12 October 2009

Playing God

Dear Thomas and Amanda Stansel,

I am sorry you had such difficulty conceiving children. I can only imagine what heartache that would bring, as I was fortunate enough to conceive my children effortlessly with no intervention. I know this is a blessing.

It is understandable that you would turn to a fertility specialist in order to realize your dreams of parenthood. Modern medicine has made many things possible that would have been inconceivable a few generations ago. The desire for children is a powerful, biological force, and in a perfect world, everyone who wanted to have children would conceive them effortlessly. Perhaps you were thrilled that your dreams of a large family were going to come true when your doctor informed you that intrauterine insemination was successful, and you were carrying not one, but six, embryos.

You lost my empathy when I learned that you disregarded your doctor's advice to selectively reduce the number of embryos to help increase your chances for a healthy outcome, and decided to play some very large odds, by bringing six babies into the world. I understand that in keeping with your religious convictions, you consider the notion of selective reduction to be tantamount to abortion, something which, as members of the Church of Jesus Christ of Latter-day Saints, you could not abide. I am glad you consulted not only with a reduction specialist, but with church elders, to help you arrive at what must have no doubt been a difficult decision to forge ahead with your pregnancy.

It must have been harrowing to deliver your sextuplets fourteen weeks early, and I imagine you were despondent to learn that they had a 60 to 65 percent chance of survival, and a one-hundred percent chance of problems. Your babies were born so early that hospital protocol dictated that no medical care be given unless specifically requested by the parents.

And this is where your logic falls apart, and you made what turned out to be a literally fatal error, when you decided that despite all evidence to the contrary, you would ignore medical statistics, because "God doesn't work in statistics."?

Do you not see that you were playing God all along? That perhaps your difficulty conceiving was God's way of telling you that it was not his plan for you to conceive biological offspring. Perhaps he had something else in mind for you, which, while not what you intended, may have led you to a rich, fulfilling life.

Was it worth it to lose three of your six newborns to gruesome deaths resulting from complications associated with a high-risk pregnancy, and premature birth? Was becoming a parent so important to you that you will treasure the privilege of knowing that one of your newborns died when blood seeped into his lungs via an open heart valve, while another developed an infection in the trachea that inflated his lungs so much that they crowded out his heart? Are you glad to be making daily trips to the neonatal intensive care unit to visit your three remaining infants, one of whom is experiencing kidney failure, and is hovering on the precipice of death?

In life, everyone suffers, and all parents will make their children miserable, hopefully unwittingly, and for as brief a period as possible. Can you live with the fact that you have played such an active role as the architects of your children's suffering? Is it lost on you that had you made the decision to selectively reduce at the beginning of the pregnancy, you might now be the parents of healthy twins, or triplets? At this point, your best outcome is two children with lifelong developmental and neurological issues. Is all the suffering you have selfishly unleashed because you could not see any further than your desire for biological offspring worth it?


  1. Your letter to parents Stansel was harsh. You yourself had complications post-birth with one of your children (which you so openly "discussed" on your blog) due to your use of anti-depressants. While the medical situations are clearly different, a sanctimonius reproach from you is a little hard to stomach when you, like these parents, made some tough choices that affected the outcome of your child's early life. I am one who has quietly followed your blog from time to time, but I've got to say, your last piece has turned me off.

  2. TOO harsh. this couple COULD NOT kill their fetuses, believing they are growing-humans, not mere protein and genetic mess. of course they would not "reduce", stupid term. God allowed these children to be implanted, to grow, to be born, and God allowed their futures to play out as they did. I agree w/the other commenter: have been following your blog, too, but this post has made my blood boil- am sad that you feel this way.

  3. yes, dangerous territory. i applaud pamela for being so thoroughly honest with how she felt at that moment and putting it out there- and the posts for feeling it was harsh. i too thought it was harsh- particularly the part when pamela said that if you can't conceive perhaps you shouldn't have children. (i bet pamela would rethink that sentence) a lot of emotions, a lot of judgement. that said- a brave clear directed blog and brave responses. tough tough subject matter. we have to pull back a just a little...these perhaps flawed attempts at "talking" are how we all get to our more balanced truths...

  4. I think it's sad that plain speaking is so often seen as "harsh" nowadays. An unintended consequence of political correctness, which I'm all for, but in speech I think we should keep it simple and keep it true. Pamela did that here. "If you can't conceive perhaps you shouldn't have children" is truly not a "harsh" thing to say - it's a gently put, but powerful truth, the kind of thing our grandmothers used to say to us. That's different from "harsh".

