Yet for all the coverage of that story, rarely did the darkerv truth emerge. Call me a curmudgeon, but something is wrong here.
We often over‐generalize from well‐publicized cases (e.g., after the 1986 Baby M case, some states banned commercial surrogacy). In France since 1982 – where couples sometimes pursue pregnancy with religious zeal because each new baby garners a bonus from the government – use of fertility drugs has increased tenfold the number of triplets and the number of quadruplets, thirtyfold.
Some complain about the costs to society of so many babies in one birth, and true, the gestation, birth, and special care of the septuplets probably cost a cool million dollars. Others complain that the human uterus did not evolve to bear litters and that large multiple births are unnatural. Still others wonder what toll this extraordinary gestation had on mother McCaughey's body and health.
These are important matters, but they strike me as morally secondary. Costs can be absorbed by being spread over millions of payers, and what is unnatural in one era becomes normal in the next (witness anesthesia). And if Mrs McCaughey made an informed choice, she was free to risk injuring her body in childbirth as she saw fit.
Still others wonder if these two parents could really nurture each of the septuplets. Would you want to grow up with one‐seventh of the attention you got from your dad? Did the McCaugheys have the time, energy, and money to nourish each child’s full potential?
My real concern is about what is best for the children. This couple took the fertility drug Pergonal, conceived seven embryos, refused to reduce any (abort), and then said that any results were “God's will.” In doing so, they risked the lives and health of their babies. They took bad odds and hoped that all seven would be healthy. In so doing, they took the risk of having seven disabled, or even seven dead, babies.
Pause a minute and consider the “frame” or background assumptions of how the media presents multiple births: often it’s in the language of “miracles,” “blessings” and “heroic” parents. But consider my experience once in China during their one‐child‐only decades: on a public bus, a woman then entered who had just given birth to her second child: the other mothers on the bus quickly shamed her: “How could you be so selfish? Your new child will take food from mine. Why were you so irresponsible?” Imagine what the same women would say to Mrs McCaughey for creating septuplets when she already had one child.
Multiple‐birth babies are: usually premature (each may weigh less than two pounds), three times as likely as single babies to be severely handicapped at birth, and often spend months in neonatal intensive care units. In the womb with multiple pregnancies, nutrients and oxygenated blood are scarce (a uterine lifeboat, if you will), so not all the fetuses will likely emerge healthy. To prevent disabilities resulting from deprivation in utero, the American Society for Reproductive Medicine recommends gestating only one embryo at a time.
It seems to me irresponsible to say, as the McCaugheys did, that it would be God's will if any turned out blind, crippled, or dead. If God was clear about anything to them, it was that they should not have kids.
If you take a fertility drug, and if too many embryos conceive, you should be willing to reduce the embryos for the good of the children born. You shouldn't run the risk of severely‐disabled kids, and say, if harm happens, that it's “God's will.” Be honest and say it’s a grave risk you decided to take.
And what about the older sister of the McCaughey septuplets? Was her role in childhood only to help her mother raise the famous septs? Did she have any choice?
In 1985, Mormons Patti and Sam Frustaci conceived septuplets. Informed of the risks of disability and urged to reduce, they refused. Four of their seven babies died, and the three survivors had severe disabilities, including cerebral palsy. The Frustacis then sued their physicians.
In 1996 in England, Mandy Allwood conceived seven embryos at once. Offered a large cash bonus by a tabloid for exclusive rights if all made it to term, Mandy announced she would not reduce any and go for maximal births. As a result, she lost all of them.
I once heard about a case of a multiple pregnancy in West Virginia where the woman refused selective reduction. As a result of taking such a risk, only one child survived and this child was blind, paraplegic, and severely retarded. The physician on the case said that henceforth he would no longer accept women who would not agree to selective reduction. He said he did not get into assisted reproduction to create severely damaged babies, and that, although women have the right to refuse abortion, they would need to find another physician who could accept such terrible outcomes.
Not too many people are interested in long‐term follow‐up, yet the details that emerge are not encouraging.
At their fourth birthday in 2001, the McCaughey septuplets lagged in development and were not all potty trained. Joel suffered seizures; Nathan has spastic diplegia, a form of cerebral palsy requiring botox injections (to paralyze spastic muscles) and orthopedic braces. Alexis has hypotonic quadriplegia, a cerebral palsy that causes muscle weakness. Nathan could not walk at age seven and had two major surgeries to help him do so. Alexis had an indwelling feeding tube for four years. Although the McCaugheys home‐schooled their children, they sent Nathan and Alexis to a school for developmentally challenged children financed by taxpayers.2
The Canadian Dionne quintuplets were born in 1934, and although all seemed healthy at birth, only three lived to 2000 (one died at age 20 of an epileptic seizure). Because their selfish parents exploited their fame, the children did not lead happy lives.
Nadya Suleman, aka the “Octomom,” of California, 32‐years‐old in 2009, had six embryos left over from previous in‐vitro fertilization treatments; she requested another cycle of IVF to implant them all. Two of the six embryos split into twins, resulting in eight embryos. When sonograms in the first trimester revealed at least five fetuses, Suleman refused reduction. At birth, physicians delivered eight babies. Nadya already had children from previous cycles of IVF, two of whom were disabled.
Kate and Jon Gosselin in Pennsylvania created a family of twin girls (born from insemination of Jon’s sperm in 2000) and sextuplets (3 girls and 3 boys). Fertility doctors started the sextuplets by injecting Kate with drugs to stimulate her ovaries (like the McCaughey case) and afterwards, introduced Jon's sperm. Informed of six pregnancies, the Gosselins chose not to reduce, so physicians delivered eight babies by caesarean in 2004.
The 2007 television series Jon & Kate Plus 8 filmed the controlled chaos of this family of ten glamorized having multiple babies. Shortly after birth, a plastic surgeon did free plastic surgery to correct the distortion of Kate’s stomach after gestating six babies.
In 2009, after both Gosselins had extra‐marital affairs, they divorced. Thereafter, Jon seemed to abandon his interest in the children. Both Gosselins and Nadya Suleman seemed immature, self‐absorbed, and not focused on the best interests of their eight children.
New York City's Major Guiliani was recently on a call‐in radio show when an Orthodox Jewish woman with five little babies (three of them identical triplets) said she felt like killing herself because her babies were driving her crazy. Although the Mayor quickly got her help (he was running for re‐election), what about all the other parents who don't get the free pampers and cars? In a similar case, Jacqueline Thompson, a black mother of sextuplets, and her husband Linden were living exhausted on the edge in Washington, D. C. until a radio caller publicized their plight.
Some argue that babies born as multiples cannot be harmed because if the mother had reduced to one embryo, the others would not have existed. Isn’t it better to exist as a disabled child than not to exist at all? My answer is that we must access morality not only from a consequentialist view but also from other moral perspectives, not just from thinking about harm to children but also from thinking about the motives of parents. Why would any parents deliberately choose a disabled child when they could have a healthy one? Can they universalize not choosing what is the best life for their subsequent children? Wouldn’t virtuous parents choose, not what is best for themselves, but