after everything we’ve already been through I’m now fighting a brain tumour), but I hope you can find peace with your situation.

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  32. Anon

    This post is very close to home for me although i didnt see 60 mins last night. I have also not read many of the comments below.

    I have always wanted more than one child, so we started trying (naturally) for our second at the beginning of the year and fell pregnant quite quickly. When my obs said that there two feutuses instead of one i have to say that i was dissappointed. I cried, there were expletives said and i walked around in shock for a number of weeks.

    So many questions regarding affordibility, space and how we were going to manage were asked, but when it came down to it, i saw it as a challenge.
    I have read so many articles on this website about women who have conquered far worse things than having an additional child they weren’t expecting.

    I know that i am in for a hard slog, but i know that i will be rewarded with a bigger family, more people but more love. I am also lucky because i have a wonderful support base, but if i didn’t have anyone to help me it would be extremely difficult to say the least.

    Having more than one baby is a big deal, it’s not an easy task, and it can come as a massive shock to those who weren’t expecting it. The pregnancy is riskier, there are so many things that can go wrong and once you have the babies things are just as hard.
    I have chosen to go through with it and i will enjoy watching my (larger than expected) family grow. That being said i can see both sides to this argument.

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  33. Anonymous

    I have worked in both maternal fetal medicine and the IVF field, and have been along on the journey with some of these women.This is not a common procedure. It is uncommon. Also, can I just say, not one of the couples I met took the decision lightly. It was made after much counselling and careful consideration, and always based on the present or potential (and likely) medical complications rather than ‘lifestyle factors’.

    The fact is, twin pregnancies (let alone triplet or so on) often carry significant health complications for both the fetuses and the mother. And there is a significant chance that the woman may end up with no live baby, or at least no healthy baby. And yes, some of these women have gone through IVF and chose to implant multiple eggs knowing the risk for a multiple pregnancy. However, the foresight does not extend as far as knowing they will ‘just have a fetal reduction!’. Usually the risks for a multiple pregnancy are not even explained to them in depth at this point. It is just a theoretical risk and these women are absolutely desperate to have a baby and know that the chances are slim if they only implant one egg. Many fertility specialists in Australia will strongy recommend two eggs be implanted for women >40 years.

    As for the potassium chloride injection, this is the safest and most ethical way to perform a foetal reduction to ensure a) quick and effective demise and b) low risk to the other foetus/s. I would also like to note that a foetus less than 24 weeks is not thought to feel pain and that this same procedure is carried out in all medical terminations (e.g baby diagnosed with chromosomal abnormality late term) from ~23 weeks onwards where the fetus might survive the early induction of labour. I know that the procedure is confronting. All terminations are – imagine being the mother and father! It is often traumatic for them.

    Frankly, your judgement of these women disappoints me. Tell me, what would you do if you now suddenly fell pregnant with triplets and were told that unless you had a fetal reduction, the chance of any baby surviving was slim?

    In any case, it does sound as though you are against abortion all together, which is an entirely separate issue. To be clear, I for one am pro-choice. I support early (first trimester) abortion for any reason including social. And I support late term abortion (even third trimester) if medically indicated i.e. foetal abnormality/risk to multiple pregnancy/medical or psychological risk to mother.

    To sum up my main point: I am yet to meet a woman who chose to undertake an abortion or foetal reduction (and I have met hundreds in my career) who took the decision lightly. To varying extents, it was emotional and difficult and unpleasant for all. To suggest otherwise upsets me. I know it must be difficult for you and I am truly sorry that you have been denied the chance to be a mum. But please, don’t let this cloud your judgement.

    To be fair, I didn’t see the 60 minutes program but I am sure they sensationalised it. If they did show a woman who had a foetal reduction for lifestyle reasons and the woman appeared ‘blase’ about the decision…please know that, in my experience, this is very rare.

