Mirror of Justice

A blog dedicated to the development of Catholic legal theory.

Wednesday, August 10, 2011

"The Two-Minus-One Pregnancy"

The New York Times Magazine explores the "stigma" (undeserved? archaic? regrettable?) surrounding the emerging trend of eliminating one fetus when IVF results in twins.  This is a very sad paragraph, among many:

Jenny’s decision to reduce twins to a single fetus was never really in doubt. The idea of managing two infants at this point in her life terrified her. She and her husband already had grade-school-age children, and she took pride in being a good mother. She felt that twins would soak up everything she had to give, leaving nothing for her older children. Even the twins would be robbed, because, at best, she could give each one only half of her attention and, she feared, only half of her love. Jenny desperately wanted another child, but not at the risk of becoming a second-rate parent. “This is bad, but it’s not anywhere as bad as neglecting your child or not giving everything you can to the children you have,” she told me, referring to the reduction.

I don't mean to minimize the hardship that can accompany multiple births, but this excerpt reflects an unfortunate (though increasingly common) view of parental love: a limited commodity that, when extended to one child, necessarily reduces its availability to another child.  Not to mention the underlying premise that non-existence is preferable to existence in a household with "too many" kids.

https://mirrorofjustice.blogs.com/mirrorofjustice/2011/08/the-two-minus-one-pregnancy.html

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I am not sure this attitude stems from a view of parental love as an end sum game. I think it arises when the view of parenthood goes from a vocation to which we give ourselves to an avocation of which we avail ourselves. The reproductive technology industry has turned children into commodities. We shop for them, trying to choose just the right one to accessorize our lives. Through contraception and abortion we have dehumanized children and diminished the vocation of parenthood.

Posted by: Denise | Aug 10, 2011 8:20:53 PM

It was obvious to me that Jenny was trying desperately to rationalize what she and her husband are doing.

Posted by: Mark | Aug 11, 2011 12:09:35 AM

I remember distinctly one day when my father, an obstetrician for nearly 25 years, came home from work openly weeping over a situation like this. He couldn't believe how much attitudes had changed since he began practicing---from children as a joy and a gift to children as a commodity, killed for their inconvenience.

Especially since often those who can afford IVF are very well-off and could absolutely afford having multiple children...just not both having children and enjoying the exact lifestyle they'd imagined for themselves.

Truly heartbreaking, and my prayers go out to both the unborn child as well as the parents and future parents...what have we come to?

Posted by: casual reader | Aug 11, 2011 10:31:48 AM

"It was obvious to me that Jenny was trying desperately to rationalize what she and her husband are doing."

While I don't mean this to be a direct response to Mark, since I can't deduce his positions on a whole host of issues from this one sentence, one of the things I find objectionable about many pro-lifers is their evident belief that those who claim to disagree with them actually don't, deep down, and are either (1) engaging in self-deception and rationalization or (2) out and out lying.

Having said that, I found the whole article in question appalling. My younger brother and sister are twins, and a very well liked co-worker is out on maternity leave with twin boys, and everyone in the office was very excited for her. Spending a great deal of time and money to get pregnant, and then reducing twins to a "singleton" just makes no sense to me.

Posted by: David Nickol | Aug 11, 2011 10:32:41 AM

I remember asking my mother once, decades after my younger brother and sister (the twins) were born, if she had known she was going to have twins. There wasn't the technology back in those days that we have today. My mother said that while there was no medical confirmation, SHE knew, but that nobody believed her. "I argued with your father all the way to the hospital," she said. She sure showed HIM.

Posted by: David Nickol | Aug 11, 2011 10:47:35 AM

Since this is a law related blog, I'd like to point out that the article makes great pains to state that these "reductions" are not abortions. This view is becoming so common that we found the need in North Dakota to revise our abortion-related statutes to make clear that these procedures are "abortions" under the law. Otherwise, who knows how many physicians, convinced by their own rhetoric, do not report these actions as abortions?

Posted by: ctd | Aug 11, 2011 11:19:35 AM

ctd,

Since most definitions of abortion specify expulsion of the fetus, it seems necessary to me to amend the laws if lawmakers intend "reductions" to be counted as abortions. In the absence of changes in the law, I would think it is reasonable not to consider "reductions" as abortions, from a purely medical viewpoint. As I understand the (extremely disturbing) "reduction" procedure, it is not anything like the various procedures one would find in a listing of abortion procedures.

Posted by: David Nickol | Aug 11, 2011 11:43:47 AM

Perhaps some or all state laws do not cover "reductions" as "abortions," if abortion is defined as expulsion of the fetus or termination of pregnancy, and if the "reduced" fetuses are not expelled (and of course pregnancy continues).

But isn't the common, lay definition of an abortion -- regardless of moral or legal assessment -- the termination of THAT fetus? How is that not what happens?

