I don’t know why anyone is seriously even trying to argue that higher order multiples aren’t a risky proposition (even regardless of mother’s age). I am sitting here with Williams’ Obstetrics (the “bible”) and several other medical school textbooks on multiples and I don’t have all night to re type the many, many risks multiples bring to both mother and babies; anecdotes about people with healthy twins / triplets, while lovely for the people involved, don’t negate the risks.
I don’t think “risk” is the central issue here. The question is should a woman have the freedom to assume that risk in a pregnancy?
She should have the right to assume undue risk on her own behalf – the cancer patient who has to forego chemo to have a child, fir example – but she should not be able to intentionally cause undue risks of harm to fetuses/ babies that she intends to carry to term and that will likely result in live births. Thus, it should be illegal to implant embryos beyond a certain number where the mother intends to carry all to term.
I really do think the crack-smoking analogy is apt for a woman who intentionally implants quads with the intention of carrying all that take (ie up to four) to term.
Unlike many others, I would not leave this decision to the patient and physician with guidance or recommendations from ethical boards. I would codify a hard stop for IVF implantation. I acknowledge there is room for debate as to whether the limit is two or three. I’d pick two. Many disagree.
I see 2 issues here:
-
To what level of specificity should lawmakers be able to regulate medical procedures?
-
Should women in high risk circumstances (e.g. drug/alcohol abusers, smokers, professional wrestlers, airline pilots, older women) be restricted from pregnancy?
^^^^from pregnancy, or from the deliberate insertion of multiple fertilized embryos, an elective procedure?
To what extent do patients have the right to insist doctors - who bear liability - do procedures that fall outside generally accepted guidelines?
There’s a reason that IVF guidelines in the US strongly discourage the “creation” of quads.
If my Hs patients are on fertility drugs and they release too many eggs in a cycle, he instructs them to wait that cycle out and not have relations. Now obviously he can’t enforce that, but he absolutely needs to document that he discouraged them from having relations. Because it would be unethical for him to tell then to do so.
Of course the Kate Gosselin and similar shows give misleading pictures of multiples. Real life multiple moms should know better. I’m kind of bothered by the sanguine “oh well, we just gained a little extra weight” attitude, frankly. It betrays a true denial about the real risks.
“Thus, it should be illegal to implant embryos beyond a certain number where the mother intends to carry all to term.”
I’m not sure I want the govt deciding things that should be decided upon by reproductive medicine experts / the neonatology community.
The quads have all been born alive at 26 weeks. Crossing fingers that they are healthy and will not suffer any long term problems.
It’s too bad she didn’t get further into the 2nd half of the pregnancy.
I wonder what prompted the delivery?
Just the mere fact that she was carrying four babies made a premature delivery pretty much inevitable.
Right, but as there are many things you can do up to that point, I wonder what precipitated that.
Had she been on bedrest?
Had she been given steroids to mature their lungs?
Anything else to delay or slow down labor?
Or were they delivered by cesarean section, because they were too fragile to withstand labor?
Was something wrong with the placenta or one of the babies that made delivery the best choice?
^^^^As far as I know, those details have not been released. Allegedly Germans are even more protective of patient privacy than we are (that was stated in the German airplane crash with reference to the medical/psych history of the pilot), so we may never know unless the mother releases that information.
I didn’t know that in Germany, the procedure she used to conceive, is illegal.
The babies are a good size, considering their Sga, but the boys especially will have a long fight ahead of them.
“To what extent do patients have the right to insist doctors - who bear liability - do procedures that fall outside generally accepted guidelines?”
This is what troubles me. Patients are going to want all kinds of irresponsible things. It’s the duty of the medical profession to establish which procedures carry an untenable risk of harm to patients and to stick by those standards.
“Ms Raunigk’s pregnancy - the result of fertility treatment in Ukraine - has been the subject of fierce debate in Germany, the BBC’s Jenny Hill in Berlin says.”
Wow. If you have the means to travel to places that disregard laws and common sense, there is always a way to get what you want even if the procedure is banned in your country.
Seems unreasonable for Germany to be stuck with the medical bill for someone who delibrately violated its laws and left the country to do so. Those bills will really mount with so many born so early.
I’m not 100% decided on this one. My initial thought is ick, how ridiculous and selfish. Then again, people who shouldn’t have kids (girls who are young, drug users, people who are irresponsible and have no means to support them and won’t take care of them) do so all the time. And we as a community, pay the price. Not just for these kids to be born, but all the costs afterwards. Don’t know if having a baby when you’re pretty old is a condition any worse than the other ones. I’m 52 and could probably have a baby for a number of years, and do a pretty good job raising it. I can’t seem to go through menopause. But I might jump off a building instead, if I got pregnant, so no worries there. I’m waiting for the grandbabies.
But a doctor implanting so many embryos? Yikes, that’s irresponsible!
I have no problem with the medical costs of the children, either those born to this German woman, or to irresponsible druggies in America. It is, after all, not the children’s fault. It is irresponsible to have children under these circumstances, but it is not irresponsible to be a child born into these circumstances.
I sympathize with wanting to withhold help from the mom but how to do it without hurting the children - well, I just have no clue.
However I’m pretty decided about the physician. Any doctor who doesn’t act according to medical ethics for the medical benefit of the patient should be disciplined. Just as a plastic surgeon should draw the line, so should an on/gyn. I mean, really, how irresponsible was this guy.