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    • J

      Anon I think you have made great points and think you have made a good argument. Maybe a bit off topic but you really think that a foetus doesn’t feel any pain up till 24 weeks? My niece was born at 23 weeks and she showed pain and emotions when she was born. I really don’t believe that at all.

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      • Anonymous

        Hi J,

        No that’s a fair question! Recent studies have shown that nerve connections in the brain are not sufficiently formed to allow pain perception until after the official 24-week. Emotions and sensation definitely, but not pain. It’s probably not that black and white though… perhaps some 22/23 weekers feel some pain, perhaps some 25/26 weekers don’t etc.

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    • Kass Hall

      Just to be clear, your comments are directed to me?

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      • Anonymous

        Hi Kass,

        Yes they are. Apologies – I probably should have used your name.

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        • Kass Hall

          Thanks. Just want to make sure that the judgment is all mine to wear.

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          • Anonymous

            I didn’t say “don’t judge anyone” kass (we all do) I said that I disagreed with your post and your harsh judgement of these women. And I think I said it rather nicely. Also, I was asking you an actual hypothetical question…but your lack of response is duly noted.

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            • Kass Hall

              Forgive my non response to your hypothetical, I have actually made my position quite clear – when there are health risks involved, I am 100% supportive of what I understand would be a very difficult decision. However, it’s a decision I will never have to make for myself.

              I guess, however, if you had watched the program and read my article in context and actually READ what I wrote, you’d also see that in no place did I say these women shouldn’t have their choice. What I said was that I did not understand their choice based on their self proclaimed lifestyle reasons, after using IVF and other technology to get pregnant.

              And if I sound defensive, you bet I am. It seems that if I agree with you is ok but if I hold a contrary view im judgmental. It’s. It just you, and I can wear disagreement no problems. But when I’m called judgmental because I hold a different view to yours, I’ll bite.

              And again apologies for the delayed answer to your hypothetical – I am busy in bed quite unwell because of my severely compromised immune system. Next time I’ll sit up late and get up early to answer everyone’s questions.

              :)

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    • Me

      Beautifully said xx

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    • Triplet mum

      Well said! I agree with Anonymous. No-one makes this decision lightly.

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    • Shelby

      Anonymous, you are right, right and well…right. On all accounts.
      Neither one of us Americans decided to race out and do selective reduction. I think people envision it as though I went through a drive through, then raced off to a party or something. Quite the opposite. It was tough, but I am strong and gain strength thru the kindness of people I meet who support my choice, even if they wouldn’t choose it for themselves.

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  34. chellebelle

    I haven’t read the comments yet so apologies if someone has already said this, but I heard an horrific story very recently about an Australian couple who had twins in utero. One of them had a very severe congenital abnormality and would have died a painful death shortly after being born. The couple decided to use the injection method in the story above to abort the ailing fetus. However the sonographer made a mistake and injected the healthy baby, killing it. It took me a long time to stop thinking about this story, particularly for the poor sonographer who made a mistake with such a devastating outcome.

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  35. Kim Kane

    I didn’t see the programme but I have twins, and two of my cousins have triplets so I do feel qualified to discuss parenting multiple births and it’s really really difficult. While I wouldn’t have it any other way, and feel terribly blessed to have two beautiful children, I’m not sure we were made aware of the social consequences of parenting twins at the time we decided to double our chances and “throw in another embryo”. We were made aware of the general health consequences for both child and mother but we didn’t think through — and I mean properly think through — parenting two children the same age. I now wonder how on earth I’m going to get the two boys reading at the same time, driving at the same time, they weren’t allowed to attend jimbaroo or swimming classes. Jimbaroo may be a “lifestyle choice” but are swimming lessons? Wracking up enough practice on your L plates? And what of the health repercussions? One of my boys has a renal problem and was in and out of hospital over his first two years, the other has asthma and we’re fortunate! I’ve met other twin mums in the hospital with really ill children born far too prematurely trying to give adequate attention to the sick twin with another kid on their hip tugging at the monitors. It’s really hard and not much fun for anybody.

