The Mandy Allwood saga is summer fun for the British press, but it embodies one of the thorniest issues in reproductive medicine. Some 20 to 30 percent of the pregnancies achieved through drugs or in vitro fertilization yield more than one fetus. And though a quadruple or quintuple pregnancy can seem like a godsend to an infertile couple, it’s exceedingly risky. The babies are typically born premature (each additional fetus knocks roughly three and a half weeks off the normal 40-week gestation time), and those who survive often suffer handicaps. Hopeful parents may recoil at the thought of killing their offspring, but it’s sometimes the only way to take home a healthy baby.
““Selective reduction’’ doesn’t involve judging fetuses by their size or appearance; a physician simply inserts a thin needle into the most accessible ones and injects a small amount of potassium chloride, a poison. U.S. doctors have performed only 2,500 to 3,000 reductions since the early 1980s, and 500 are the work of Dr. Mark I. Evans, the Wayne State University obstetrician who pioneered the procedure in this country. One of his past patients is Denise Foltz, a 33-year-old Michigan woman who delivered healthy triplets after conceiving sextuplets. ““Sometimes I hear about these big deliveries and wonder if I could have done it,’’ she says. ““But I know I made the right choice.''
Right-to-life purists oppose selective reduction as vehemently as any other form of abortion. ““The term is a euphemism for what’s really going on,’’ says Paige Cunningham of Americans United for Life. ““This is not breast reduction we’re talking about. What is happening here is the direct killing of a child because it was inconveniently conceived along with several others.’’ Cunningham praises Mandy Allwood’s decision to keep all her fetuses, reasoning that ““if those children die, it will be because of mother nature.’’ But most physicians would rather not watch a drug-induced accident run its course. ““The chances that any one of [the octuplets] could come through alive and intact are so small it’s unbelievable,’’ says Dr. John Elliott of Good Samaritan Medical Center in Phoenix. ““Money won’t make up for the suffering she could face.’’ The odds suggest she won’t collect much anyway.