    On a different topic, I read how teachers in Italy, when children give a wrong answer, don't say, "Oh, that's almost right!", or "not quite" or even "good answer!" the way we would here. No, they say, "That's wrong!" and think we Americans are more than a little wacko to turn ourselves inside out to praise our kids even when they're wrong. And of course we here think it's "harsh" to be honest. But perhaps truth is more important? Are we and our kids such weaklings we can't face it when the world is a tough place to be?

  5. Sorry, one more thing, just remembered the classic grandmother's/mother's/auntie's line from my teenaged years: "Why buy the cow if you can get the milk for free?" and cracked myself up.

    I thought they were so crude. And harsh. And right. Thanks for letting me comment. I'm really done this time.

  6. This is not about fertility treatment. Note that I never said if you can't get pregnant you should not have children, as I do not believe that to be the case. I empathize with the plight of couples trying to conceive a child, and understand that the decision to terminate, or selectively reduce, or whatever we call it, is a horrible one.

    This is about the fact that when you make a decision to become a parent, it is no longer just about you and your partner, and where someone's health and well being is concerned, you can no longer put your desires ahead of what is best for your children.

    This is about the dubious logic of invoking God when it is convenient, without necessarily thinking about the consequences that choice will have on someone who is completely dependent on you.

    If I have offended you to such an extent that you can no longer read me, that is your prerogative. Clearly I have touched a nerve. But it is one thing to respectfully disagree with someone, and quite another to have a tantrum.

  7. This piece by Pamela was not "plain speaking;" it was a rant with plenty of judgment and so little compassion. The NY Times piece was "telling it like it is," complete with the sad picture of the parents standing over the tiny coffin holding three of their infants inside. Did Pamela not recognize the hypocracy; was there no self-awareness about how her own circumstances (taking anti-depressants while pregnant and perhaps endangering the health of her unborn child) required compassion from her husband, family and friends? This is what I found so harsh - the attack on the couple when she herself seemed to ask for compassion only a few blogs ago when recounting the harrowing tale of her own son's lengthy stay in the hospital. This last lacked maturity; it lacked wisdom - so unkike many of her past thought-provoking, intelligent essays.

  8. I know many children who were the result of fertility treatments. Many of them are very important parts of my life and I am thankful for the technology that has brought them about. My life would not be the same without some of the kids I know now.

    It sickens me, however, to read of families like this. People who go against their religions stance on fertility treatments (LDS discourages it- and generally pushes prayer and alternative medicines rather than this kind of "heroic" effort) and then hide behind that same religion when the results aren't positive.

    I don't think it is fair of those who are comparing your experience with Sasha with these people. I was also on antidepressants when I conceived one of my children- my first. I stopped taking them because I was too sick to take pills. I did not stop taking them because anyone at any step along the way indicated that there was any problem with taking them during pregnancy. There simply wasn't the research to show that at that point in time. In fact, prior to Sasha's case, I had not heard of any problems with anti-depressants in pregnancy. I HAVE, however, been made quite aware that high order multiples result in pain, suffering, and deaths.

    It is one thing to want to be a parent. It is another to cause harm to another human being and to refuse to accept responsibility for your actions.

    So, long story short, Pamela, I agree with you. I know you are going to get slammed, but I think it is by people who aren't paying attention to the message of your post.

  9. Isn't it odd that health insurance covers infertility treatments but not dental? We have to pay for a separate dental policy and I'm sure many people forego the dental because of the cost. I understand that teeth problems often lead to heart disease. Its shocking that some states mandate infertility coverage; that must be the result of huge campaign contributions to state legislators and governors.

  10. For me, the issue is about the decisions we make, how we consider the consenquences and whether we take responsiblity for the outcome. Aren't we all sometimes guilty of finding a rationale that enables us to avoid the uncomfortable or painful feelings that accompany truely responsible living? But decisions are made daily, and are brought on by a wide range of situations, from trivial to life-changing. They are made with varying degrees of insight, success and failure. The decision to embark on fertility treatment, and it's outcome, is a life-changer and to seek counsel as the Stanels did is wise and prudent. I know, our first born is the result of IVF. But I, like Pamela, find it hypocritical to advail youself of fertility advancements (cycle-altering drugs, IUI, IVF, etc.) and then say you can't preform a selective reduction because it is against God's will.
    My husband and I agreed that knowning where we stood ahead of time on selective reduction was one of the complexities that needed to be thoroughly explored before we could begin fertility treatments. As I see it, the simple fact remains that without the advances in science and medicine that made Mrs. Stansel's pregnancy even possible, their infertility was God's will. Accepting that would most likely have meant they would remain childless. But their desire have a child of their own was greater (the desire to be a parent can always be satisfied through adoption) and so they forged ahead. To suddenly follow God's will halfway through the equation, when in the beginning it was OK for them to willful reject His will, sounds more like selfish rationalization and convenient religious practices. Or maybe it's just irresponsible decision-making. Since Mr. and Mrs. Stansel do not agree with selective reduction, I think keeping the likelihood of mulitiple births w/mulitple problems front-of-mind before they agreed to a IUI procedure. Maybe they might have chosen IVF instead.
    And just as an aside, the NYTimes got it wrong when they said "something had gone wrong" with intrauterine insemination procedure when "an ultrasound revealed Mrs. Stansel was carry not one but six babies." Nothing went wrong. IUI is uncontrolled fertilization (as opposed to IVF which is controlled). The woman's overies have been medically induced to produce and ripen multiple eggs. If fertilization occurs, the fact is this procedure overwhelmingly increases the odds of mulitiple embryos. I feel anyone who doesn't know that before agreeing to this procedure is simply not making am informed decision. Know ahead of time where you stand on IUI and selective reduction and don't start playing the "God's will" card because difficult decisions could not be made beforehand. The next set of difficult decisions you'll be making after your 3, 4, 5, (should I go on?) children are born will be far more complex and far more painful for the innocents who will carry the load.

