Selective reduction

shabbatiscoming

Tue, Jun 21 2016, 5:54 am

Im just curious to hear what others think about this. I just watched a very sad video (Ill put it at the end of my post) about a woman who became pregnant with septuplets. She was asked about selective reduction but she and her husband did not want to even think about it. In the end all babies were born and lived a few hours and then all passed away (at week 21)
The story makes me so sad. What would you do in such a situation? I am not judging this specific woman, but I wonder what you ladies would do, or think you would do, in a situation where you became pregnant with lets say more than twins, and were told about selective reduction so that the remaining fetuses would have a chance of surviving.

Kumphort

Tue, Jun 21 2016, 6:44 am

I think there was a person who posted here a while ago about making a decision like that. Not sure what the end result was
I think we glorify the few people who have healthy high order multiples so that it seems normal that people can have healthy babies but that takes away from the grim realty that comes with that. Think octomom and other famous celebrity families because of their high order multiple status

amother

Orange

Tue, Jun 21 2016, 7:28 am

The video didnt mention the extreme risks to the mom as well in carrying this pregnancy. It just seems like such a huge waste and loss of life....IMHO the parents absolutely make the wrong choice not to follow medical advice, instead going along with wishful thinking. AFAIK, halacha rules on the preservation of life, so selective reduction is Allowed to preserve the lives of the other babies. The extra babies are looked at as "rodfim" to the lives of their mom and siblings and reduction is allowed.

The other thing thrat struck me here is the irresponsibility if the fertility MD in producing this pregnancy. Clearly her ovaries were overstimulated in this cycle, and she should not have been allowed to proceed with insemination in this cycle, if it was properly monitored. Fertility treatments need to be carefully monitored and applied. Does not seem to be the case here. Very sad.

amother

Coffee

Tue, Jun 21 2016, 3:00 pm

What kind of doctor allows this to happen??? Sad to have to even be faced with such a choice but it never should have happened in the first place.

mirror

Tue, Jun 21 2016, 3:12 pm

amother wrote:

What kind of doctor allows this to happen??? Sad to have to even be faced with such a choice but it never should have happened in the first place.

After she lost the first of the seven babies then she should have been on bed rest. Her doctor should have been monitoring her for that point on to make sure that she does not go into labor. There are medications that a woman can take to stop the contractions and prevent labor but that's where the negligence lies in this case.

Rosemarie

Tue, Jun 21 2016, 7:07 pm

mirror wrote:

Actually, I think the negligence began with allowing her to go ahead with insemination when she was clearly hypersimulated. No legitimate doctor would allow such a pregnancy to occur in the first place.

Miri7

Tue, Jun 21 2016, 7:14 pm

Could not agree more that the doctor should have prevented this from happening. Couples should know that getting pregnant is such a cycle may result in such a situation. A difficult and impossible choice for the parents whichever choice they make.

amother

Brown

Tue, Jun 21 2016, 7:35 pm

What a sad story. For those questioning their doctor: I noticed that they didn't discuss fertility doctors and had only been trying for nine months before taking meds. I don't want to minimize their fertility issues or be accusatory, but I have a suspicion that they may have bought clomid on their own without consulting a doctor.

Rosemarie

Tue, Jun 21 2016, 8:00 pm

amother wrote:

If thats posaible, that would be extremely foolish and dangerous.

I doubt it's possible to buy clomid without a doctor, it's a prescription drug. But often people go to their ob/gyn when they have a hard time conceiving and the ob/gyn gives clomid without further monitoring. That is how such a situation can occur.

That in itself is problematic. People should not take clomid without being monitored frequently by an RE or at least their ob/gyn should do frequent monitoring.

amother

Puce

Tue, Jun 21 2016, 8:04 pm

When I transferred to embryos my doctor made it clear that I we should end up with 3 fetuses she would only allow me to carry 2. Bh we didn't have to make that decision. I can imagine it's a very difficult thing to go through.

nylon

Tue, Jun 21 2016, 8:06 pm

You can get Clomid from Mexico. And some OB/GYNs hand it out without full cycle monitoring (even my RE did not do ovulation monitoring for Clomid and he was at a major university hospital).

BUT, the likelihood of septuplets is minimal. Clomid is a form of indirect stimulation and the rate of higher order multiples is pretty low. I've heard of one set of quads, but not more.

Most of the famous cases came from injectable gonadotropins.

greenfire

Tue, Jun 21 2016, 8:21 pm

it is extremely heartbreaking to hear of her losses ...

what I can tell you is a cousin of mine had selective reduction on triplets to twins, and one of the twins that were born is autistic ...

how on earth would the doctors know which ones to select - what if they choose the less viable fetuses ... I don't think I could ever find out - what about all the other people who have 6 babies that survive

guess we cannot judge either way - I cannot imagine what I would do in a similar situation

I wanted to see the picture of their little feet - creative memorabilia of their short lives

animeme

Tue, Jun 21 2016, 9:39 pm

I heard a shiur on this many years ago by Rav Yitzchok Breitowitz, who knows issues like this. (He is also a legal scholar, and was teaching about abortion in general, and where he thinks a frum Jewish should hold in the legal abortion debate.) I believe he said that if the doctors identify a specific baby (or babies) that is becoming a danger to the others, halachah says you do the reduction. If the doctor does not identify specific and it is a random choice to get the number down, it's more complicated. All of this is if there is no real danger to the mom. Then, I don't know...

So I guess if I Chas veshalom had this, I would call Rabbi Breitowitz.

So heartbreaking.

Ema of 5

Tue, Jun 21 2016, 9:45 pm

Shabbat, to answer your question, I don't think any of us could know what we would do in such a situation. How can we know NOW how we would deal with such a heart wrenching decision. I just read a story about a village that was descended upon by some type of monster. The monster would knock on the roof of a home, and that family had until morning to send out a child. If they would not do so, the monster would kill all the children. What would you do?