Let’s Not Get Too Excited About The Idea of Octuplets

Filed Under Demography, Family Issues, Media Praises and Critiques, Original Essays and Analysis, Pregnancy and Childbirth, Sexuality and Heterosexism, Sociology, Uncategorized by Rachel

Everyone is talking about the California woman who gave birth to octuplets. Yes, my friends, that’s 8 babies, and it looks like they will all survive. While the news media is gushing, my own response is a little more subdued. We don’t know all of the details surrounding the birth and conception of these babies, but the likelihood of having this many babies at once without some type of intervention is slim. The birth of high order multiples (HOM), while it is amazing, it’s troubling.

First, it’s very dangerous. I can speak first hand as a mother of multiples. Multiple pregnancies are closely monitored, and I routinely went for ultrasounds and stress tests during the last 2 months of pregnancy. This monitoring is because the risk of nearly all major complications for mother and children are higher. I was lucky to have no complications and to go full term–that makes me part of the minority of twin moms. If the risks are this high for twins, can you imagine how high the risks are when a woman is pregnant with 8. The risks to mother and children are very high.
Another ethical issue that arises with an HOM birth is the difficulty that arises in giving adequate care to that many babies. In talking with other twin moms who formula feed, they estimate that formula would cost over $200 a month. Even if this mother is providing some breast milk, the cost for just food would be nearly $1000 a month. By the time you add the cost of other basic necessities, paying for these kids would be nearly impossible. The other issue would be basic care. When my twins were born, I spent nearly all of my time feeding, diapering, burping, and clothing them, and I had help. My spouse was here, and my mother was here for the first week. It was a daunting task, and my twins were full term. Since these babies are micro-preemies, their care will be even more challenging. They will need to eat often, probably every two hours, and there is no way possible that one or even two people can feed all eight of these babies. Plus, the babies will likely have feeding and breathing difficulties associated with low birth weight and prematurity. Moreover, reports indicate that this family already has 6 children. Taking care of 14 children, including 8 preemies is a nearly impossible task.
There are also social and economic costs that the larger community faces in cases like this. The hospital and insurance costs in these cases is huge, and I can’t help wondering if care for other babies in that hospital is suffering. Who knows maybe the hospital has some additional temp nurses to handle these babies, but I wonder if the care of other infants is being compromised because the extreme burden this is placing on the staff. What about the costs of insurance, assuming the family has health insurance? Will all of this medical care be covered; how will the financial burden be shifted around to others. I also cannot imagine in the long term that this family will get by without significant amounts of public assistance. The octuplets will be automatically eligible for early intervention programs, which are often government sponsored programs for children with disabilities. I don’t have a problem with people getting public assistance, but I worry that a case like this is a very heavy burden on the system.
I’m hesitant to comment of the specifics when it comes to ethical fertility practices because we don’t know the exact details of this conception. However, I do worry, as do many fertility doctors, about the ethics of HOM. It’s not likely that a doctor used in-vitro fertilization in this case, but I wonder about the monitoring in this case. In cases where injectible fertility drugs are given, doctors often closely monitor the development of follicles, and the release of eggs. I’ve also heard some speculation about black market fertility drugs, but clearly, we don’t know enough details to focus on the specifics of this conception. Nevertheless, we do know that mainstream fertility doctors do not consider these HOM births a success. Here’s quote from MSNBC:

It’s fine to celebrate the healthy delivery, said Sean Tipton, spokesperson for the American Society for Reproductive Medicine. But, a pregnancy resulting in this many babies is “clearly is not a medical triumph. Eight babies is not an outcome anyone should want.”

Unbridled celebration of these multiple births ignores the risks that this type of pregnancy can bring and the huge costs to the medical system and the parents, say experts.

This leads to my last point. I understand that people are fascinated with multiples. I can personally attest to the public reaction to twins. When we are out with the babies, numerous people approach us and provide unsolicited (sometimes nice and sometimes not so nice) comments. Multiples are a spectacle, and it is understandable because it’s different, but media coverage of multiples treats them with wonder, but generally ignores the challenges. I’d like to see more media coverage that is realistic. After all we rarely hear of HOM pregnancies that result in the death of the mothers or babies. I found this case from the UK that highlights a multiple pregnancy gone terribly wrong. I know for every one success story there are other stories that are not so happy.

