Abortion Back in the Headlines

The Telegraph today reports on the rise in abortions to reduce multiple pregnancies as a result of IVF treatment.

According to the article, 'more than 100 unborn babies were aborted last year by women expecting twins, triplets or even quintuplets but who wanted to give birth to fewer children, official figures disclosed to The Telegraph show'...

'Over the past few years, there has been a sharp rise in the number of women terminating one foetus or more but continuing with a pregnancy and bearing at least one other child. 

Experts say that the increase in so-called “selective reductions” has largely been caused by a rise in multiple pregnancies following IVF treatment. The disclosure is likely to provoke renewed debate over the practice in which IVF clinics implant several embryos in order to improve a couple’s chances of having a baby. 

Department of Health figures, released under Freedom of Information law, show that 59 women aborted at least one foetus while going on to give birth to another baby in 2006. In 2010, the number had risen to 85. During 2010, 101 foetuses were aborted in this way – as some mothers aborted two or more unborn babies.'

Of the 85 women undergoing selective reductions last year, 51 were reducing a pregnancy from twins to a single baby, up from 30 four years before. There were also 20 abortions to reduce triplets to twins and nine procedures to take a pregnancy from triplets to a single child. 

The other terminations counted in the 2010 data were three mothers who reduced four foetuses to two, and two mothers who reduced five to two. 

Separate figures from the Human Fertilisation and Embryology Authority, show that almost one third of selective abortions carried out in 2009 involved pregnancies that were a result of fertility treatment. 

Multiple pregnancies are more dangerous to both mother and baby and the Department of Health said that about three quarters of the selective reductions were made on medical grounds. 

The risk of birth defects is about twice as high for multiple pregnancies and the babies are far more likely to be premature. Twins are four to six times more likely to suffer cerebral palsy, brain damage that can leave them wheelchair-bound, unable to speak and having fits.
They are also more likely to have impaired sight and heart defects. 

The rise of selective reductions will also lead to discussion over the ethics of aborting a potentially healthy foetus while one or more siblings survive. Some mothers-to-be have said that they were considering the procedure because they could not cope with more than one baby at a time. 

Prof Richard Fleming, the scientific director of the Glasgow Centre for Reproductive Medicine, said that the link between fertility treatment and selective abortions was clear.
“I would be surprised if multiple pregnancy through fertility treatment was not a significant component to the increase in selective reductions,” he said. 

“One of the components within that is the health to the mother and health to the offspring as well – both are compromised by multiple pregnancy. The more complicated multiple pregnancies lie almost exclusively in the IVF domain. It’s a horrible decision to make but a very sensible one.” 

Last night, Dr Peter Saunders, the chief executive of the Christian Medical Fellowship and a former surgeon, said: “There is no doubt that the rising use of IVF has contributed to a rise in multiple pregnancies. 

“If prospective parents are not willing to have twins then they should not be implanting more than one embryo at a time. Parental preference should never take precedence over the right to life of the unborn child.” 

Last year there were 189,000 terminations in England and Wales. Women can apply for an abortion on medical grounds up to the point of birth. Although selective abortions represent a small proportion of the total figure, they are often viewed as among the most controversial.
In recent years there has been a move to reduce the number of multiple pregnancies because of the risks. In the 1990s the HFEA, which regulated fertility clinics, issued guidance saying that no more than three embryos should be transferred at any one time. A lower limit of two embryos for women aged over 40 was issued in 2001. 

In recent years the HFEA campaigned to persuade parents and clinics to implant just one embryo at a time and set clinics a limit on the number of multiple pregnancies they could produce. 

NICE, the value-for-money advisory body, is currently reviewing NHS guidelines for fertility treatment and is expected to examine the issue of multiple pregnancy. Women who have undergone fertility treatment resulting in multiple pregnancies have taken to internet sites to seek help and discuss the dilemma they face. 

One wrote: “I’m 12 weeks pregnant with my first pregnancy achieved through [fertility treatment]. At my six-week scan, we found that I’m carrying triplets, which has taken a long time to sink in, and we feel we have to consider foetal reduction. My concern is about the best outcomes for my babies, and to me. I’m not sure that being two months premature and incubated is the best thing for my children, along with the other potential risks. I just want the best possible outcome for my pregnancy and my children, and that might not be keeping all three.” 

Another wrote: “I am seven weeks pregnant with twins (non-identical). After two weeks on an emotional rollercoaster, I have decided that I cannot cope with twins due to health, emotional, practical, financial reasons. I am considering foetal reduction.” 

Despite the risks, many women undergoing fertility treatment remain keen to increase their chance of becoming pregnant by implanting multiple foetuses. 

“Women are encouraged to have a single embryo implanted and then freeze any others,” said Susan Seenan, from the Fertility Network, a support group. “But if one of the embryos is poor quality or the woman is having treatment on the NHS or paying for it privately, they are likely to want to maximise their chances.” 

A spokesman for the Department of Health defended the practice. “Over three quarters, 78 per cent, of the selective terminations were performed under ground E – that there is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped,” he said. “Multiple pregnancies are generally a greater risk to the mother and the babies. The risk is greater for twins than single babies but rises dramatically with three babies or more.”

Quite chilling, isn't it?