“The Two-Minus-One Pregnancy”

This week the New York Times Magazine has a long article entitled “The Two-Minus-One Pregnancy” about women who are pregnant with twins after undergoing IVF, and who decide to have one of them aborted.

The painfully obvious subtext of the article is to get you to believe that women “need” this particular type of abortion to be better mothers — a talking point the “pro-choice” movement has been using more and more in recent months.

“Almost Half an Abortion”?

The first thing that struck me as I was reading the article was the verbal gymnastics employed by the writer, Ruth Padawer, in referring to what is so coldly called “selective reduction” (but which in laymen’s terms might be better called “killing one or more babies in a multiple pregnancy”).

In the opening paragraph, we’re introduced to a 45-year old woman named “Jenny,” who was “choosing to extinguish one of two healthy fetuses, almost as if having half an abortion.”

Wow.  It’s bad enough that the word “abortion” is so often replaced by vacuous euphemisms like “termination of pregnancy” or “voluntary interruption of pregnancy”, but it’s perhaps even more insane to see a professional writer speak of an abortion of a human baby er, fetus “almost [!] as if” it’s “half an abortion”.

Several other times throughout the article, Padawer baldly tries to say that “selective reduction” is not abortion.  But does anyone who knows what “selective reduction” is — namely, a fatal injection of potassium chloride or digoxin into the heart of a baby in the 10th to 12th week of life — actually believe it’s not an abortion?

The article goes on to record Jenny’s misgivings about her “reduction”:

“Things would have been different if we were 15 years younger or if we hadn’t had children already or if we were more financially secure,” she said later. “If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner — in a test tube, choosing an egg donor, having the embryo placed in me — and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.”

In other words: it’s easy to look at children conceived through IVF and believe they’re disposable.

An Ethical Flip-Flop

The article goes on to talk about one Dr. Mark Evans, an OB/GYN and geneticist who was among the first Americans physicians to carry out a “selective reduction.” According to Padawer, Evans “quickly became one of the procedure’s most visible and busiest practitioners.” In 1988, he and an ethicist from the National Institutes of Health issued some industry guidelines, one of which was that “most reductions below twins violated ethical principles”.

Starting off with ridiculously arbitrary guidelines like that, it would hardly surprise anyone to learn that in 2004, Evans flip-flopped. He now sees no problem with twin reductions:

For one thing, as more women in their 40s and 50s became pregnant (often thanks to donor eggs), they pushed for two-to-one reductions for social reasons. Evans understood why these women didn’t want to be in their 60s worrying about two tempestuous teenagers or two college-tuition bills. He noted that many of the women were in second marriages, and while they wanted to create a child with their new spouse, they did not want two, especially if they had children from a previous marriage. Others had deferred child rearing for careers or education, or were single women tired of waiting for the right partner. Whatever the particulars, these patients concluded that they lacked the resources to deal with the chaos, stereophonic screaming and exhaustion of raising twins.

Gosh, who could have possibly predicted that “selective reduction” would be such a slippery slope?

A “Choice Revolution”

Later in the article, Padawer writes:

Who doesn’t want to create a more certain and comfortable future for themselves and their children? The more that science makes that possible, the more it has inflated our expectations of what family life should be. We’ve come to believe that the improvements are not only our due but also our responsibility. Just look at the revolution in attitudes toward selecting egg or sperm donors. In the 1970s, when sperm donation took off, most clients were married women with infertile husbands; many couples didn’t want to know about the source of the donation. Today patients in the United States can choose donors based not only on their height, hair color and ethnicity but also on their academic and athletic accomplishments, temperament, hairiness and even the length of a donor’s eyelashes.

Sheena Iyengar, a social psychologist at Columbia Business School and the author of “The Art of Choosing,” suggests that limitless choice is a particularly American ideal. In a talk at a TED conference last year in Oxford, England, Iyengar said that “the story upon which the American dream depends is the story of limitless choice. This narrative promises so much: freedom, happiness, success. It lays the world at your feet and says you can have anything, everything.” Nevertheless, she subsequently told me, “we are in the midst of a choice revolution right now, where we’re trying to figure out where the ethical boundaries should be.”

Reading this, I can’t help but recall G.K. Chesterton’s observation that “we are learning to do a great many clever things. Unless we are much mistaken the next great task will be to learn not to do them.”

“I Didn’t Want to Raise a Handicapped Child”

If I had to pick one excerpt that summarized this lengthy article’s basic point, it would be these two paragraphs:

In some ways, the reasons for reducing to a singleton are not so different from the decision to abort a pregnancy because prenatal tests reveal anomalies. In both cases, the pregnancies are wanted, but not when they entail unwanted complications — complications for the parents as much as the child. Many studies show the vast majority of patients abort fetuses after prenatal tests reveal genetic conditions like Down syndrome that are not life-threatening. What drives that decision is not just concern over the quality of life for the future child but also the emotional, financial or social difficulty for parents of having a child with extra needs. As with reducing two healthy fetuses to one, the underlying premise is the same: this is not what I want for my life.

That was the thinking of Dr. Naomi Bloomfield, an obstetrician near Albany who found out she was pregnant with twins when her first child was not quite a year old. “I couldn’t have imagined reducing twins for nonmedical reasons,” she said, “but I had an amnio and would have had an abortion if I found out that one of the babies had an anomaly, even if it wasn’t life-threatening. I didn’t want to raise a handicapped child. Some people would call that selfish, but I wouldn’t. Parents who abort for an anomaly just don’t want that life for themselves, and it’s their prerogative to fashion their lives how they want. Is terminating two to one really any different morally?”

No, I suppose not — both are equally, and unquestionably, wrong. God help us if we can’t recognize that.

UPDATE, 9/7/11: Check out other pro-life blog posts on the topic of IVF at Life Report’s Pro-Life Link Party here.

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