Octomom versus Doctor: Are Either to Blame for the Family of Fourteen?

Imagine the shock that Nadya Suleman, age 33, must have felt upon hearing her obstetrician exclaim—“There’s an H!” It was at that precise and unequivocal moment on January 26th 2009, that the mother realized she had just given birth to not one, not two, not five, but an astounding eight babies (see image right). The woman with the seemingly interminable ability to have children would bring home her litter of eight (A through H) to join her other six offspring, all of whom fall under the tender age of eight years old. While on the surface this story harbors all of the endearing qualities of a heartwarming tale—even a miracle some argue, it is a far cry from that. The octuplets have been repeatedly featured in the headlines in the past week, as their birth has sparked much controversy nationwide. The focus is concentrated heavily on the mother, Ms. Suleman, who conceived these children via in vitro fertilization (IVF) all the while single and unemployed. Also under the microscope is Suleman’s fertility doctor, Dr. Michael Kamrava, who enabled the mother to continue to undergo IVF treatments even though he was well aware of her financial status and burgeoning family. Although it is clear that Nadya Suleman has made poor decisions which have compromised the well being of those around her, the fertility doctor is just as culpable for his part in exacerbating the already ominous situation. While Suleman acted wholly irresponsible, Dr. Kamrava operated out of his own interest and greed, using her fecundity to boost the overall fertility rate of his clinic.

In vitro fertilization is a procedure “designed to enhance the likelihood of conception in couples for whom other fertility therapies have been unsuccessful,” states the Overview for IVF Patients. The industry has doubled in size since implemented in 1996, and more than 50,000 children a year are born as a result—a booming 1 billion dollar business. An explanation of the IVF procedure in summary includes the retrieval of the woman’s egg, the collection and preparation of the sperm, the insemination of the eggs and embryo culture, and finally, the transferring of the embryos into the uterus. IVF is a complex process, wherein each stage of the procedure is associated with specific risks. It is important to note that the Overview specifically designates IVF as a procedure designed for couples who cannot have children, not for single mothers already caring for six children. Fertility clinics are not simply places to create a personalized soccer team, and in undergoing the procedure, the mother puts herself and her children at risk each time she assumes treatment. Yet from this, a significant question is raised—is the nation merely judging Suleman because she chooses to raise her children single-handedly and without the help of a man? How is it politically correct or fair that in vitro fertilization is outlined as being specifically couple-oriented? The procedure discriminates against women as it intimates that a woman cannot raise a family on her own ability. And those on Nadya's side agree with her statement: "I feel as though I've been under the microscope because I chose this unconventional life." For instance, Jennifer Block of the Guardian UK believes, "Couples who've had multiples haven't suffered the same scrutiny because they are couples. The media went easy on the McCaughey family, who had septuplets in 1997, and barely acknowledged the Chukwus, who had octuplets in 1999. And then there are the Duggars who have 18 children and their own reality TV show." Furthermore, another Octomom supporter blogs, "We have something called reproductive freedom in this country. If you tell a woman that she can’t have 14 children, regardless of her circumstances, then you leave the door open for telling all women when and how they can give birth in general. You can forget about making your own decisions about abortions, birth control and, yes, fertility treatments."

It appears then the single mom does have some advocates to root her on and have faith in her ability to provide. Unfortunately though, Nadya Suleman is by no means Angelina Jolie, her hypothesized role model. Suleman does not have millions of dollars, a property the size of a small country, a wealthy husband, nor an army of body guards and baby nurses to help care for her brood. The single mother lives modestly in a small house that barely even fit the first of her six progeny and receives federal assistance for three who are disabled with autism. Ms. Suleman already owes a whopping $50,000 in student loans and was in the same situation when deciding to undergo IVF yet again a year ago (using the last of a life's savings), placing the yearning for a child-filled utopia before her existing children’s necessities. Never thinking logically of how to care for the babies financially or emotionally, Suleman placed her faith in a far-fetched dream: “I will feed them. I will do the best I can. In my own way, I do believe wholeheartedly that God will provide." With no money, and holding firmly to a childhood fantasy of a house filled with cherubic faces, she is sadly twelve arms short of reality. In opposition to Suleman and to the blogger's statement above, pro-choice psychiatrist Carole Lieberman argues, "Freedom, including women’s reproductive freedom, entails responsibility. Nadya is the poster child for women’s reproductive irresponsibility. Prochoice essentially means that she had the choice over her body in regard to reproduction. She had several options, including donating her frozen eggs or giving the babies up for adoption.” In essence, Nadya Suleman has been designated one of the most selfish mothers to date by many.

Although it is clearly ludicrous and irresponsible for a single woman living off welfare to continue requesting the IVF treatments, it is ultimately the doctor who should have regulated and firmly put his foot down. Like many mothers who have acquired the biologically evolved need to protect and care for all their children, Suleman simply did not want to leave the unused embryos in the fertility clinic. She thought they deserved the chance to live and thus decided to implant what was left. Upon realizing how many survived, she was astounded like the rest of the world. When this phenomenon occurs, doctors normally perform a “selective reduction,” wherein by injecting a couple of the fetuses one can increase the chances of more healthy babies instead of a miscarriage. So, why did Dr. Kamrava not undergo the routine procedure? Apparently he is not one to follow rules. According to the American Society for Reproductive Medicine, the guidelines for in vitro fertilization in women under 35 encourage the transfer of only one embryo, with two being the maximum (see image left). Dr. Michael Kamrava implanted six embryos into Nadya Suleman, two of which resulted in twins. The real difficulty is that concrete, enforceable laws do not back these guidelines and regulations. Says the NewYorkTimes, “The Center for Disease Control and Prevention has a surveillance system that collects data on fertility clinics, but reporting is voluntary and there are no government sanctions for not reporting. As a result, experts say many doctors are still implanting too many embryos to increase the chance of pregnancy." Apparently they are doing this in order to boost their clinic's fertility rates, but doctors, such as Dr. Potter of the Huntington Reproductive Center, are supposed to make the final decision regardless of a patient’s wishes: “We have an obligation to protect the patient and not let the patient do things that are unreasonable." And yet, Dr. Kamrava did not abide by this descriptive norm, instead taking advantage of Suleman and her robust fertility. In documents recovered by the Los Angeles Times, it was found that the doctor's clinic actually has one of the worst success rates for pregnancy in the entire country, with Ms. Suleman's children representing a "sizable portion" of his clinic's fertility increases in the last several years. It is no wonder he turned a blind eye against what was surely going to be disastrous and irresponsible. And where he should have selectively reduced Suleman's embryos, he failed to, probably relishing in his success of producing octuplets. Meanwhile, Nadya and all of her babies could have easily died from the high-risk pregnancy. Speaking of Kamrava's participation in the fiasco, embyrologist John Scodras notes, "That's a dangerous thing to do." And indeed it was, on both the mother and the doctor's parts. Both acted selfishly and without thinking of the consequences. Nadya Suleman failed to take into consideration the effect that an additional eight children could have on an already large family. She did not care that she could potentially be bringing disabled children into the world, simply desiring to be surrounded by children, even ones she could not afford or pay individual attention to. Dr. Michael Kamrava similarly thought of only himself and his personal needs and potential gains when playing the role of the scientist-God. He broke rules and took risks that could have cost him the life of a patient and numerous children. Neither parties feel that they are in the wrong and yet the whole country is outraged at both their carefree and egoist attitudes. It is unfortunate that fourteen beautiful children are going to have to live with these unfortunate and avoidable mistakes.