    However, I pulled out our DVDs the other day and what shocked me was how clear it is right from that very earliest scan which boy is which boy; their little faces are quite distinct. They were punching each other in the womb. Should have been a sign of things to come, but it startled me because they were absolutely themselves at that very earliest stage and while I don’t judge women for aborting or selective aborting, it’s not a decision I could now make.

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    • me

      Just interested in why they couldn’t attend Jimbaroo & swimming? Was it financial or because of health reasons?
      My sister has twin girls in prep & for reading she uses flash cards & the girls alternate nights with picking a story to be read to them one night & reading one to mum the other night.
      As for driving she will most likely do the alternate trips because that is what seems to work best for them. It’ll take them a bit longer to reach the needed hours but they’ll get there eventually.

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      • Kim Kane

        Twins are prevented from attending a number of activities when they’re young as many require a ratio of one adult per child. Some mothers get around this by enlisting their own parents or doing something like swimming on the weekends when their partners are around, but for various (tedious!) reasons this wasn’t an option for us. Thanks for the reading tips — multiple mums are always wonderfully resourceful!

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        • Kass Hall

          wow. Both my best girlfriends have twins and have never mentioned this hapening. I’ll have to ask them about it :)

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        • me

          Thanks for replying. The only extra activity the girls do is swimming with both parents so I don’t think she has experienced being limited yet.
          She was lucky with the girls health being good but she has said it’s a lot less chaotic now that they are in school & becoming a bit more independent from her especially now they dress themselves. Good luck with your two.

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          • J

            Not sure if this will help “me” but gymbaroo is very over rated. I have 2 children close together and sometimes with homework etc it can be very hectic you will work it out and do what is best for them in the long run. All of these things mentioned only last for a short time and be over before you know it

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        • Lil

          I have experienced the same problem. I was asked to leave jymbaroo because I couldn’t find a second adult to attend with me. It is not easy juggling twins and they don’t always have the same opportunities as singletons.

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      • Koby & Max's Mum

        I’m a twin mum and we weren’t allowed because you need someone to help you with each child. Same with swimming you can’t get in the pool with two babes.

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        • J

          I’m sure your children will learn to swim regardless if you take them to swimming lessons as babies. All of these “activities” aimed at mothers and babies are a great big waste of time and money if you ask me. My mother never took me or my 4 siblings to gymbaroo, mini maestros, swimming lessons etc etc and we turned out fine and we all crawled and walked without the need to do baby yoga.

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          • Jane DJ

            Agree – clever marketing makes a beeline for those with disposable incomes….

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          • Koby & Max's Mum

            Yeah that is true J. They are 4 years old now and I don’t think they have missed out on that much. Maybe I would have made a friend for a Saturday coffee but that is about it. Oh who am I kidding, I would have been too exhausted anyway!

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    • Mooner

      I understand having multiples is hard. However, I don’t think that is an argument for aborting one of a set of multiples in utero. I think that is an argument for not implanting multiple embryos in IVF procedures.

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  36. Anonymous

    This just makes me sad for humanity.
    To me abortion should be used in the cases of rape or maternal physical or psychological damage.
    Using abortion to protect your lifestyle just disgusts me.

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    • kaufman

      Why?

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    • Shelby

      And those are your thresholds for any decisions you might be faced with in the future. I knew what mine were long before I got pregnant and remained steadfast in those.
      I am grateful we live in a world where you can make a choice, and I can make another choice. I would hope that, at the end of the day, you can respect my choice and I can respect your lack of agreement with it.

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  37. Bea

    Maybe we should all take a closer look at the society we are becoming, and perhaps let God be God… Sure, having a termination because a mother or her child’s life is in danger, or for other valid reasons, is an important discussion to have… But this…

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  38. Bel

    Forgive me if I am repeating something below.

    To me the diference between abortion and selective reduction as per the 60 min story, is that abortion is is usually the outcome of an unwanted pregnancy.

