Ever since I last devoted an entire post to Nadya Suleman, the single woman who not only conceived and gave birth to octuplets with a little help from a fertility clinic but also was already had six other children--including a set of 2-year-old twins--who were also conceived with help from the same fertility clinic, her mother have given an extensive interview with RadarOnline.com (where she called her daughter's decision to have her octuplets "unconscenable") and her father have even given interviews as well. In addition, there are two blogs that have been created that are totally devoted to her--NadyaSuleman.com and Suleman Without Pity--and the entries and comments in both blogs are very hostile.
Some of the hostility is justified to some extent. Nadya Suleman hasn't held a job outside her home in 10 years, she's been collecting disability benefits based on an injury she received while working her former job, and she currently receive both food stamps and monthly SSI disability payments. She's currently going to college in pursuit of a Masters degree with the help of student loans and grants. Yet, at the same time, she has made repeat visits to the same fertility clinic where she had succeeded in getting a large brood of 14 children in eight years.
She has denied that she's getting welfare, although there's plenty of dispute as to whether the help she's gotten from the government is technically "welfare". There have also been calls for the removal of all of her children from her home and many statements on how she should have never gone through that last pregnancy in the first place.
Okay, I'm willing to admit that it's possible that Nadya Suleman have been gaming the system for years with being able to get disability and school loans while being able to afford expensive fertility treatments. Even if she has been ripping off the taxpayers in California, the amount of money is pretty small potatoes compared with what certain Wall Street executives did with the massive government bailout money (such as larger banks buying smaller banks, paying for expensive spa treatments at luxury resorts, and giving outrageous bonuses to the same executives who made disastrous business decisions that brought their companies to the brink of collapse). Personally I'd rather heap all of my scorn for those overpaid bloated Wall Street executives than Nadya Suleman.
I'm also willing to concede that Nadya Suleman is not exactly dealing with reality. In her interview with the Today show she said that she expected to be able to resume her studies this fall despite the fact that she'll be dealing with eight infants, one set of two-year-old twins, a three-year-old with autism, and three other children--with the oldest being seven years old. Even if she could afford to provide for all those children while paying for tuition, books, and other supplies, she'll still need to balance her time between her children and being able to devote some time away from her kids for attending classes, doing homework, and studying for exams. But the fact remains that if it weren't for the enablers in her life, she would've never been in the situation that she is currently in.
Recently it's been reported that Nadya Suleman has been getting death threats. The some of the comments on those two aforementioned blogs have claimed that it's just her being a drama queen but I'm not prepared to call her a liar on that one. Over the years I've witnessed all kinds of stalking and troll behavior that has affected other people I know. There are a lot of disturbed people out there on the Internet who don't have lives of their own so they find someone or something to get an unnatural obsession over. I wouldn't be surprised if she has been getting threatening messages from some deranged troll.
I personally think that Nadya Suleman has mental health issues that have caused her in doing the things that she has done. I'm not a psychiatrist or psychologist so I can't say for sure what she's suffering from. But I think it's wrong to throw so much hostility towards her because I don't think she's playing with a full deck of cards. She really needed professional help from a mental health expert--not a fertility clinic doctor.
I also think it's wrong to throw hostility towards any of her children because they didn't ask to be born into this situation. I've read calls for the California government to cut off all benefits to her children, which is misplaced because they are the innocent victims in all of this. I think those kids need as much help from the government as possible until they reach adulthood so they'll become independent functioning adults who'll pay their share of taxes.
And, yes, all of those children will need some kind of help from outside the family, especially the octuplets. According to this recent article, a U.S. study of nearly 250 mothers found that for each additional multiple birth child — from twins to triplets, for example, or triplets to quadruplets — the odds of having trouble meeting basic material needs more than tripled. The odds of lower quality of life and increased social stigma more than doubled with each added child. And the risk of depression in the mothers also rose with each additional child.
