The Human Cost of ‘Selective Reduction’

 

Janet Morana

   
 

Thirty years ago, I was in the ninth month of my second pregnancy when I received what was a very unsettling referral for a sonogram, which was not nearly as routine in those days. My eyes never once left the technician’s face as she studied the monitor. You can imagine my doubled apprehension as she left the room without offering me the small mercy of that nonchalant, “everything-is-normal-and-on-track” smile. When the OB-GYN followed her back into the room moments later, I really needed him to compensate for the technician’s serious breach of sonogram etiquette. Instead, he informed me that I was pregnant with twins.

I left that appointment just as frightened as every other woman who has ever received the same news. At the time, I already had a 23-month-old daughter; my financial resources, while not as limited as those of many new mothers, were light years away from reassuring; and my mental preparations had been for one baby, not two.

As the news began to sink in over the following few days, however, my fear got some competition from a growing awareness of my personal strength. I was still terrified, naturally, but on some level I made a decision to battle that fear, to refuse to let it take me without a fight. I remember throwing open the phone book (the Google of the ’80s), and aggressively tracking down the contact information for the local Twins & Multiples club.

In “The Two Minus One Pregnancy” article in The New York Times Magazine (Aug. 14), Ruth Padawer interviews women who, after becoming pregnant with twins using fertility drugs and procedures, decide to undergo a selective reduction. The women describe with illuminating candor their fears of the challenges of birthing two newborns at once; of not being the best mother they can be to all of their children, including those already born; of being spread too thin. And so they abort one of the twins.

The story begins:

As Jenny lay on the obstetrician’s examination table, she was grateful that the ultrasound tech had turned off the overhead screen. She didn’t want to see the two shadows floating inside her. Since making her decision, she had tried hard not to think about them, though she could often think of little else. She was 45 and pregnant after six years of fertility bills, ovulation injections, donor eggs and disappointment — and yet here she was, 14 weeks into her pregnancy, choosing to extinguish one of two healthy fetuses, almost as if having half an abortion. As the doctor inserted the needle into Jenny’s abdomen, aiming at one of the fetuses, Jenny tried not to flinch, caught between intense relief and intense guilt.

The women’s honesty allows no confusion about what’s making their decision for them: fear.

It’s scary to be carrying twins; scarier to think about the labor that will bring these twins into the world; scarier still to contemplate “Now what?” Without these Orwellian choices open to mothers of this generation, we answered the question “Now what?” one sleepless night at a time.

So when I brought my twin girls home back in 1980, I took it one day at a time. Scratch that, I took it one action at a time. I made that nightly pilgrimage to the nursery with tired eyes and tired feet. Constant feedings and changings, yes, but accompanied all the while by the twins’ mutual gazes, touches, and gurgling “twin talk.” Exhausting days and nights, but ones that I would never trade away. I still look with personal pride on the technique I developed to feed the twins with two pillows — my home-grown version of Boppies. There were fun trips to the Mall to share my joys and accomplishments with the countless strangers who would smile and approach the twins and their beaming older sister. There were joyful milestones of birthday parties, school events, sports, and dancing lessons. My burdens grew easier with time, too, as the twins grew up entertaining and supporting each other, sharing experiences that only twins can share. And I got some unique life training that I could later bring to my career life: No one learns how to multitask with efficiency like a parent of twins.

Maybe our lives would have been easier had I “reduced” my pregnancy, but we would have missed the crazy magic of those early years.

I can’t put myself in the shoes of a woman who decided for a selective reduction, but I can imagine that her decision stays with her always, perhaps evoking one emotion one day, another the next. Decisions made out of personal powerlessness and lack of support are the decisions that no one wants to make. And they’re the decisions that refuse to let you rest, the puzzles that you try to solve and resolve for the rest of your life.

These decisions born of fear and powerlessness will probably always exist in one form or another, but does that mean we should all simply raise the white flag on this issue? That physicians should abandon their vow “to do no harm” because twins cost more money to raise?

I propose that all of us - the medical profession as well as society at large - make a collective decision to fight the fear. Let’s not abandon these women in the cynical belief that there’s not enough support for all of them.

Janet Morana is the executive director of Priests for Life, co-founder of the Silent No More Awareness Campaign, and co-host of The Catholic View for Women on EWTN.