    In this case all of the women wanted a child, too bad if they were blessed (IMO) with more than one. Call me judgemental on this, but selective reduction for no other reason than a lifestyle choice is questionable.

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    • Shelby

      I worked at an abortion clinic for 2 years. Abortions occur for a variety of reasons, genetic problems, health problems (with the mother), rape/incest, lifestyle, age (advanced age or being too young), financial, the list goes on. Abortion (per the medical community) is the evacuation of the uterus. Selective reduction is the process by which one or more fetuses is terminated, but the remainder of the pregnancy is maintained.

      If you are interested in further reading on the outcomes of high order multiples, check out:
      http://www.ncbi.nlm.nih.gov/pubmed/21357334
      http://www.reuters.com/article/2010/03/17/us-triplets-idUSTRE62G00A20100317

      These statistics WERE taken into account during the decision making process.

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  39. kaufman

    Maybe three babies all born at once doesn’t suit their lifestyle. There are also more risks involved when pregnant with multiples.
    IVF cycles are expensive and it is unlikely that a single embryo will implant itself, that’s why more than one is implanted. Your opinions come across as very hypocritical. I don’t believe it’s right to say that abortion is okay in one situation but not in another.

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    • Kass Hall

      Thanks Kaufman. Did you actually read what I wrote? Have you read the comments throughout the day?

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      • kaufman

        I did read what you wrote. I did not read all the comments as I find a lot of the sentiments expressed very frustrating.

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        • Kass Hall

          And you still think I am a hypocrite?

          I’m just clarifying – not preparing to launch at you, just asking.

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          • kaufman

            I think your argument is hypocritical, yes. You state that you believe in women having complete control over their bodies and then question whether or not it is okay for women to choose to abort fetuses they don’t want.

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            • Kass Hall

              Hey, that’s cool. You can call me a hyprocrite. I didn’t and dont think my views are infalliable. But while I do think women should have total control over their bodies, I also wonder whether this is the best use of IVF – that implanting multiple embryos should be practiced if a woman is then going to abort one for lifestyle reasons.

              I think if you read carefully what I wrote, while I don’t understand the mindset of undertaking IVF and then aborting, I never ever said that it was not their right to do so. I just dont understand how one can lead to the other.

              Medical reasons? OK, horrible but understandable. Accidental pregnancy aborted? Again – not idea but that’s a woman’s right. But IVF then abortion because you got too many babies? Because it doesn’t suit your “New York Lifestyle” (the woman in the story’s words, not mine). Yeah, I object to that. Not on the basis that she doesn’t have the RIGHT to choose that but on the basis that it is unnecessary, cruel and totally not in the spirit of what IVF is designed to do. AND, for people such as myself, who don’t even have the opportunity to utilise IVF technology, it is a slap in the face.

              If feeling that way makes me hypocritical, then I’ll happy wear your label.

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    • Koby & Max's Mum

      Over a certain age you are asked if you would like 2 embryos transfered, as we were. There is no evidence to suggest that it is unlikely one will not implant itself, that is crazy. It depends on the health of the embryo and age of the egg prior to being fertilised.

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      • kaufman

        Apologies for replying here, but I can’t reply directly to Kass’s above comment.

        Kass – it seems as if you are taking this far too personally. I am truly sorry that you can’t have children. However, your situation should not dictate what other women choose to do. Your article and subsequent comments convey a real sense of offense. The fact that you “object” to other people’s medical decisions doesn’t sit right with me. It isn’t your place.

        Having multiple babies might not suit these people’s lifestyles. Perhaps they can only afford, or only want, one or two children. The fact is that each person has their own life and circumstances which impact on whether or not they want children, and how many they want. In my opinion, it is better that these unwanted (for lack of a better word) fetuses are aborted before they become unwanted children. If a family hasn’t got the financial resources to care for 3+ children (or simply doesn’t want that many children) then it is within their every right for them to choose that. Whether the fetus was conceived via IVF is totally irrelevant.