The bottom line is that it's too late to undo the existence of all 14 of Nadya Suleman's children. They are already here and one can't go back in time to do everything possible to prevent their births. And you can't go into the hospital nursery and kill all of the octuplets or blow up the home where the six older children live--that would be murder. The general public is just going to have to suck up and and accept the fact that they are here and they will need help from people outside the family.
I think much of the scorn should be hurled at Nadya Suleman's enablers because, without their help, Suleman would've never gotten into her current situation in the first place. First there are her parents. I've read the mother's interview and the father's interview. Both have spoken about their disapproval for what Nadya has done in her numerous visits to the fertility clinic, how she's irreponsible for what she has done, how they have told her fertility doctor not to help Nadya and he broke his promise to them.
But not once in those interviews did either one of them say whether they had ever spoken to Nadya directly about this. Since it wasn't mentioned, I'm going to assume that they haven't done so. You'd think that after Nadya had her second, third, or even fourth child, they would come to her and say "This is about as many children that we can handle under our roof. If you want to make any more visits to the fertility clinic, you're going to have to get a job and get your own place to live. As long as you're living under our roof, that baby you're currently holding in your arms will be your last child."
Had they said something like this to Nadya then followed through by kicking her out when she returned to the fertility clinic, Nadya would've been forced to grow up and face reality very quickly. Because there's nothing that forces maturity on a biological adult faster than being completely on your own with little or no help from the parents. Nadya would've been forced to face the reality of raising children on her own--the same reality that thousands of other single parents in the U.S. face on a daily basis. It's possible that Nadya would've seen the light, stop being a babymaker, focus her efforts on supporting the children she already has, and the whole octuplet incident could've been avoided.
Basically Nadya's parents just didn't have the backbone to confront their daughter about her choices. I don't know whether they were always doormats when it came to raising and disciplining their daughter but I wouldn't be surprised if they were the kind of parents who catered to their only child's every whim when she was growing up and that girl rarely heard the word "no" from either parent.
Then there is David Solomon, the friend who is reportedly the biological father of all of Suleman's children. He hasn't made any public statements so not much is known about him other than what others have said about him in the media. It seems like that every time Nadya wanted to become a mother again and again, she would come to him, he would say okay, and he would just donate his sperm. Not once did he express his concerns about her having too many kids at once. You'd think he would do so since they are all his biological children.
Had he been simply an anonymous sperm donor, this wouldn't be an issue since such donors usually donate for the money then walk out the door without every thinking about whether their specimens have created children or not. But this guy is a family friend who knew Nadya Suleman who didn't say anything about her frequent need for more children and just went along with whatever she wanted.
Okay, you can't do much about either Nadya's parents or the sperm donor. None of them have broken any laws so they can't be thrown in prison. You can't pass laws requiring any of them to grow backbones and learn to assert themselves by saying "no" once in a while. Sure, you could publicly shun and shame them for what they did but it'll ultimately become an exercise in futility because one can't change the past.
But something can--and should--be done about Nadya's other enabler: her fertility doctor and the fertility clinic he works for. While it's too late to undo Nadya Suleman's current situation, something can be done to prevent any future Nadya Suleman-like situations from ever happening again.
While there are guidelines for how many embryos can be implanted into a woman's uterus at one time that were adopted by the American Society for Reproductive Medicine, unlike some other countries, the United States has no laws to enforce those guidelines. The Centers for Disease Control and Prevention has a surveillance system that collects data on fertility clinics but reporting is voluntary and there are no sanctions for not reporting.
As a result, any doctor who wishes to disregard those guidelines can legally do so with impunity. In the case of Nadya Suleman's doctor, Dr. Michael Kamrava, he had one of the nation's highest rates of embryo transfer in younger women--3.5 versus a national average of 2.3. Ironically he had the lowest number of resulting pregnancies in the nation. Of the 56 procedures he performed in 2006, only two resulted in live births. One of them was the twins born to Nadya Suleman.