  11. One of the things that I think gets lost in the debate is the total fear of these parents-to-be when they get on the fertility roller coaster. Religion and logic clash when a longed for pregnancy becomes an avalanche of babies. It's natural to expect that your 6-baby or 7-baby pregnancy will work out just as well as those you see on the covers of magazines. After all, why would God finally allow you to become pregnant only to take those babies away? But that is exactly what happens, and more often than we are led to believe. I agree with Pamela 100% on this one. If you played God to get pregnant, you may not abdicate your role once you are informed of the risks of your mega pregnancy.

  12. I just had to see what all the hullabaloo was about -- all these comments. Read Pamela's piece, the article in the NY Times and all the comments...I think many of you and Pamela have strong arguments but this piece brings to mind the essential problem I have with blogging -- the nuance and subtltey of in-person conversation (no matter how interesting and thought-provoking the subject) is taken out of the equation. The art of conversation and the moment to connect with another human being face-to-face is gone, gone, gone. I'm also reminded of another bloggy venue or outlet....Baristanet...which I am not very fond of because of its "snarky", "edgy," "snippy," "snappy" tone. And that's where I think Pamela erred in this last installment to her often enlightening, interesting and FUNNY blog.

    Even if her argument about not invoking God when it suits you in your choices is sound (the similarities between Pamela's personal choices she made about using anti-depressant drugs during pregnancy and the medical/religious choices made by the Stansel couple seem to me to be a bit of a stretch, but I do understand how the first commenter could have been struck by the hypocracy) because in the end, it's the tone of voice in Pamela's piece that could be viewed by some as offensive. Pamela, I think you were too cavalier with such a serious topic by writing a "letter" to the parents, often using taunting and sarcastic phrases that judged the couple's religious convictions and gut-wrenching decisions -- it was mean.

    Is the point of writing a blog to try to be hip and clever and snarky? I guess so, for some. It's your blog and you can write whatever you want and present yourself in whatever light you want. And if people don't like it, they don't have to read it -- as you so succinctly stated in response to one of your commenter's "tantrums." That's a reader's perogative - to never read the blog again. But those offended readers would be missing so much of the good stuff that you write on your blog!

    I ask, is this blog an open book diary for you, Pamela, for all to see - the rants the criticisms and judgments -- some of them perhaps written in haste? Or, is it a place where you'd like to preserve memories, quips and funny moments from your family's life? (And boy do you ever have some funny moments...often told so well in your blog.) Do you really want your children to read some of the more judgmental, harsh (to coin one commenter's phrase)rants that you've written -- ten years from now? I keep thinking...omg, what if your mother were to read this - wouldn't it hurt her so much? Why not scrounge up the courage and air some of these feelings in a face-to-face conversation with family members who have offended instead of writing about it on your blog? Is this blog therapy?

    Maybe your blog is a little bit of both - open-book diary and a creative space where funny family stories and favorite recipes to be shared with loved ones can be preserved, but I really think there are two kinds of essayist writers - the ranters who judge others and are quick to point a finger (Maureen Dowd - she IS funny but boy I do get tired of her game after a while) and those who are honest and write what they know, from the heart, reflecting on their own life and the lives of their children and family...possibly making the reader smile and feel better about themselves and their lives. I think plenty of what you've written on your blog is the latter -- very well-written, heartfelt, humorous sketches of life in the Goldsteen household but some of your pieces do seem to turn ugly or "harsh"...for all to see. Which kind of writer do you really want to be? Isn't it important to ruminate and meditate on the effect of your words sometimes before you sit down to write a piece that exposes you to such a great degree and reveals your inner core?