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        • Shelby

          Kaufman, I tend to agree with you. I did not come to this decision lightly, it was a multi-facted process by which we arrived at reducing to a singleton.

          I do feel like Kass’s article should simply have questioned the ethics surrounding my choice, and the ethics that go along with IVF…as she has every right to question those. Her article did seem to have a hint of: I cannot have children, so my opinion is a) more biased, b) more valid.

          And, intent aside: what woman walks into the fertility process (besides octomom or Kate Gosselin) and hopes for high-order multiples? Just because we undertake a process (and SOME fertility docs promise LOADS of things: no multiples, pregnancy, I’ll fix it, etc) by which we get pregnant, does not mean we must suffer the consequences thereafter. Fertility is the “wild west” of medicine, there’s lots of unknowns. People desperately want to explain away my situation: but you were sick, but you knew the risks. Sure, I knew that there were risks…but I also knew there were risks when I had wrist surgery (paralysis, death) but the benefits outweighed the risks. Anyone who undergoes any procedure then is taking risk…and will everyone sit around and announce “Joe, you knew that wisdom tooth removal could result in death, you must suffer the consequences of that choice?” Come on, I doubt a SOUL would say that…but because my choice involved a fetus, I get to endure verbal assaults & structural violence.

          For all of the heartache, the discomfort, the questioning and the abuse I’ve experience…I would do it all over again if it meant I’d get my happy, healthy, beautiful daughter. I love her more than you can imagine. She’s our little miracle…and I’d do it all over again, for her.

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  40. Ali

    Just an FYI I believe at least one of the women interviewed last night who had undergone selective reduction had actually conceived the triplets naturally so it’s not just limited to ivf

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    • Kass Hall

      Correct – as was noted in my article.

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  41. Monica

    Forgive me if this has been brought up already but I couldn’t read all 169 comments so far.

    As far as I understand, IVF practices are a little different in the States than here. Economic reasons in the US have encouraged many IVF practices and recipients to agree to a larger than average number of embryos being implanted in one cycle. We are not talking about one or two extra with the hope that one sticks. Just look at Octomom and the parents from the show Jon & Kate + 8. Octomom had 6 implanted (2 split and made twins) and Kate had 7 implanted of which one didn’t survive but the pregnancy resulted in six babies.
    No one wants to endure endless failed IVF cycles so it does make sense to implant more than one embryo at a time. Friends of mine couldn’t take the chance of ending up with twins so it took a few years to get their single embryo to take. I don’t know what they would have thought of selective reduction if offered but if people can make the calculated decision to reduce based on economics or even lifestyle then so be it. As long as IVF remains reasonably regulated here in Australia then I’d like to think it’s a rare choice made here.
    The irony is that I don’t know who is villainised more; a single mother who chose to have 14 children via IVF and now relies on taxpayers, or women who choose selective reduction because quite simply, they know the maximum number of children they want.

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    • kateinlondon

      actually (and yes, I think it is ridiculous that i know this, but at the time i was considering ivf), Kate from Jon and Kate didn’t have IVF – she used Clomid and IUI….

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  42. J

    I have had a termination when I was a teenager. After having children and experiencing the joy of a baby (YES A BABY) growing inside me I would not be able to ever terminate again and it just doesn’t sit right with me anymore. I think in circumstances termination is the right choice but not in this case. I think what these women are doing is selfish and wrong. You want a baby and you end up with 3 then you take what you get. I do not believe that doctors should ethically agree to do this procedure for their “lifestyle choice”.

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  43. anon for this

    Im pregnant, (about 4 weeks) We already have 2 beautiful kids. This will definitely be our last pregnancy. There is no way we could manage 4 kids. So we are waiting to see what the blood tests and 1st scan shows. If it is at risk from any genetic issues, we will not continue. If it is more than one, we will not continue. So if there is one healthy embryo we will have a new baby come January. Does this make my husband and I horrible people?
    I dont think so.

