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01/31/2009

Oh, come on, you had to know this post was coming eventually.

Okay, octuplets?

Seriously?

I wasn't going to write about this.  Every time I get all twitchy here about HOMs after ART, I inevitably get my judgmental ass handed to me on a silver platter.  No, wait: a plastic fast food tray, because the ass-handing's generally done with a terrifying Kroc-like quickness.  It usually begins, "I would have thought that you, of all people..." and, well, how can all that go anywhere good?

So in the early days after the octuplets' birth, when little was known about the circumstances of their conception, I kept my Good Christ, is that woman insane?s to a minimum.  I have learned that when I can drop my own defensiveness long enough to find it, there is usually a kernel of value in criticism.  Therefore instead of kneejerkfully condemning another woman's reproductive choices, I-of-all-people tried to think of her as someone not so different from people I know and love: infertile, frustrated, perhaps unable to afford IVF.  Someone willing to take on the risk of conceive multiples, but unwilling to terminate despite the risk of prematurity, disability, and death.  Someone whose situation could well have been my own, though with different convictions and priorities once pregnant.  I tried to imagine myself in her place, as unlikely a destination as it seemed.  Let a hundred flowers bloom, I counseled myself; let umpteen embryos contend.

And it went very well, I think.  I was feeling downright smug with how warm and unjudgey I was for a minute there.

I initially assumed, as did everyone quoted everywhere, from the highly concerned Zev Rosenwaks on down, that this was another instance of an IUI gone awry, where too many follicles developed and someone, ah, 'ow you say, shot first and asked questions later.  Regrettable, but by no means unprecedented.

A few days later, the story unfolded further and we learned that the mother is in her early thirties and already a mother of six.  Okay, I thought, hanging on to my hundred happy flowers, but even with six already, why shouldn't she try for another?  I don't think fertility doctors should refuse treatment to anyone based simply on the number of children she already has.

And certainly her marital status — un- — and her living situation — at her parents' — are similarly immaterial, right?  The fact that she's unemployed?  Well, it makes me wonder how she afforded treatment and how she proposed to support the children, but I don't tend to get too lathered about such matters.  Days passed and more information became available, but I surprised myself by remaining largely unruffled.  I wasn't even all that exercised when the octuplets' grandmother was quoted as saying her daughter had had embryos implanted.  I figured she must not know what the hell she was talking about.  Please: how firm is your mother's grasp of the details of ART?

But then another few days passed and we learned that as improbable as it had seemed, this high-order gestation was the result of IVF.  An FET, to be specific.  Maybe that's why Zev looks so rueful and wrinkly and...well, brown.  He is wrinkly and brown with chagrin, because damn.  According to the babies' grandmother, who sounds, incidentally, like a magnificent piece of work, all 14 children were.  Which...I mean, what?

And that's where my hundred fucking flowers get stuffed down the garbage disposal.  I tried.  I did.  In the beginning, it was easy not to judge.  The coverage all began quite responsibly, even if courtesy phrases like "It's unknown whether she used fertility drugs" strain even the most elastic bounds of belief.  During the first few days after the birth, as I clicked from report to report, I was nodding my head in appreciation when a reporter pointed out that insurance coverage for IVF would reduce the number of high-order multiples conceived through poorly-managed IUIs.  When an article resolutely refused to romanticize what is actually a fairly horrifying scenario.  When one well respected doctor after another soothingly assured the alarmed fertile public that infertiles don't pull this shit on purpose. 

But now I'm reading a paragraph like this:

Angela Suleman told reporters Friday that doctors implanted far fewer than eight embryos but they multiplied. Experts said this could be possible since Nadya Suleman's system has likely been hyperstimulated for years with fertilization treatments and drugs.

...which leaves me, by no means an expert but certainly an educated layperson, completely flummoxed.  So much for elucidating the process.  And a statement like this:

Nadya Suleman's goal in life was to be a mother, her friends and family said. That is why, even with a brood of six, including 2-year-old twins, she decided to have more embryos transferred in hopes, her mother said Friday, of getting "just one more girl."

...which sets my teeth a-grinding.  (Proof that my miraculous transformation into a kinder, gentler Julie was, alas, temporary: this made me wish all eight had been boys.)  And a passage like this:

The single mother of octuplets born in California last week is seeking $2m (£1.37m) from media interviews and commercial sponsorship to help pay the cost of raising the children.

Nadya Suleman, 33, plans a career as a television childcare expert after it emerged last week that she already had six children before giving birth on Monday. She now has 14 below the age of eight.

Although still confined to an LA hospital bed, she intends to talk to two influential television hosts this week — media mogul Oprah Winfrey, and Diane Sawyer, who presents Good Morning America.

Her family has told agents she needs cash from deals such as nappy sponsorship — she will get through 250 a week in the next few months — and the agents will gauge public reaction to her story.

...which leaves me gasping, for about a thousand obvious reasons, assuming any of it is true. 

Assuming
any of it is true.  There's an awful lot here that doesn't sound right, and I don't know about you, but the grandmother doesn't exactly strike me as the soul of veracity and discretion.  And with that statement, well, I'm off!  As anyone might have predicted, here I am a-judging.  But here's the novel part: I'm not actually judging the mother.  Swear!  No, my deliberate compassion for her is largely still intact, if only because I truly believe she's probably somehow disturbed.  I mean, unemployed, single, living at home, and infertile are some pretty high barriers to extending one's family, so how determined must she be, and why?

Further, although I can't say I know people exactly like her, I can identify with each individual variable in her story, even associate it with a real live person.  We all know someone who's trying to conceive as a single mother by choice, or who's pursued ART even after several other children, or who can't easily afford treatment but manages it somehow, or who transfers too many embryos — i.e., more than we think we would — in a last-ditch effort and, whoa, hey, lookit: four heartbeats.  It inclines me to rather more sympathy than I might have mustered in the past.

But, me being me, I have to judge someone.  So I'll settle for the doctor responsible.  The doctor who transferred at least four embryos into a young woman with five successful previous pregnancies.  (I suppose it is possible that only two were transferred, "but they multiplied"...three...times...each.)  Who either didn't conduct a useful psychological assessment before this cycle, or who did so and missed something major.  (Apparent lack of a functional support system counts, in my opinion, as something fairly major.  Bigmouth wackaloon of a mother, ditto.)  The doctor who's singlehandedly undone years of patient explanation — It's fine, Mom; you don't get sextuplets with IVF — and promoted the popular perception of infertility treatment as the last refuge of the selfish, entitled, and irresponsible. 

Thanks for the help, Doctor Anonymous!

And with that single sentence, I'm starting to think maybe I have evolved somewhat after all.  I thanked him quite politely, and didn't use the words reckless, charlatan, or revocation of license, not even once.

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