selective reduction - page 2

i was wondering if anyone had any info on selective reduction...how it is done...how risky is it....and where it is done in the midwest (ie ohio, indiana, kentucky,michigan)...how many fetuses do... Read More

  1. by   kids
    Originally posted by SmilingBluEyes
    I am sooooo gonna stay outa this one.
    I was going too, honest I was.

    Which makes more sense:

    A) Continue a pregnancy with 4 (5-6-7-8) babies, knowing it is very likely they will be born very premature and any of them that do survive will probably have serious health conditions that effect them their entire lives.

    B) Reduce the pregnancy to a number that is statisticly safer for the surviving babies and their mother.

    I agree with imenid37, I think the fertility industry is creating these situations.
  2. by   PegRNBSN
    Sorry but I disagree. Yes the fertility industry is creating the choices but the parents are making them. I know many infertile couples who choose not to use methods that will give a good chance of many multiples.
    Our society needs to make those making the choices see that the results are their responsibility. So many people today in so many areas just take the stance that they are victims. They aren't. In the vast majority of cases their situations are the result of choices they have made.
  3. by   imenid37
    Peg, I'll pray for you and her this week at my Catholic church. I don't personally agree w/ selective reduction, but I see people put between a rock and a hard place I would neither put myself in nor would I wish to be in. Think of the Mc Coy (I know I spelled this wrong) septuplets. Several of them have signifigant medical problems related to being preemie multiples. Why when this couple was so opposed to abortion or selective reduction, would their medical team have implanted so many embryos in this woman who knew she would choose to carry them all no matter what? That is simply unethical on the part of the professionals involved. Plain and simple. Yes, there was a small chance that all of these embryos would develop into viable babies, but there was that chance and given that the team should've proceeded w/ implanting only 3 or 4. That way even if all survived this created a more manageable # of babies that had a better chance at survival w/ less chance of disability. All of these implantation attempts cost big-time $$$, so I think it is tempting to implant as many as possible, since the couple may have only limited $$$ available to pay for this procedure over and over again.

    Last year, I took care of a lady who had had one of her triplets terminated because of a lethal anomaly at a tertiary facility. I had her after she miscarried the other 2 babies. She was devestated and so was her family. She did what she thought was best. She did what the medical professionals involved told her she should. Was it her choice? YES! Was it the one I would've made? NO! Did that make her any less deserving of my care and compassion? Did I have to tell her I agreed or disagreed w/ what she did? NO! That's not my job.

    If you believe so strongly in this, make a positive statement to this mom. Something like.. "I am praying for you to have a good outcome. I hope you go on to have all of the babies and that they're healthy." Remember the couple may make the choice but who provides the information and performs the selective reduction. The medical team needs to be responsible and ethical. If selective reduction was not an available option, people wouldn't be able to choose it. The impetus for responsibility lies w/ the professionals not w/ the lay public. I read a great article in a recent Readers Digest (November 2003) about a physician's dilema re. doing abortions, now that the age of viability has been pushed back and things like fetal surgeries are available. He was stating, among other things, the dilemma when the fetus is considered a patient on the one hand and a disposable piece of tissue on the other. Peace to you!
    Last edit by imenid37 on Oct 24, '03
  4. by   PegRNBSN
    I'm not sure how you got the idea I was replying to a mom. I was replying to the idea of selective reduction initially and the genteral ideas put forth by others following.
    I work in a level three hospital and have taken care of several moms who have ahd selective reductions. They get the same care and compassion as others. I NEVER let my personal feelings known to patients. I NEVER let my personal feelings interfere with my care.
    I have taken care of women who have had 10 abortions. At the point I am taking care of them, what has gone before is immaterial to my care.
    I am a Catholic who prays for the end to legalized abortion, who is active in the pro-life movement and who prays for those who have made the choice of abortion. I volunteer at a pregnancy help line to help women see the other options besides abortion.
    It frustrates me when only those without strong anti-abortion opinions can be thought of as compassionate.
    There isn't even anything in the original message that says this is a mom making a personal choice. And if it was I would be praying for her and her babies.
  5. by   imenid37
    Originally posted by PegRNBSN
    I'm sorry it's the attitude of people like imenid37 that allows the killing of innocent life. We don't know what the circumstances are, we need to be compassionate, we can't put ourselves in their position blah blah blah..... And who is being compassionate for the babies?? Difficult circumstances in life do not give the right to kill after birth and they shouldn't before either.
    It is exactly this slippery slope that gives women who kill their babies AFTER birth such leniency in the liberal justice system.
    The poor mother, she was under such stress, she couldn't cope with a baby. We have devalued human life in our society and we will all pay for it some day.
    Well Peg, I guess that's how I got that idea. I am glad you give compassionate care to those who've had abortions, even though you are pro-life. I am pro-life and I do too. I don't place responsibility on clients who are at the mercy of a multi-million dollar industry dominated by high paying well-educated people for policing the ethical practices of that industry. The fertility clinicians should be policing themselves and not place couples on the so called slippery slope by engaging in practices which are unethical. One of those practices would be placing high numbers of embryos into women who will be faced w/ the choice of either aborting some of the children, they so desparately want or giving birth to children w/ a high risk for prematurity and disability. To me, bottom line is, be responsible in your practice, esp. when you have a couple who are definitely anti-abortion...don't implant the mom w/ 6 or 7 embryos. It's that simple. That's my point.
  6. by   fergus51
    All I'll say is if you are against abortion don't have one. Otherwise, everyone is entitled to their opinion and should remember what they say about opinions being like a$$holes, everybody has one....
  7. by   Dave ARNP
    The older doc who's leaving made my wife the director of Obstetrics would "strongly suggest" any pregnancy more than twins be reduced.