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    • Kylie2

      I hope you don’t mind me asking…If there is more than one embryo would you terminate the pregnancy or practice selective reduction?

      If you would consider selective reduction, what criteria would you use to decide which embyo would be carried to term (assuming there were no health problems)?

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      • Anon for this

        No if there is 2 then we wont continue on. Flipping a coin is not an option

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        • J

          Is there a reason you decided to get pregnant again? I believe if you get twins/triplets then that is what you are meant to have, and before you tell me not to judge before I know I actually do have twins and other children. If you didn’t want twins then don’t choose to have children at all.

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          • Anon for this

            I will agree that you get what you are given, I agree if you dont want twins dont get pregnant what I dont agree with is you saying you dont judge. You are judging me. My hubby had the snip in january, doc said there was no problem with getting back on the horse and even tho he had, I still took the morning after pill. It didnt work. This pregnancy was not planned. I have a problem that most women would love to have and that is being overly fertile. I have fallen pregnant whilst using multiple forms of birth control. The pill, implanon and condoms all at the same time. I hate the fact that many of my friends struggle to concieve and have had to suffer through the ivf process and multiple miscarriages. But just imagine peeing on a stick every time you have sex. Just imagine not having sex with your partner because you cant bring yourself to terminate another pregnancy. Our youngest is now 4, since he was born I can count on 1 hand how many times my hubby and I have had “proper” sex. So if its 2, sorry to be harsh, but its no deal.

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    • Claire

      I don’t think you’re horrible people at all. You sound very sensible to me.

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      • Anon for this

        Thanks Claire.

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  44. What I find troubling is that both the 60 Minutes segment, and this opinion article are both coming from an anti-choice angle. Could we please have a pro-choice voice here, to calm the hysterics and the ‘won’t somebody think of the children!’ cries.

    Also for those calling a 11 week along foetus a baby, it is not a baby. It is not a child, it is not an infant. It is a 4cm long foetus. Science ain’t nothing to be afraid of, you guys, although I know anti-choicers like to ignore it.

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    • K

      K here. One of those who so offends you by ‘unscientifically’ calling my own foetus a baby. Hey, when I’m talking with the doctor, or when I’m studying my psych units I am quite comfortable with using the terms embryo and foetus. Other women are entitled to call it foetus, piece of tissue, baby or whatever they like too. When its my own body and my own baby I’ll call it whatever the hell I like. I sometimes call my buttocks a bum too, and a penis a love sausage (well, not really), but I think its safe to say I’m quite comfy with science.

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      • Anonymous

        here, here K!

        All three of my 4 cm long foetus’s were, in my view, lives. And I love science.

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      • Cool, you can call yours a baby. You are entitled to do so. You might even say it’s your choice. But when we are referring to foetues in relation to abortion, we’ll call it a foetus. Because that what is is and referring to a baby being aborted is not factual and is a tool used by anti-choicers to push their “baby-murdering” emotive campaign.

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        • Kass Hall

          in fairness, I havent seen any rabbid anti-choicers commenting on this thread, latherrinserepeat. And I think K can call her baby a baby if she wants to, whether it is in utero, aborted or alive and well and walking around.

          The comments throughout this thread have been differing and varied but for the most part people have played fairly and respectfully.

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          • I agree that K can call her baby that if she wants. Again, her choice, and I’m all about supporting women’s choices.

            I haven’t seen rabid anti-choicers either, but when I see comments like “terminating the lives of those babies growing inside you” (taken from below), I’m motivated to point out that to someone considering termination, these are not babies. They are foetuses. Emotive language like this can be accusatory and lays blame with the woman.

            I respect your view too, Kass, although mine slightly differ from yours, and we both seem to be passionate about the topic.

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            • Melf

              Have you had a child? When I saw that heart beating at 7 weeks I saw my baby, not a piece of tissue or just a foetus. I saw my baby. Perhaps you need to experience it, to understand it? You sound very cold.

