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The drawbacks of multiple births

It is easy to marvel at the birth of the Chukwu octuplets in Houston and to wish nothing but the best for the babies and their parents. Although the smallest Chukwu baby died last Sunday in the Houston hospital where it was born only a week earlier, the seven infants who remain there are said to be improving steadily. Barring unexpected reversals, they are now expected to be home within three months with their parents, Iyke Louis Udobi and Nkem Chukwu. The mother left the hospital last week, healthy and beaming with obvious maternal radiance and devotion.

While that is good news, the birth of the Chukwu octuplets, like the birth of the McCaughey septuplets in Iowa last year, is not cause to celebrate. It raises disturbing questions of medical ethics that both the medical profession and society need to consider. Multiple gestations of this magnitude, made possible only by the aggressive use of fertility drugs, carry enormous risks and costs, not only for the mother but for the infants.

Assuming they make it past the first tenuous months, babies born more than two months prematurely, as the octuplets were, face a higher risk of lifelong lung, heart and other health problems, doctors say. Special health problems aside, basic care for a brood this size can exhaust the resources and energy of even the most loving parents. If the Chukwus or donors are unable to do so, taxpayers will ultimately have to foot the tab, including an estimated $2-million in hospital costs for the babies' first 90 days of life.

With all these risks, isn't it obvious why Mother Nature, when left to her own devices, does not mean for women to produce so many babies at once?

Like Bobbi McCaughey and others before her, Nkem Chukwu received one fertility drug to stimulate her ovaries, producing multiple eggs, and another to help those eggs mature. For religious reasons, she later declined the option of "selectively reducing" some of the fetuses (by removing them or causing them to stop growing). Together, the doctors and parents ended up producing the first live octuplet birth in history.

That feat may be scientifically impressive, but it should also jar fertility doctors _ and their patients _ into recognizing the more sober aspects of the accomplishment. The risk of multiple births can be reduced, experts say, if doctors more closely monitor fertility treatments and receive better training in their proper usage. Others urge more research be done on ways, short of the selection-reduction method Ms. Chukwu found objectionable, to prevent the maturing of multiple eggs.

"It's done and over," the octuplets' father said last week when asked about the ethics debate. "We're giving glory to God for what he did, and we want to leave it at that."

Given the enormous task that lies before them, it's no wonder the couple would have little time or energy for joining the debate over medical ethics. But that's exactly what the rest of us should be doing, before more record-breaking multiple births, with all their risks and disadvantages, take us even farther down this troubling road.

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