Two recent cases in Britain highlight the issue of selective abortion in multiple pregnancy, used in high-risk pregnancies in order to increase the chances of success for the remaining fetus or fetuses. This issue has become more important in an era in which many infertile couples seek medical assistance in attaining pregnancy in the first place, and some of the procedures contribute to an increase in multiple pregnancies. Studies show, for instance, that selective reduction of triplet pregnancies to twins may be fairly safe in light of the increased risks of preterm birth of triplets, though it should also be noted that prevention of multifetal pregnancies in the first place is preferable to selective reduction after assisted reproduction treatments. Selective reduction of multifetal pregnancies to twins can reduce the risk of preterm birth and of losing the entire pregnancy, but it still poses the danger of the loss of the entire pregnancy. Selective reduction may be warranted in triplet pregnancies as well as in pregnancies with four or more fetuses. However, this procedure raises ethical issues beginning with the issue of abortion itself, opposed by many in society as the unwarranted taking of a human life, a concern made all the greater when the fetus can be considered otherwise as viable as the remaining fetuses. This raises the issue of how the fetus to be aborted is selected. The procedure is depicted in the literature as simple medically, but it does have the potential for physical as well as psychological consequences.
The choice actually begins in many cases with the decision to use fertility drugs or some other assisted fertilization method. The individual must be informed of the dangers and of the potential need for an abortion to reduce multiple fetuses when they occur, as they often do when using these methods. Selective reduction should not become a backup for infertility providers, but this is precisely wh...