Over the past year not only had Dr. Kamrava's procedures resulted in Suleman's octuplets but another woman he treated is currently pregnant with quadruplets.
The main reason why some doctors will implant more than two embryos is because many health insurance companies in the U.S. will not fund fertility treatments. This says something about the lack of health care reform and standardized health insurance coverage in the U.S., which could easily be written about as a separate topic.
Other countries take a stricter approach when it comes to fertility clinics. In Europe, laws limit the number of embryos that can be used in a single procedure. National healthcare typically covers a certain number of IVF treatments, taking the pressure off doctors to achieve success on their first try. Birth rates are generally lower, but so are rates of multiple births. In the U.S. there are no laws regulating the maximum number of embryos that can be implanted at once. On top of that, fertility clinics don't routinely counsel prospective parents about the emotional and financial strains of multiple births so parents who end up expecting a large litter have no idea what they're in for.
I think this needs to be changed. The reality is that there are women with fertility problems using these clinics and they are literally playing Russian roulette with their uterus and their potential children. If the Federal Government can pass a law outlawing third trimester partial birth abortion, surely it can pass a law limiting the number of embryos that can be implanted in a woman at a time.
There also need to be enforcement as well. If a doctor is caught violating the law he should be subjected to paying a very stiff fine, be responsible for paying the health care expenses of the multiple births, and possibly be stripped of his medical license.
Had such a Federal law been in place at the time of Nadya Suleman's last visit to the fertility clinic, I'm willing to bet that Dr. Kamrava would've thought twice before implanting those six embryos inside Suleman. (Two of the embryos later split, which resulted in the octuplets.)
There should also be Federal guidelines as to who should get fertility treatments to begin with. If a prospective mother fails one or more of the guidelines, the doctor would be required to reject her for treatment. What kind of guidelines should be implemented? Well here are a few ideas.
Pre-screening of the prospective parents. I have a friend who adopted a child as a single mother. When she made the decision to adopt, she had to go through psychological tests, interviews, and even home visits before she could even be placed on a waiting list. Had she chosen fertility treatments instead, she may or may not go through similar screening depending on the individual fertility clinic. If she went through one doctor or clinic that had pre-screening and got rejected, she could've easily found a doctor/clinic with more lax standards.
This is not right. By many accounts, Nadya Suleman had suffered from depression prior to her first fertility treatment and she thought that having a baby would solve that problem and she did mentioned that having the first child "helped my spirits". When that effect wore off, she thought that having another child would do the trick. She kept on having child after child and it still didn't resolve her mental health issues. Had she received pre-screening similar to what my friend went through, there's a chance that she would have been referred to a mental health professional to help her deal with her depression instead of a fertility clinic. A child generally thrives better when a parent doesn't have mental health issues.
Pre-screening would also consider the prospective parent's income and current living situation. An adoption agency would've rejected Suleman on the grounds that she has been on disability, hasn't held a job in many years, was currently attending school full-time while living with her parents in their home. Had any laws regulating fertility clinics been in effect, Suleman woudl've been rejected on similar grounds.
Spacing between pregnancies. If you look at the list of the 14 children whom Suleman have given birth to, you'd notice that over the past eight years, she has given birth six times (one delivery involved twins and the other involved the octuplets). Of those children, she currently collects SSI disability payments for three of them--one child has autism, another child has ADHD, while a third child has speech development delay problems with a potential for also having autism.
It's possible that the lack of spacing between her pregnancies may have been responsible for the health problems of her three younger children. Researchers in one study have found that infants born to women who conceived less than six months after giving birth had a 40% increased risk for being born prematurely and a 61% increased risk of low birth weight, compared with infants born to mothers who waited 18 months to two years between pregnancies.