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        • K

          Yep, its about choices. I don’t judge others at all for what they wish to call their foetus. What they DO with said foetus is their own choice too and I respect that, even if I might not always like it.

          I totally agree that using scientific terms or emotive terms can reveal a person’s agenda, whether its to bond with a potential baby, manipulatively guilt trip someone or remain emotionally detached (“piece of tissue” is just as unscientific as “baby”, wouldn’t you agree?).

          By the way, I find the idea of someone using the term “baby” to guilt trip someone wanting an abortion abhorent too. My personal use of the word is not a condemnation of others, its just my own agenda – of developing the maternal feelings that will be useful to me in the months to come.

          Peace.

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          • I think overall we do agree, but maybe had a few defensive exchanges below. Yay for choices and respecting them! I personally wouldn’t use the words piece of tissue, because it’s much more than that, but I can understand the woman on 60 Minutes choosing to use the term to maybe justify and comfort herself.

            Very best with your pregnancy and I hope your baby is healthy and wise.

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    • Tess

      I’m not afraid of science at all, but as someone who has lost a baby at 11 weeks, I definitely see it as a baby. It looks like a baby, it has a heartbeat, in a lot of cases of a wanted pregnancy it has a name, even a bedroom!

      Don’t be so quick to shut people down for loving their babies, even at 11 weeks.

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      • I’m sorry for your loss, that must be so difficult for you and your family and I hope you’re on the road to healing.

        I’m not shutting people down for loving their babies. If they are wanted, than of course they are babies even in those early stages. Every mother has that choice to see their pregnancy as their longed-for baby or not. That’s the great thing about the right to choose.

        My point is that people seeking to terminate may prefer to refer to it as a foetus, and they are absolutely entitled to do that. I object to people shaming women for their choice and for trying to guilt them with emotive language.

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        • ameliastclair

          I get what you’re trying to say! Some women will recognise a foetus at 11 weeks as their baby because they are wanted and loved, but to other woman a foetus of the same gestational age remains a foetus, not a baby. There’s an emotional difference :)

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    • melmills

      Despite all that I had read, I did not greatly perceive my first 3 miscarriages as losing a baby each time. Then I gave birth to my baby girl (healthy, full term). Then I gave birth mid-pregnancy to our angel daughter. Those original 3 miscarriages suddenly all took on more importance and I saw them all as lost babies. Then I had another miscarriage. Let me assure you, by that 4th miscarriage, I was 100% losing a baby. Even though I was only 8 week pregnant and the “foetus” had only grown to about 5 weeks gestation – that was my baby who had died inside of me and who had to be surgically removed. Giving birth gave so much more meaning to those losses.

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    • Shelby

      After reading your comments, I emailed the producer and asked why Mr. Usher presented this piece in a pro-life light. He said they were playing devil’s advocate and attempting to balance the piece, as there wasn’t a pro-life individual invited to join the discussion.
      Was it really that pro-life? I haven’t seen it but I can assure you that Mr. Usher was both professional and supportive of myself and my decision. I’m sure they pulled the most controversial things I said and used those…as opposed to my huge long discussion on all the things going on in my life at the time (my husband was at war, we had an issue with one of the fetuses & I had just completed a masters degree in public health, the last class I took was reproductive rights and had just examined the risks of high order multiples…). But, I’m guessing that wasn’t sexy enough…comments regarding litters & what is life made it to print…and my respect for women in ALL choices was left on the cutting room floor. Sigh…should I not watch this? I have the DVD… I’m almost fearful of watching it!!!

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  45. Robyn P

    I do not agree with women being given the chance to abort one or more of the foetus’ in order to suit their lifestyle. In order to have one or more foetuses through IVF, it more than likely means that they chose to have more than one egg transferred back. If you make that decision then you know from the start that you run the risk of having a multiples pregnancy. That is the risk these women take, and I do not believe they should then be given the opportunity to terminate one of those pregnancies after they make this decision.

