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Ask anyone who is generally anti-abortion if there is any situation in which the termination of a pregnancy is warranted, and the first answer you are likely to hear is: "When the pregnancy puts the mother's life at risk."

Selective reduction, selective termination, or multifetal pregnancy reduction all mean the same thing; the abortion of one or more fetuses in a multiple pregnancy to improve the medical situation for the remaining fetus or fetuses, and the mother. This practice raises many moral and ethical concerns. Where do you stand? Like many ethical questions, the issue of selective reduction in multiple pregnancies is fascinating as a theoretical topic. Many studies and theses can, and have been, created around this issue.

When faced with the situation, the topic becomes even more difficult. Women who are pregnant with triplets or more, and have been informed about the medical risks that such a pregnancy can pose for both mom and babies, don't benefit much theoretical debates. "Is it ever appropriate to end one life to save another?" is a very painful question when you are expecting higher order multiples and your life, and the lives of your babies, are already at risk.

If you are currently in this situation, the ethical concerns of others don't matter much: It is you, and your immediate family, who are faced with the choice. Your doctor may be pushing for a selective reduction, and anti-abortion advocates in your life may be pushing against, if they are aware of your pregnancy. At the end of the day, there is no getting away from the fact that you decide though the decision is not easy. Before you make a choice, here are some things that may help you make sure you are making the right choice for you:

  • Discuss the risks of your pregnancy and the negative feelings you have about selective reduction honestly with your partner, and write everything down. Make the decision together, after seriously looking into each aspect of both possible decisions.
  • Go for counseling sessions on the issue, separately and as a couple. If you are in any way open to the idea of selective reduction, Christian organizations who are strongly anti-abortion are not the right venue for counseling, obviously.
  • If you really don't feel right about selective reduction, don't do it. Even if your doctor is strongly in favor of it. Once you have made the decision to continue your pregnancy as is, ask your doctor not to bring selective reduction up again, and instead focus on reducing the risks of your pregnancy as much as possible.
  • You may want to refrain from talking about your pregnancy with friends and relatives before you make the decision.

If you are not pregnant with multiples yourself, pondering on the ethical concerns of selective reduction remains fascinating. But if, by any chance, you ever come across a woman who is in the situation that she is considering selective reduction, realize that she is not the right person to practice your debating skills with. No matter what your views are, these are very, very hard and very, very private decisions. Unless a woman asks for your views, I am sure she will be grateful if you remain silent.

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