I really think that fertility clinics need to enforce a minimum of two years after the birth of a child before a woman can become pregnant again. Had that rule been in effect, Nadya Suleman would've been required to wait a couple of years between children and she might've had better outcomes regarding the births of her younger children.
The number of other children of certain ages that the prospective parent already have. Obviously if a woman have never had children before she should be allowed to proceed with fertility treatments. But if the woman have previous children, then the fertility clinic must take their ages into consideration because it's a known fact that a--let's say--14-year-old and a 3-year-old have different needs and require different kinds of supervision.
I think that a fertility clinic should turn down a prospective client if a person already have more than two children under the age of five. The State of Maryland (where I live) places a strict number on how many preschoolers a licensed home day care provider can have in his/her home at any time and has an even stricter number on how many infants a person can care for at a time. There's a reason for that--younger children require more supervision and the more young children there are, the harder it is to supervise them all, and the greater likelihood that a tragedy can strike.
Had such a standard been in place, Nadya Suleman would've been turned down on the basis that she already had a five-year-old, a three-year-old, and a set of two-year-old twins. All she had to do was wait until her twins were a few years older before making a repeat visit to the fertility clinic.
The health of the other children. If a prospective parent already has a child with severe health problems that will take up much of the parent's time and money, then that parent has no business trying to bring more children into the world. The health of other children must be taken into account on whether a fertility clinic can accept a patient or not. Had that standard been in place, Nadya Suleman would've been rejected on the basis on having a three-year-old with autism, a condition that can challenge even the most dedicated parent.
Make selective reduction a requirement. Fertility clinics should do everything possible to prevent large litters of fetuses from being created. But if something goes awry, then the doctor should be required to make a selective reduction.
I know this requirement is controversial to those who are anti-abortion but think about this. Without selective reduction, a high order multiple pregnancy is generally likely to result in premature births. Some of those births result in death while others result in health complications that can last a lifetime (such as brain damage and cerebral palsy). Let's face it, unlike dogs and cats, a human woman's uterus is not designed for large litters.
A prospective parent's opinions about selective reduction should be taken into consideration whether a fertility clinic should help that person or not. If that person is strongly opposed to selective reduction, then that person should be rejected as a patient. Nadya Suleman's objection to selective reduction would've been enough to reject her as a patient.
For those who say that selective reduction is against God's will, I say this. Perhaps it was God's will that a prospective parent had fertility problems in the first place and getting pregnant through a fertility clinic is against God's will. That's the reason that the Roman Catholic Church uses when it expresses its opposition to fertility clinics as being "unnatural".
In short, we need to make quadruplets and higher a thing of the past.
The age of the prospective parents. Okay, this doesn't really apply to 33-year-old Nadya Suleman since she is in her prime childbearing years and one can assume that she has several years of her life ahead of her. But over the past 10 years or so I've read so many stories about women in their sixties and seventies getting pregnant and I think it's very unfair to the children born under these circumstances. The older the mother is when the child is born, the less likely she will live long enough to see that child grow into adulthood. It's one thing if a 70-year-old mother of a newborn is lucky enough to live to 90 and beyond but how often are people that lucky?
Personally I think fertility clinics should make age 55 the cut-off age. Anyone who's older than that should be encouraged to do something else--like volunteering as a tutor at an elementary school or becoming a Big Brother or Big Sister to a child who needs another adult in his/her life.
I know that some people will call me sexist since post-menopausal women can only get pregnant through fertility clinics while older men can father children until well into their 80's. But I personally think that once a man achieves a certain age, he should think seriously about not fathering any more children since having a child at an advanced age is just as unfair to the child as a post-menopausal woman having a child.
In short, something must be done about fertility clinics in the United States or else we'll be seeing more stories similar to Nadya Suleman's in the future with the children bearing the brunt of all this. With standards and guidelines in place, it would be easier for the authorities to yank the license of and impose a very stiff fine on any doctor or fertility clinic who created any multiple birth larger than triplets.
Labels: reproduction issues
