Thursday, May 24, 2007

Selective reduction lies

The Washington Post is at it again – this time pushing the Editor’s political views by addressing a relatively unknown procedure called “Selective Reduction”. This is a procedure where one or more babies from a multiple pregnancy (usually triplets or more) are “Reduced” by selective injection of potassium chloride directly into the baby during the pregnancy, killing it instantly. If all goes well and the mother is lucky, then the remaining babies will continue to grow and develop. Unfortunately, this is not always the case. The misconceptions around this issue revolve around the statistical information that is or is not readily available, and these are not discussed by the Post reporter. Most reductions are not reported, so the CDC does not keep accurate statistics, and therefore the stats that are available are across the board – depending on who you are talking to, a triplet pregnancy can either mean that you have a high likelihood of losing an entire pregnancy, or a minimal chance, not any greater than a twin pregnancy. The fact is that reducing triplets to twins does not statistically improve the outcome of the pregnancy due to the increased chance of losing the entire pregnancy.

Unfortunately, one of the biggest groups advancing the SR issue is the fertility clinics themselves that are often responsible for multiple pregnancies. These groups are required to report their success rates to the CDC, and in these circles anything more than one baby is considered a statistical failure due to the higher risks associated with multiple births. Of course, there are doctors and clinics that make a living by performing SR procedures. Dr. Evans is a pioneer in this procedure. According to a representative of the Triplet Connection, the leading organization for families of triplets and higher order multiples, “he has been on the forefront of the selective reduction bandwagon since 1986. We have gone head to head with him since then with verifiable stats showing the pregnancies with the best outcome are those who are managed with proper prenatal care and monitoring. The selective reduction advocates have coerced the Department of Health and Human Resources to alter their recording data to not reflect a true outcome of lost pregnancies 1 week after the procedure. When the overall outcome is viewed from beginning to end the final result is quite shocking.”

It is unfortunate that families facing a multiple pregnancy often do not know where to turn, and therefore take advice from doctors who may not have the most accurate data, or in fact may have other motives. And these decisions can leave lasting scars on a family. “The long-term psychological consequences of reduction are still little understood. According to Isaac Blickstein, one of the world's experts on multifetal pregnancies, the studies that have been done suggest that the aftereffects of selective reduction are different from those of abortion”, “psychoanalytic interviews with women who underwent [selective reduction] describe severe bereavement reactions including ambivalence, guilt, and a sense of narcissistic injury, all of which increased the complexity of their attachment to the remaining babies."

The answer to this problem lies in education, and removing the politics from the issue. Until we get the “Pro-Choicers” out of this issue, the correct statistics and facts will always be masked from public view – and babies will continue to die because their parents are told that they must kill them.

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