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    • Kylie2

      A friend of mine had a single embryo transferred which then split, resulting in identical twins. I have no idea how common this is, but clearly it is possible.

      My friend happily continued with the pregnancy and feels blessed to have an instant family of four after many years of heartbreak.

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  46. me no understand

    When I had fertility treatment (artificial insemination) the clinic would not inject the sperm if there was more than three follicles.
    Then when that treatment didn’t work we went onto IVF where they would only ever insert one embryo.
    They believed the health risks of an IVF multiple pregnancy were too great a risk.
    So how often do the cells separate after being inserted?
    Maybe they should stop inserting more than one or two embryos before thinking about taking them back out again?

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  47. Faybian

    I agree with some others here. Either you’re for abortion, or not at all. There’s a lot of times when abortions are done that I don’t agree with, but everyone’s viewpoint on what that is, is different.
    I thought also the reporter came at the story from a fairly strong pro life/anti abortion viewpoint and was probably not the right person to do the report, even though the whole thing seemed to lean that way.
    Also, it’s a very interesting subject to report about, given some of the crazy reproductive/abortions laws coming out of America atm. I wonder if 60 minutes would report on that????

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  48. MissT

    I am pro-choice due to being raised by a midwife who worked in hospitals when abortion was not legal. Who saw first hand what happens when it’s not, and who told me about it.

    Does someone choosing to end the life of a baby, looking at it with cold indifference and a callous attitude, make me a bit sick? Absolutely.

    Will I still defend their right to do so? Absolutely.

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    • Katie

      You’ve just put into words exactly what I feel. I am strongly pro choice, always have been, but I must admit this did make me a bit uncomfortable. However, it’s not my decision to make, and therefore I support it. I just wouldn’t make the same decision for myself.

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      • Ellie

        I’m all for pro-choice, but in the cases of IVF it is unnecessary, they should only transfer ONE embryo into the uterus! transferring 3, knowing you want & will only keep 1 is crazy!!!

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    • k8e.

      Thank you for stating what i was feeling, so much better than i could have!

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    • ameliastclair

      Articulate as always MissT! Bang on x

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  49. Guest

    Some interesting comments here but I think the main issue is what being “pro choice” means. Some seem to have the view that you can have an abortion for no reason at all but not for some specific reason such as selective reduction which seems bizarre.

    Either you support the right to an abortion or you don’t and if you do any reason should be good enough, no matter how apparently wrong or trivial – it could be not bothering to use contraception, the wrong sex, getting in the way of a promotion, the baby likely to be gay (not a possibility now but I’ll be that in ten years this is a reality just as gender screening is now) – or any of the strawmen the pro life movement throws up. Once we start deciding that only some reasons are good enough we start down a very slippery slope.

    I accept that society can reasonably demand some very good reasons for an 8 month termimation up to the point of banning it completely but at 12 weeks this is a decision between a woman, her doctor and her God (if any) and nobody else has any right to interfere.

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    • J

      I had a termination as a teenager and am pro choice but for ethical reasons I do not agree with terminations for “lifestyle” or gender choices. I don’t think it has to be so black and white and I am allowed to agree with abortions for legitimate reasons only and still call myself pro choice. After all when you have a termination you do have to see counselors etc and explain your reasons and go through a process which then has to be agreed upon by the doctor so its not just “your choice” in the end.

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  50. Gobbledygook

    As with abortion in general, I’m conflicted about selective reduction.

    But the 2 comments that had me *chilled* were:

    1. Yes, the “tissue in my body” comment, because of how it was said even more than what was actually said; I know I can’t legitimately judge what goes on “below the surface”, but it sure came across so coldly, callously.

    2. The doctor towards the end (the woman) talking about kids with CP in particular. Yes, people with disabilities are more of a burden on the parents, and the siblings…..but it seemed to really dehumanise and devalue kids & adults who have CP & other disabilities. Like society & their families/friends would be better off with them dead.

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