While multiple pregnancies may be fascinating or interesting, the challenges shouldn’t be glossed over, especially when we are talking about high order multiple pregnancies. From child care issues, to medical and financial challenges the difficulties and risks are numerous. Parents, doctors, journalists, and the general public need to grapple publicly with what these HOM births mean for society. Unreflective celebration and freak show voyeurism seems to be the dominant way of viewing HOM pregnancies at this time.

Comments

11 Responses to “Let’s Not Get Too Excited About The Idea of Octuplets”

Rape myths challenged, plus other good reads. « Small-Town Elitist on February 1st, 2009 2:26 am

[...] Rachel of Rachel’s Tavern has written a great piece of the difficulties and complications of carrying pregnancies with multiple babies. [...]
Kate L. on February 1st, 2009 2:38 am

my feelings on this situation are similar to yours. However, more details surrounding this case have been released. She did do invitro. She did invitro with ALL 6 of her other children too. These 8 were the “leftover” frozen embryos. She wanted them all implanted, they all stuck and so she has 8 children.

I think the physician who agreed to implant all 8 should be taken to task by a medical ethics board.

I think the woman herself probably needs to be evaluated psychiatrically. Normally, I wouldn’t be so quick to say that kind of thing, but based on what I am reading, it sounds like she has a mental illness of some sort.

I am not celebrating the medical miracle at all. What is the quality of life like for the other 6 children (under the age of 8) in a 2 bedroom house with a single mom? I don’t have issues with single moms at all, but I don’t know how ANYONE can take care of FOURTEEN children under the age of 8 by herself. There is no daycare in the country licensed to handle that load! Just the 8 infants alone would require at minimum 2-3 people.
If discovery or TLC offer this woman a TV show I’m going to go balistic. Yes, lets reward the irresponsible behavior and invite more spectacle. I actually have to wonder what kind of effect the monetary success of shows like “17 kids and counting” and “John and Kate plus 8″ have on encouraging people to seek out HOM so they can get their own show too. It’s just awful.
Amy Tuteur, MD on February 1st, 2009 3:09 pm

The story this woman tells about how her children were conceived is almost certainly a fabrication. Six IVF procedures in 7 years? All IVF procedures 100% successful? No means to pay for any of these IVF procedures? A doctor returning 8 embryos to a uterus at once and all of them implanting?

No, it is far more likely that this woman treated herself with fertility medication, without the aid of any doctor. Possibly she was hoping for a spectacular number of babies, with an eye toward attention, money or both.
lechatnoir on February 1st, 2009 4:16 pm

No matter how hard I try to believe this. There is no way she would have conceived those babies naturally.The thought of 8 lives in a small belly is really disturbing to me.

Rachel you should have let at least 3 of your husband’s relatives take care of the babies. Twin birth is a big deal in Naija even elsewhere in Africa. The babies are usually taken care of until they can walk and talk so the mother can recover. In our culture now mothers, all they do is kiss and cuddle her babies. The rest, feeidng , changing diapers etc.. is a family duty. I know you are doing quite well with the help of hubby but ….
Adam on February 1st, 2009 8:11 pm

I think a case such as this raises a good Sociological/Philosophical question:

When medicine, science, technology or ecomonics allows a person a greater range of personal choices to make…does that mean a person has to engage and embrace the range of choices?

Is there wisdom in limiting oneself? Or deciding far in advance that enough is enough before a new techo/medical/gadget/operation comes to a store or clinic near you?

To what extent have we been duped into believing that “progress” in the above areas I mentioned means “freedom”? Does having one’s range of choices expand really mean more Freedom? Questions to ponder.

On a lesser and comical note, I have not owned a cellular phone since 1997 - I got sick of it after six months. I have never sent a text message in my life - my tin cans with string did not come with a keypad or keyboard.
gradmommy on February 2nd, 2009 12:38 am

Hmm, I don’t have as strong feelings as you all do, but I’ll admit not knowing much about the story except the basic facts. So if I knew more perhaps I’d feel differently.

First, I know mothers who have used IVF and, due to religious beliefs, have decided that all embryos will be implanted and none will be destroyed. Now most of them aren’t having 8 implanted at a time, but sometimes 3 or 4 with the hope(?) that not all will stick. Do you feel that 5 is too much? 6? 7?

