a choice, a responsibility

Last night I was watching the evening news—something I try never to do—and there was a story about the sextuplets just born in Minneapolis, at the same hospital where Stella was born. They are now on warming tables in the same children’s hospital where I sat for weeks, staring at my daughter.

The coverage of the story went like this: the couple decided on fertility treatment when they hadn’t become pregnant in a year. They were surprised to find they were carrying six fetuses, but they refused to reduce. Now they have six babies, born at less than 23 weeks. The smallest weighs less than 11 ounces. The reporter said, “The babies came a little early.” Call me crazy, but 4 months premature is not “a little early.”

Why, please tell me why, the media continues to cover high order multiple births this way. The pregnancy and births were referred to as a “miracle.” This is not a miracle. It’s a tragedy. This couple is living through hell, certainly, but there was no mention of the dangers of prematurity. No mention of the reality.

A preemie is not just a small baby. A preemie is not “cute.” Micro-preemies (born at less than 26-weeks) often do not “catch up.” That all preemies “catch up” by age 2 is a myth.

A 23-weeker’s eyes are still fused shut. A 23-weeker is still covered in lanugo. A 23-weeker’s lungs are underdeveloped. S/he will potentially spend months on a ventilator. Being on a ventilator that long puts a him/her at high risk for an intraventricular brain hemorrhage and for chronic lung disease.

The rate of premature birth increased 31% between 1981 and 2003. According to the March of Dimes, 25% of the youngest and smallest babies who graduate from the NICU live with long-term health problems, including cerebral palsy, blindness and other chronic conditions. A study published in the Journal of the American Medical Association in 2002 found that children born prematurely were at greater risk for lower cognitive test scores and for behavioral problems when compared to full-term children.

For babies born at less than 500 grams (1 lb, 1 ounce), the mortality rate is 863 deaths per 1000 live births.

Between 1980 and 1998 the triplet/+ birth rate (the number of triplets, quadruplets, and quintuplets and other higher order multiples per 100,000 live births) increased by more than 500 percent, rising from 37.0 to 193.5. The number of triplet/+ born in 2003 was the highest ever reported: 7,663. (CDC’s National Vital Statistics Report Vol. 54, No. 2)

Write that. Cover that.

In my frustration over the coverage of stories like this one, I turn, as I always do, to literature. Suzanne Kamata has written one of the most honest, moving essays about IVF and selective reduction that I’ve read. Originally appearing in Brain, Child, her essay “Multiple Choices” was reprinted in the Utne Reader in 2000.

After a D&C at age 20 and an infection in her late 20s, Kamata and her husband used IVF to get pregnant. Three embryos took root.

“When I visit the doctor at eight weeks,” she writes, “all three are still there, growing and squirming in my womb. I love them all equally. I cannot bear the thought of giving one up. Of having one killed.”

But the thing is, she weighs the risks. She and her husband make the decision, the difficult decision, to reduce. And it’s a decision that may have saved her other babies. At 26-weeks, Jio and Lilia were born. How early would they have been without selective reduction? Would any of them have survived?

Technology helps many couples conceive. Technology can keep the smallest babies alive. But there are dangers associated with this technology, and I want to know why these dangers are not being discussed honestly (or at all). It’s not a black and white issue. Selective reduction would not be an easy choice. But isn’t it necessary to weighs the risks?

Kamata’s essay ends like this: “Yoshi and I heap adoration on our surviving twins, while the spirit of the third hovers, a reminder. And so I carry my guilt. In quiet moments, I pray for forgiveness, while out of love for my newborn children, I find it impossible to repent.”

Thank you, Suzanne, for this essay. Thank you for your honesty and grace. Thank you for talking openly about hard choices. I wish everyone were so brave.