An recent NHS watchdog warned that women pregnant with twins or triplets may be at high dangers of aborting one of their babies.
Accordingly, mothers-to-be with multiple pregnancy should be given information on the “physical risks and psychological implications” of what is known as “selective fetal reduction” before their fetuses are screened for Down’s syndrome or risk of disabled after being born. Consequently, they should choose to abort one of their twins or triplets. The report, published on Wednesday, states: “Before screening for Down’s syndrome offer women with twin and triplet pregnancies information about … the physical risks and psychological implications in the short and long term relating to selective fetal reduction.”
There is now an increasing number of women choose to make this difficult decision because of the fact that more older women are becoming pregnant after having IVF treatment. Nice’s guidance, however, also suggests that the procedure of aborting one of two or three fetuses is itself dangerous, and may later lead to emotional problems in both the mother and the remaining twin. This makes having twins or triplets more likely, which can mean complications in birth.
The guidance follows a 60 per cent increase in the incidence of multiple births in England and Wales over the past three decades, from 10 women per 1,000 giving birth in 1980 to 16 per 1,000 in 2009.
“This rising multiple birth rate is due mainly to increasing use of assisted reproduction techniques, including IVF,” says Nice.
Women expecting multiple babies are at higher risk of miscarrying and having high blood pressure, as well as suffering stillbirths or having babies with congenital abnormalities.
As a result, the watchdog says that these women need “more monitoring and increased contact” with midwives and doctors as well as a mental health professional, infant feeding specialist, dietitian and women’s health physiotherapis for “increased need for psychological support”.
Nice (The National Institute for Health and Clinical Excellence) recommends they should be seen at least seven times by an “experienced multidisciplinary team” including obstetricians, midwives and ultrasonographers to provide frequent tests on the development of their pregnancy. They should try to find if the babies are sharing a placenta, which can increase the risk of complications still further.
There were 54 “selective terminations” in 2008; 71 in 2009 and 85 last year, shown Department of Health statistics.
The most recent annual report stated: “In 2010, there were 85 abortions which involved selective terminations. In 51 cases, two fetuses were reduced to one fetus.
“Over three quarters (78 per cent) of the selective terminations were performed under ground E [risk that the child would be born handicapped].”
Nice does not suggest that health professionals give any similar warnings about the risks of abortion for women expecting one baby.