by Lisa Marsh, AFA London Correspondent
This news flash, combining eye-catching key words, #scandal, #aborted and #IVF, made an appearance on the front page of The Sunday Times yesterday. It was suggested that the abortions were for "social" reasons. It's not at all surprising that it’s been picked up on Twitter and re-Tweeted around the globe, supporting the idea that medical procedures, the creation of a life and a hard-won pregnancy were being tossed around thoughtlessly by patients and doctors alike.
Professor Bill Ledger, a member of the Human Fertilisation and
Embryology Authority (HFEA) in the
While I am both pro-IVF and pro-choice, I agree that it is tragic, not only for the actual ending of each pregnancy, but also for the inevitable fallout it will create in public opinion of IVF.
Having been through IVF myself, I can hardly imagine that anyone would let themselves in for that rigorous, physical and emotional experience unless they really wanted to be pregnant. An IVF cycle is planned months in advance, requires drug treatment and, while not surgical, is an invasive procedure. It's expensive, so must be justified whether your insurance company, the National Health Service (UK) or you are paying for it. It inconveniently interferes with your work and social schedule, does a number on your self-image and practically invites the opinion of third parties. It’s stressful, requiring the voluntary suspension of control over many aspects of your life, including intimacy.
How does a much-wanted pregnancy turn into a self-imposed tragedy? I don't believe that these abortions are carried out on a whim. Having an abortion at the end of a relationship is not considered at the same level as the old song from the film South Pacific: "I'm gonna wash that man right out of my hair." Pro-life activists assert that all abortion is unconscionable and those carrying it out are thoughtless, selfish and sinful; using abortion as a method of birth control.
According to an article in The Telegraph, approximately 190,047
abortions were carried out in the
An IVF procedure is voluntarily sought and undergone, not forced, therefore a pregnancy resulting from IVF will always be purposeful. At each step forward, a woman is assessed by her general practitioners, gynaecologists, reproductive endocrinologists and hopefully, by counsellors or coaches, to determine whether IVF is absolutely necessary and appropriate for her to conceive. It requires conviction and commitment; the lack of either almost certainly showing up before she has gone through the IVF procedure. Statistics show that of 36,861 women who had IVF treatment in 2007, only 11,091 of them had successful births, resulting in 13,672 babies or a 30% success rate. There being alternative means of family-building, for a woman to pursue IVF to the stage of conception and become part of that minority who succeed, it's unlikely that she will merely change her mind. The circumstances would have to be dire. One woman cited her need to break all ties with her soon-to-be ex-husband.
My personal reaction to the news reports about aborted IVF babies ranges from dismay to distress. As a fertility advocate, I educate people about infertility and treatments like IVF, in the hope that any residual stigma will eventually disappear. I know that this news item could negatively affect public opinion about infertility, fertility treatment and those who need it, particularly in a country that provides such treatment through tax-supported, public funds.
In a scathing comment to Lois Roger's article in The Times, a
person calling himself Forrester Christopher said: "This
is just obscene. The problem with IVF is the consumerist attitude it denotes.
Some are not intended by nature for genetic reasons to conceive. IVF is a
form of pet ownership...just odd... adopt a child and get real!"
Another reader took a financial stance, saying that all people who wanted IVF should pay for it themselves instead of it being provided by the NHS. In the U.S., an equivalent argument would be a person who believes that his insurance premium is inflated in order to pay out to women who claim for fertility treatment. These kidns of comments are uninformed, insensitive and boorish, making sweeping judgments of all people who can conceive a child only with the help of medial science. That's the forest. There there are the trees; the thousands of women who, one by one, may now reverse the tide and decide to hide their efforts to conceive through assisted reproductive techniques, fearing renewed scrutiny and judgment.
