Thursday, August 18, 2011

NY Times piece on the "selective reduction" of twins

Last Sunday, the New York Times' Magazine featured a story on women, who after becoming pregnant with twins through in-vitro fertilization, decide to have one of their twins killed through a type of abortion known as "selective reduction."

The concept of killing one of two twins solely for elective reasons even makes some who favor legal abortion uncomfortable.
As word spread, a stream of patients called Wapner’s office, scheduling reductions to a singleton. A few months later, after the last patient of the day left, the sonographer who had worked with Wapner for nearly 20 years stopped at his office. She told me what happened next, on condition of anonymity because she doesn’t want her relatives to know everything her work entails: “I told him I just wasn’t comfortable doing a termination of a healthy baby for social reasons, and that if we were going to do a lot of these elective reductions, I thought he should bring in someone else who was more comfortable. From the beginning, I had wrestled with the whole idea of doing reductions, because I was raised in the church. And after a lot of soul searching, I had decided there were truly good medical reasons to reducing higher-order multiples to twins. But I had a hard time reconciling doing reductions two to one. So I said to Dr. Wapner, ‘Is this really the business we want to be in?’ ”

Wapner immediately called a meeting with his staff. Every one of them — the sonographer, the genetic counselors, the schedulers — supported abortion rights, but all confessed their growing unease with reductions to a singleton. “There’s no medical justification in a normal twin pregnancy to reduce to one,” Wapner said. “So we decided to allocate our resources to those who would get the most benefit. We were in the business to improve pregnancy outcomes, and those reductions didn’t fit the criteria.” He hasn’t done an elective two-to-one reduction since.