Foetal Reduction: Different Perspectives

Foetal reduction also known as multifoetal pregnancy reduction (MFPR) is a medical procedure in which one or more foetuses are selectively terminated in a multiple pregnancy. This procedure is often performed in cases where a woman is carrying more than one foetus, typically twins, triplets, or even higher-order multiples, as a result of fertility treatments or natural conception. The aim of foetal reduction is to reduce the risks to both the mother and the remaining foetuses, improving the chances for a healthier pregnancy and birth outcome.

When is Foetal Reduction required?

Foetal Reduction is a necessity in certain conditions and the most common medical need for foetal reduction is the management of high-order multiple pregnancies, such as triplets or quadruplets. This is because these pregnancies carry an increased risk of preterm birth, low birth weight and complications like gestational diabetes, hypertension, and preeclampsia.

Used like a preventive, Foetal Medicine can reduce the number of foetuses, thereby lowering these risks and improving the likelihood of a successful pregnancy.

The procedure is usually performed in the first trimester, between 10 to 13 weeks of gestation.

Foetal Reduction: The Procedure

Foetal Reduction is a highly advanced procedure that involves a needle being inserted through the mother’s abdomen under ultrasound guidance. In this procedure, a lethal dose of potassium chloride or another substance is inhected into the heart of the foetus targeted for reduction. This injection stops the heart and causes the foetus to stop developing.

While this may sound brutal, it is, as mentioned, a necessity at times for the sake of the remaining foetuses which are usually monitored through ultrasound to ensure their continued health. In some cases, foetal reduction can be done more than once if multiple foetuses are involved.

Ethical Considerations

As mentioned, foetal reduction raises significant ethical concerns, as it involves ending the life of a developing foetus. Somewhat troubling, the ethics of this procedure are a topic of intense debate.

As with every story, there are two sides to the coin. Supporters of foetal reduction argue that it is an important medical intervention, which can significantly reduce maternal risks and improve the outcome for the remaining foetuses. According to them decision is ultimately a personal one, and that women should have the right to make choices based on their own health, well-being and family circumstances.

While what supporters of foetal medicine believe is rational, opponents view foetal reduction as morally troubling, as it involves the deliberate termination of life. Some are of the opinion that it is a form of selective abortion and can be misused for non-medical reasons, such as gender selection or preferences for certain characteristics.

The psychological aspect of Foetal Reduction

Foetal Reduction can be very taxing in the psychological respect. The decision to undergo foetal reduction can be a very emotionally and psychologically complex one for parents. While some women may be relieved after the procedure, knowing that it increases the chances of a healthier pregnancy, others may experience feelings of guilt, sadness or loss. The psychological effects depend on the individual’s values, cultural background and the specific circumstances of the pregnancy. Considering this, counselling and emotional support are essential. To deal with the emotional upheavals and ups and downs, support groups, therapy and open communication with healthcare providers can prove invaluable.

A double-edged sword

Foetal reduction therefore is a double-edged sword, being medically necessary but ethically controversial at the same time. While it offers significant benefits in some cases, it also raises complex ethical and psychological issues that need to be carefully considered. Access to accurate information, medical advice and emotional support is crucial for those grappling with the decision of whether to avail foetal reduction or not.