    Actually, if you had three, he would suggest reducing to, one.

    In the end he only wanted one baby to deal with.

    Should you disregard his advice, he made sure he was mean enough to you that you didn't come back. If you did........ he referred you to another MD.

    What scares me more, is he used to be a L&D RN.

    But he beleived that women just couldn't handle more than one baby.

    Dave
  8. by   AndreaRN23
    Had some people not jumped on their band wagons maybe we could have helped this person in her apparent struggle... maybe she was trying to help a friend or make the hard choice for herself... i know everyone has the right to an opinion, but why voice it in such a hateful manner?
  9. by   imenid37
    Andrea, I see your other current post and I hope all goes well for you. If my opinions offended you in any way, I apologize. I've got my opinion and I try not to be too offensive in expressing it. To quote fergus (who disagrees w/ me on this one-but I do enjoy your other posts, incidentally) everyone has an opinion. The important thing here is to realize that this and many other things are a reality for our pt's and maybe even co-workers and we need to be kind and objective when dealing w/ these folks, no matter how strongly we disagree. All the best to you Andrea and I too wish I knew what happened to Wendy and hope for the best for her.
  10. by   kids
    Originally posted by AndreaRN23
    Had some people not jumped on their band wagons maybe we could have helped this person in her apparent struggle... maybe she was trying to help a friend or make the hard choice for herself... i know everyone has the right to an opinion, but why voice it in such a hateful manner?
    Please look at the date of the original post. It is 5 years old and had no replys until recently. Give that the situation that prompted the initial post is long past I think this is an excellent oppertunity to discuss it without fear of offending the original poster.
  11. by   Zee_RN
    Ten years of infertility here. In 1989, I underwent in vitro fertilization. The optimum number of embryos to implant for the highest chance of obtaining ONE live birth, at that time and to the best of the medical knowledge, was four. They obtained six eggs from me. Five fertilized. They implanted all five -- not with the hopes that all would attach -- just with the hope that I would get pregnant, period.

    Two actually implanted -- and one of those split. Hence, I have triplet daughters -- two are identical and one is fraternal.

    You cannot believe the number of people who assume that I went through in vitro because I wanted multiples. I wanted A BABY. I'm delighted to have three and am astounded by physicians who recommend selective reduction for triplets. Even quads are delivered with relative safety these days. I did know a woman who actually had herself on the OR table for selective reduction (with triplets) who changed her mind right then and there.

    I cannot imagine choosing selective reduction for myself. I am pro-life. I cannot imagine being put in the situation of having six, seven or eight babies growing inside me either, with all the risks to babies and self.

    Oddly enough, there are times when I "mourn" the three embryos that didn't implant. Can't explain it. I wonder who they would have been....(and if there were any boys in that lot!).
  12. by   JUSTYSMOM
    Being an IVF infertility patient myself, I am well aware of the risks of multiple's. However, IVF clinics have become very attuned to keeping that risk to a minimum. That is why now most clinics only transfer 2-3 max on women under the age of 40. Even women in their forties are now down to 4 maximium.

    To think that we are irresponsibly killing innocent babies is so far from the truth of why we are going to a fertility clinic to begin with! We WANT a baby. But we certainly don't want to risk our lives in doing so.

    The truth of the matter is this- Selective reduction is a very personal matter between husband & wife. In fact, we have to sign forms regarding our intentions of selective reduction.

    If I got pregnant with more than 2 embryos, I would most definetly have a selective redution. I already am a mom to one little boy. I am in a high risk category (due to age, weight and past pregnancy complications). I would not chance maternal death just to try to have triplets. I would not want to leave my son motherless.

    But the point being, infertility patients really don't have a "choice" as to how many embryos will or will not stick. This is our only way to have a baby.
  13. by   PegRNBSN
    I guess it's all in how you view life and when life begins. If I asked you if you would have two babies but had to kill one shortly after birth for the other to survive, I am sure everyone would say no, they wouldn't do that. If the question was you had to kill an 18 week twin to let the other survive it becomes much more unclear to many what is the answer.
    My whole point in this argument is that when life is deemed dispensible to obtain a perceived greater good, we are devaluing life. We are playing God.
    While I feel for those who are unable to conceive without in vitro,( close friends and relatives among them) I do not believe that the desire for a baby supercedes the responsibilities to the lives that are created.
    We recently had a case where a man received a stronger sentence for cruelty to his dog than a young girl who threw her baby in garbage can to die. I sincerely believe that society views a baby's life as disposable and it is very difficult to punish those who could have legally killed the baby a few weeks earlier.

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