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Problems in multiple births

The birth of a baby is for most people a joyous occasion, and the historic birth of sextuplets in Trinidad and Tobago has naturally aroused considerable interest and celebration. Nonetheless, this should not blind us to the discomfiting issues behind this event.

First of all, the reason these are the first set of sextuplets in the Caribbean is because the mother in question used fertility drugs to conceive. Other women who have gone through this process may also have had six or more ova fertilised but, because multiple births pose serious risks, doctors advise that no more than two zygotes be retained.

In this case, for religious reasons, the patient refused to have any of the embryos removed.

So the first question that arises is whether this possibility was made clear to the woman when she was seeking fertility treatment. Did her doctors tell her she might have multiple conceptions and explain the risks to her?

Did they know her religious beliefs would prevent her removing any of the embryos and, if they did know this, did they go ahead with the treatment anyway?

Assuming doctors were involved, and the woman didn’t just obtain fertility drugs without a medical prescription, then the issue of regulating such clinics becomes pertinent. After all, it was the public health care system which, with great efficiency and dedication, oversaw the births of the sextuplets.

Yet the financial cost to taxpayers is the secondary issue. The main issue is that, if a fertility clinic were involved, it endangered the woman’s life by allowing her to conceive in these circumstances. Even worse, the babies have also been put at risk.

Dr. Bharath Bassaw, one of the two surgeons on the team which delivered the sextuplets, described them as “fragile”. If a woman is having three or more babies, there is a high risk that not all the children would survive beyond birth.

A normal birth-weight ranges from six to ten pounds, but none of the babies weighed more than three pounds, while the lightest was one pound, nine ounces. Even when they do survive their first year, such infants are at higher risk of health problems. A low birth-weight has been correlated with conditions ranging from heart problems to high blood pressure to cancer in adulthood.

The question that arises therefore is whether the persons who assisted this woman to get pregnant were aware of these issues. Did they transgress medical ethics?

Yet they have done nothing illegal, inasmuch as there are no laws regulating fertility clinics. This is an issue which should be addressed since, as more women defer their first pregnancy till later in life, such treatments will become more common.

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