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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?

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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?

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