Posted by: curious | Aug 11, 2011 1:15:35 PM

curious,

I don't think the common, lay definition of abortion is the killing of a fetus in any manner whatsoever. I think if a woman pregnant with twins were to say to me, "I'm going to have an abortion," I would assume she was going to end her pregnancy. I would not think to say, "Are you going to abort one, or both?" I would also think that a woman who had IVF and had a "reduction" from four embryos to two would answer no if asked, "Have you ever had an abortion?" This is not a matter of approving of a "reduction" and disapproving of an abortion, or vice-versa. It's just my guess as to what people think of when they hear the word "abortion." I would further conjecture (without any proof whatsoever), that the more pro-life people are, the more likely they would be to say about a "reduction" that it is just an abortion masquerading under another name.

Posted by: David Nickol | Aug 11, 2011 2:08:24 PM

Actually, David,any killing of a fetus in any manner is an abortion. Medically speaking, when a woman has a miscarriage it is referred to as a spontaneous abortion. When the fetus is intentionally killed it is a direct or procured abortion. Pope John Paul II defined abortion in Evangelium Vitae (#58):"the deliberate and direct killing by whatever means it is carried out, of a human being in the initial phase of his or her existence, extending from conception to birth." The first paragraph addressing abortion in the Catechism quotes the Congregation for the Doctrine of the Faith document Donum vitae and states "Human life must be respected and protected absolutely from the moment of conception. From the first moment of his existence, a human being must be recognized as having the rights of a person--among which is the inviolable right of every innocent being to life." Note that neither of these statements refer to the expulsion of the fetus. In fact, William May, in his book Catholic Bioethics and the Gift of Human Life, specifically points out that no moral definition of abortion requires expulsion of the fetus--only killing the fetus.

Posted by: Denise | Aug 11, 2011 8:39:28 PM

The common legal definition of abortion is "termination of pregnancy," with various exceptions and definitions. It is also the common medical definition. The concerns about abortion, however, including the basis for laws regarding abortion, revolve around the unborn child. Even under Roe/Casey, the state's legitimate interest in regulating abortion is its interest in the unborn child. For that reason, "reductions" should be considered abortions.

North Dakota's new definition is:

"Abortion" means the act of using or prescribing any instrument, medicine, drug, or
any other substance, device, or means with the intent to terminate the clinically diagnosable intrauterine pregnancy of a woman, including the elimination of one or more unborn children in a multifetal pregnancy, with knowledge that the termination by those means will with reasonable likelihood cause the death of the unborn child. Such use, prescription, or means is not an abortion if done with the intent to:
a. Save the life or preserve the health of the unborn child;
b. Remove a dead unborn child caused by spontaneous abortion; or
c. Treat a woman for an ectopic pregnancy.

This was based on American United for Life's model and other models, with the "including the elimination of one or more unborn children in a multifetal pregnancy" added to make clear it covered reductions. So far as I know, no other state has enacted legislation to make clear that reductions are covered.

Posted by: ctd | Aug 12, 2011 1:35:23 PM

Denise,

We are talking about the "common, lay definition" of abortion. We could also talk about the dictionary definition of abortion:

1 : the expulsion of a nonviable fetus: a : spontaneous expulsion of a human fetus during the first 12 weeks of gestation -- compare MISCARRIAGE b : induced expulsion of a human fetus c : expulsion often due to infection of a fetus by a domestic animal at any time before completion of pregnancy [Merriam Webster Unabridged]

Yes, a miscarriage is a spontaneous abortion, and a spontaneous abortion is a miscarriage, but there are unfortunate cases of stillbirth, when a baby has died after the 20th week of pregnancy but before delivery. The death of such babies is not a miscarriage or a spontaneous abortion.

I am not disputing Catholic doctrine here. I am arguing about the commonly understood use of words. Abortion is generally understood to entail expulsion. If the pope wants to redefine it for purposes of clarifying Catholic doctrine on when human life begins, he has a perfect right to. However, he is departing from the commonly understood meaning of the word. Why not just say that any deliberate killing of a human being from conception on is the unjust taking of an innocent life? Why does something have to be labeled "abortion" to make it clear it is wrong?

Posted by: David Nickol | Aug 12, 2011 1:49:29 PM

Why would you not label it abortion? The term abortion means to abort a pregnancy--to end it before it is natural to end it. These "reductions" are most definitely abortions. Choosing a euphemism like "reduction" does not change the facts about what is going on. So yes, a woman who "reduces" her pregnancy from four fetuses to two has aborted two fetuses. Perhaps we do a disservice to everyone's moral understanding if we avoid using the word abortion.

Posted by: Denise Hunnell, MD | Aug 12, 2011 3:39:17 PM

Hey, hell with you. I remember being absolutely terrified, in early pregnancy, that I might be carrying twins. I did not want twins; I had an ill husband and no backup from family. I knew quite well that I couldn't manage twins on my own, thank you. Very easy for you to talk about "hardships but" when you're not the one living them. I remember the moment I became aware that if I was carrying twins, I likely wouldn't be able to find a doc who'd do a selective abortion on a twin. At which point I realized, with great anger and pain, that if it was twins, I'd likely wind up aborting both despite wanting a baby sincerely, and despite a long wait to get pregnant in the first place.

I know my limits. I wish more parents did. I am perfectly happy to call it an abortion; I just want it available.

Posted by: amy | Aug 14, 2011 4:41:20 AM