There is also a troublesome dichotomy: whether aborting a single IVF baby is any different to aborting "extra" foetuses if it appears that there will be multiple births. It has long been a practice of fertility doctors to implant several embryos during IVF to give a woman the best chance of conceiving. Many doctors then recommend aborting (Is "thinning out" a more acceptable term?) one or more for the health of the surviving babies, the best chance of a healthy childbirth and ultimately, the lifestyle of the prospective parents. Some might think this is only common sense, but from the moral standpoint of the pro-life community, these procedures would be classed as murder. Yet, it seems to have slipped under the radar and even to be considered a second, but preferred, choice to another woman becoming Octomom, which was a scandal in itself.
There's an uncomfortable, unresolved question
hanging in the air over the difference, if any. The far more neat solution
would be to limit implantation to one embryo, which is the choice that is
advocated by the
On a personal level, I shudder to think how this negative media attention could affect the dozens of infertile women whose blogs I read. Many have blogged for years under anonymous usernames to protect themselves from the perceived disapproval and/or hurtful comments of others. Some of them have let down their defences after becoming familiar with each other on Twitter and infertility forums. They consider themselves part of a sisterhood and rejoice with each other at every positive test result and feel each other's pain at every negative result, whether it be a number on a chart, a failed cycle or a miscarriage. It's a fantastic support network when you find like-minded individuals who click in a cyber-friendship and even better, when the friendship survives in "real-time."
Unfortunately, one common theme among members of the infertile community is resentment toward women who can conceive easily, who announce their pregnancy with great fanfare on social networks like Facebook, and blissful, pregnant women or new mothers out and about. It isn't their most shining quality, however, its source is deep inside the emotional well: the deep sadness, sense of insecurity, lack of self-worth and envy. What I do know is that even those IF sisters who sound almost militant and separatist are in truth, still vulnerable. To think of another woman, who had already achieved with IVF what they want so much for themselves, throwing away that achievement would be the ultimate slap in the face.
I felt a little current of electric shock
myself when I first saw the news report about the “scandalous” abortions of IVF
babies. However, we haven't been made aware of a breakdown of the 80 or
so women included in the HFEA statistics, if one has even been done. We don’t
know their ages, mental health, cultures, health risks, relationships, change
in employment or financial situation, or indeed, any possible anomalies in the
foetus. According to the UK National Statistics Office, there were 690,013
births and 198,500
abortions performed in the
I hope that anyone reading articles mentioned and Tweets about this finding by the HFEA will understand that, while it’s shocking to realize that post IVF abortions are occurring at all, these headlines are just hype. I hope they will not use it as a weapon to negate the status of infertility as a medical condition deserving of treatment, funding and research. I hope that the infertile community does not crawl back into the shell from which it only recently emerged. I hope that I can cast off the gloomy thought that any of these 80 women may have used abortion of an IVF baby with no other reason than a change of mind about being a mother.
Lisa Marsh is an American fertility coach
who lives and works out of
Personally, I believe that Ireland needed a panel composed of bioethicists, sociologists, doctors, performing basic researchers and professionals in public policy again on sensitive issues of reproductive medicine and research on embryos, and then make recommendations on areas of medicine and science on Should the government legislate. I also personally believe that the human embryo is a valuable and worthy of deep respect, because of its huge potential and that the existence and status of moral pair should rest Beliefs whom it Came From.
Posted by: Jenny Briesel | 09/11/2010 at 02:38 AM
Reply to Amy Demma -
I would like to address your question of whether I feel that "easier (financial) access to IVF in the U.K. may entice some patients to sign-up who may not have otherwise done so?"
The answer is "no." My observation is that patients who qualify for NHS care do not think of medical treatment of any kind as being “free.” They see it as something for which they are taxed and to which they are entitled. However, the system delivering that care is highly regulated. It is not available for unnecessary procedures, like cosmetic surgery, unless the patient’s enjoyment of, and functioning in, life would be compromised if they did not have corrective surgery. There are many grey areas, as elective surgery for varicose veins, breast reduction, and gastric bands increases. As you may expect, there is controversy regarding procedures like IVF; some UK residents believing that parenting is luck-of-the-draw and not something to which we are all entitled. It's still a hotly debated issue, mostly by people who object to their taxes paying for what they see as someone else's lifestyle choice: parenting.