Second, I think it’s presumptuous to think that the quality of life for these children is 100% certain to be bad. I know you all are not for the publicity that people with a lot of kids get, but both shows on TLC with 8 kids and with 17 kids, those families look happy. They have what they have, and they deal with it and make it work. As far as I can tell, neither family has paid help, and yes, it’s hard, but who are we to judge?

I’m not advocating for unbridled celebration, b/c the dangers of carrying multiples should be discussed as fertility treatments are more widely used. But it sounds more like unbridled judgment, and that just does’t sound right when we are talking about people bringing life into the world.

Just my opinion…
Gretchen on February 2nd, 2009 6:00 pm

I don’t know about the Duggars, as they have the older kids take care of the younger children, but John and Kate hire babysitters (and have them more often in the later seasons, when the show/publicity is obviously making them more money) But both families have the ability to take care of their children because of publicity and because of TLC. The Duggars new airplane hangar sized house was built for them by TLC and donations. The second new house the Jon and Kate plus 8 people got was paid for by show proceeds. People offer them free vacations all the time and other free perks that they would likely not receive if it weren’t for the publicity of the show. That sets an unrealistic example for other families. I think that that is the point of this article/posting. The media does nothing but celebrate the multiple births, without showing how incredibly difficult it would be for someone, especially a lower income single mom, to shoulder the monetary and physical responsibility of taking care of multiples. And it is unreasonable to expect that all of these families with multiples are going to get the same publicity, and the same monetary help, that the TV show families receive.
Lynn Gazis-Sax on February 2nd, 2009 7:18 pm

Having had one niece who spent months in the hospital due to being born way premature (one pound six ounces), I do feel very strongly about not deliberately doing something that’s nearly certain to have your children born as micropremies. My niece is now a healthy and intelligent grade school child - but those months in the NICU were scary, and no way would I deliberately put a child through that.

There are medical guidelines for doing IVF, and if this woman’s story about how she conceived is true (Amy Tuteur’s arguments for why this is unlikely are fair), then the doctors would be way outside acceptable medical practice for how many embryos should be implanted in a 33-year-old woman.

In general, women under 40 are at high risk of supermultiples if you implant a large number of embryos, and giving birth to anything more than twins (and certainly anything more than triplets) is going to be high risk.

It’s possible to donate your extra embryos to another woman if you feel that strongly about not having them destroyed; then at least you’d be giving them a shot at being part of a sufficiently low order pregnancy that they can be born healthy.

So, my view is that no fertility clinic in the US ought to be permitting the kind of procedure that’s alleged to have taken place.
pseudonymous in nc on February 2nd, 2009 10:18 pm

both shows on TLC with 8 kids and with 17 kids, those families look happy. They have what they have, and they deal with it and make it work

But ‘what they have’ includes money and in-kind bennies from TLC.

There’s a judgement call to be made in those rare cases when it appears that medical ethics have gone out of the window, because the standards by which the medical profession works affect us all.
Adam on February 11th, 2009 8:20 pm

I half-kiddingly/half-seriously tell people that there is wisdom in having a lot of children.

Why? 1) The burden of care is spread out among syblings (in the case of my wife’s family there is five). 2) Parents who raise many children are rarely in want of anything…at least in the western societies. You increase the chances of least one of them becoming successful - my father was 1 of 10 kids - doctors, lawyers, and accoutants came out of that fold - my grandparents were well taken care of. Rarely have I seen where a parent of 5 or more children who has spend their last years staring at the four walls of semi-private nursing home bedroom.

There were many periods in history (across many cultures) where having lots of children was a potent economic asset. We still see it here just a little in the western mountain states and the midwest - where having an extra set of hands on the farm or ranch saves a tremendous amount of time and energy for farmers or ranchers.

It does fascinate me that we have seen a shift in the west from viewing children as economic assets to viewing them as resource consuming liabilities (until age 18 or 21).

As one wise farmer in downstate Illinois said, “My children were never a hindrance to my personal goals in life. Because building a successful future WITH my children was my main goal”.
Miss Profe on March 9th, 2009 7:19 pm

What frightens me is that multiple births of more than four children at a time is becoming more the norm. When I was a child, coming of age in the 70s and 80s, having twins was a rare event, let alone three or more.

I do not want to see the government regulating the number of children one can have, but, there must be regulations placed on fertility clinics.

Then again, I don’t see the need to replicate myself. I believe in zero population growth. If i ever get a strong maternal urge, I’ll adopt.