The news that octuplets were safely delivered at a hospital just outside Los Angeles this week was mind-boggling enough. But subsequent reports that revealed the mother already had six children — ranging from 2 to 7 years old — raised even more eyebrows — and questions.
Neonatologist Dr. Harold Henry explained Thursday how Kaiser Permanente hospital inherited its extraordinary patient.
"Our patient came to us in the first trimester of pregnancy from an outside provider," Henry said at a news conference at the hospital in Bellflower, Calif. "Our patient was counseled as to her options for the pregnancy. Her options were to continue the pregnancy or to selectively abort."
That the woman did not elect what is referred to as "selective reduction" surprised many within — and outside — the medical community. And when a local news station revealed she was already the mother of six, critical chatter spiked: "What was she thinking?"
In response, the mother who asked not to be identified had the hospital staff read a statement on her behalf.
"The babies continue to grow strong every day and make good progress," Dr. Karen Maples read. "My family and I are ecstatic at their arrival. Needless to say, the eight was a surprise to us all, but a blessing as well."
Because the mother has declined to be identified, not much is known about her babies' conception. The unidentified woman's mother told the Los Angeles Times her daughter had taken fertility drugs, but never expected them to result in so many children.
Alexander Capron, a professor of bioethics at the University of Southern California, says there are accepted medical guidelines for assisted pregnancies.
"In the case of fertility drugs, the standard is that the doctor will monitor the number of eggs that are developing and will counsel the woman not to have intercourse, or will not use artificial insemination," Capron says.
Those caveats are designed to avoid what doctors call mega-multiple births, which are dangerous and difficult for mother and children. And they're expensive: 46 doctors and nurses were required at the octuplets' birth.
But as the Kaiser doctors realized, they can only counsel — not mandate — selective reduction for the health of the mother and her remaining fetuses.
Capron says that with assisted pregnancies, most doctors intentionally stick to medical considerations and don't focus on things such as economic or marital status — or even age.
In a society that recognizes reproductive choice as a human right, the bioethicist says most doctors shy well away from questions such as who is and isn't entitled to bear children and how many and with whom.
"I think the general view in the profession is there is a line that isn't the doctors' business," Capron says. "We probably don't want doctors exercising what amounts to a social choice of that sort."
And, Capron says, he wouldn't want highly unusual cases like the octuplets' to be the basis for standard policy guidelines on future assisted pregnancies.