Additionally, not everyone qualifies for fertility treatment such as IVF. If your General Practitioner (GP) decides to refer you for specialist diagnosis or care, you can do so under the NHS or privately, the latter for payment directly or through an insurer. You may not be referred at all, unless you are between the ages of 23 and 39 and have no children already. The important factor here is age, because NHS statistics have shown that this group is most likely to benefit. However, a woman could be disadvantaged by a "postcode lottery," in which the local Primary Care Trust applies its own criteria, such as the funds they have available or health factors such as obesity, or refusal to stop drinking or smoking, habits which could lessen the chance for the IVF to be successful. Additionally, I believe that there is a limit imposed of 3 IVF cycles. If you are 39 and had a failed IVF cycle, you may not get another chance. There are plenty of women who have not been offered IVF, thus the recent trend of going abroad to less regulated and less expensive countries like India for treatment. It doesn’t look good. Media attention and the increasing demand for fertility treatment has forced the NHS to be generous and more even-handed in its supply.
I have not yet met anyone in the UK who jumped at the chance to have any medical treatment just because they weren't paying for it out of pocket. First of all, there are those bureaucratic hoops to jump through. Secondly, waiting lists are long, so you might have to wait several months to be assigned a specialist and up to a year to have treatment commence, instead of a few weeks to get a private appointment. The side effects of fertility treatment are no walk in the park, whether paid for or provided. Decision-making by a couple is just as difficult; treatment just as stressful.
I have no information breaking down the proportion of the 80+ abortions that resulted from IVF on the NHS and those whose IVF was paid for privately. However, regarding fertility treatment generally, I very much doubt that the decision to undergo IVF in the UK is approached with less gravity because it is free.
Lisa
Posted by: Lisa Marsh | 06/19/2010 at 07:54 AM
Lisa,
Thank you for writing such an informative blog, I am just delighted to learn that The AFA has a London correspondent. Having undergone several IVFs myself and therefore understanding not only professionally but personally the heartache and general toll the process takes on every patient, I am wondering what your thoughts may be on how the differential in costs of IVF in the U.K. and here in the states may impact whether or not one would choose to undergo the process w/out being fully committed. When in London meeting with clients last year, I learned that IVF is covered under the U.K. socialized medicine program (pardon me for botching the reference to the govn't medical program) and costs less than pennies on the U.S. dollar compared to what most patients pay over here. While I remain cynical about the stats relied on in the article of discussion and while I too am so very concerned about how this may be used to support an anti-ART agenda, do you feel that easier (financial) access to IVF in the U.K. may entice some patients to sign-up who may not have otherwise done so?
Many thanks.
Posted by: Amy Demma | 06/10/2010 at 09:37 AM
Reply to Lisa Ansell:
I believe that you and I interpreted Professor William Ledger's comment differently. I agree with what I think he meant, which was that it is tragic that a woman who wanted a baby so much that she sought, and successfully underwent, IVF would find herself subsequently in a situation in which she deemed it necessary to abort her baby.
I would have welcomed a breakdown of the reasons that these 80+ abortions were carried out, in order to better understand, not judge. It's likely that they were not available, but in their absence the headlines and the suggestion that the reasons were social in nature, can potentially cause harm in the form of uninformed, public speculation. As a result, I do think that Ms Roger's article, and particularly the headline, was inflammatory.
Posted by: Lisa | 06/08/2010 at 12:40 PM
http://deeplyflawedbuttrying.wordpress.com/2010/06/08/response-from-professor-william-ledger-re-article-in-the-times/ THis blog post is the response I got from Professor Bill Ledger, who was cited in the article.
THis was the post I wrote in response to the original post. Absolutely appalling piece of 'journalism'.
Posted by: Lisa Ansell | 06/08/2010 at 06:17 AM