Thursday, June 4, 2009

A Few to Spare, Perhaps?

Since late January of this year, I have joined millions of other Americans in an absurd obsession: an irrational fascination with Octomom. When I first heard the announcement that a woman had given birth to healthy octuplets, I didn’t realize that she would touch my life in so many ways.

My immediate reaction was, “Wow! Clomid overdose! Someone wasn’t being appropriately poked and prodded.” Clomid is the “gateway” fertility drug, often doled out before there is any real diagnosis of the problem conceiving. Its main function is to boost the number of eggs that ovulate during each cycle. Responsible doctors and clinics will require their Clomid patients to come in on a regular basis (like every other morning during some weeks, in my case) so that their egg follicle development can be monitored closely via vaginal ultrasound. This monitoring has a couple of very important functions. First, it should reveal when there is a follicle ready to ovulate – thereby indicating a good time to meet up with sperm, either via Intra Uterine Insemination (IUI) or the other, much more romantic way. Second, it should show how many follicles are ready to go.

In most cases, if there are more than two or three follicles of a certain size, health professionals will cancel insemination and strongly discourage intercourse. The most catastrophic side effect of Clomid and other follicle stimulating medications like it is multiple births. So, when I heard about the octuplets, I assumed that either someone had made a huge error in counting developing follicles, or the mother had ignored the advice of her doctor. (Of course, we’ve now learned that I was wrong about this; Octomom conceived through the reckless implantation of at least six embryos during IVF, while the best practice for a woman her age is implantation of no more than two or three.)

How can I call eight healthy babies a catastrophic side effect? Well, of course the births of healthy multiples aren’t that for the parents who so desperately want children. In fact, I bet many subfertile parents of twins and triplets feel like they hit the jackpot. After all, if they’ve always envisioned having more than one child, the prospect of repeating treatment for a subsequent baby must be daunting, and multiples are often welcomed as an “instant family.” (In some circles, boy/girl twins are considered the gold standard.)

But I’m not talking about twins, or even triplets (although study after study shows that even their gestation can be very dangerous, for them and for their mothers). I’m talking about higher order multiples, which have skyrocketed in the last couple of decades and are a hot topic among fertility specialists and medical ethicists.

So when I first heard about Octomom, it was with some sense of connection and gratitude that I had received more responsible care than I supposed she had. Then I learned that her children were born at the same hospital where we went for our treatment! It came out later that she arrived at Kaiser Bellflower already very pregnant, but for awhile there, I wondered if it was MY docs who’d goofed!

My sense of a bizarre personal connection was further strengthened when I learned that she lived in the town to which I’d just moved. In fact, her mother’s home, where she was reported to reside, was less than a half-mile from my office. When we learned Octomom’s name, I discovered the weirdest of all my personal connections. Her last name is what we call our precious cat! (Maybe I’ll share how Suleyman got his name sometime. For now, I just want to be sure everyone knows he got it long before Octomom’s 15 minutes of fame. As proof, his name is spelled differently than hers.)

These coincidences piqued my interest. They also generated a lot of conversations around me, many of which I found fascinating, and some of which I found very disturbing.

To be sure, this case of a woman - who already had six young children with the help of a sperm donor and a fancy Beverly Hill doctor, who was manipulating public assistance - brings up controversial issues about reproductive freedom, the role of government intervention and support, medical responsibility and liability, privacy, and good parenting.

One interesting conversation I had was about selective reduction, which some would say is the recommended medical procedure in pregnancies with high order multiples that removes one or more fetus so that others can thrive, and to prevent sometime life threatening complications for the mother. Others would say it is the heartless murder of innocent life. At the risk of getting overly political here – and even worse, spouting off about something I’ve never been faced with, thankfully – to me it seems ironic that many of the people who become pregnant with multiples but refuse selective reduction for religious reasons are the same people who relied on extreme medical technologies to achieve conception and pregnancy. Why does Octomom think it was God’s will for her to have eight babies at once, but not His will for her to be infertile?

Perhaps the most interesting – and heated – conversation I got into about Octomom was with another waiting adoptive mother. We began by only half joking that it seemed she should share her good fortune with us, and that we’d be glad to take a few of her children off her hands. It led to discussing whether the government has the right – or the responsibility – to remove some or all of Octomom’s kids. And then in meandered even further, to whether the government has the right – or the responsibility – to prevent Octomom and other parents deemed “unfit” (by whom?) to have more children. Yes, I agreed with my friend that it is horrible that abusive/drug addicted/homeless women sometime seem to get pregnant without any concern about the difficult lives to which they have almost certainly doomed their progeny. But I vehemently disagreed that it is the role of my government to sterilize such women. (I must say, I believe I have more faith in my government than most Americans; I feel that – for the most part – it is still a democracy of, by, and for the people. But I suppose I don’t trust my fellow citizens enough to make such deeply personal reproductive choices. And I imagine most of us can identify atrocities committed by leaders of nations who were democratically elected.) This increasingly difficult chat with my buddy ended when I blurted out a somewhat non-sequiter: “So, you don’t want your tax money to be used to ensure everyone has access to good health care, including safe abortions. But you do want it to be used to eliminate the opportunity of parenthood to anyone who’s made some bad choices at one point in life?!”

By far the hardest things for me to hear about Octomom, though, have been the angry statements that she and her family should not receive any further support. To me, what gets so lost in the outrage about Octomom are those eight (errr…make that fourteen) innocent little children.

All of the vitriol does not help them. And they need help. As distasteful as it may be to swallow, ensuring that their likely unstable mother has the resources to keep them in school, receiving attentive care, eating well, etc. is probably the best chance they have in life. Unless she is truly neglectful or abusive, removing them from her home and placing them in (and out, and back in to) foster care - separating them from each other and their extended family - would not improve their lots in life.

Truly, I wish Nadya Suleman and all of her many children the very best. Perhaps I’ll invite one or two of them over for playdate someday.

1 comment:

Amy said...

Loved this Blog Kristin! I'm really enjoying reading your thoughts.....