One of the loneliest and difficult types of losses is selective reduction, i.e. the choice to reduce one or more fetuses for either health reasons (mother’s health or deformed fetus) or to reduce one or more in order to give the remaining fetuses the best chance of survival, e.g. five to three, three to two and such. It is not as simple as reducing one or more in order to give the rest a chance. That decision seems, on the surface, to be obvious. There is another part to the equation: that of the family. The family, after a decision to reduce, must live with their choice for the rest of their lives. Not always is this an easy spot to be in.
As a mother looks as her healthy twins playing (reduced from triplets), she will fantasize about what should have been, considering of course, another healthy child. The decision was made with the best of intentions to reduce, but there is pain and residue and quite often, an inability to come to restful terms about such decision. Some parents ask themselves if they are murderers. Some have tried very hard to get pregnant and are now counselled to reduce. This is opposite from how their journey began and can be more than they can bear.
Finding support for reducing families can be extremely difficult. Those who have chosen to reduce want to “forget” their decision and just get on with their lives, coping as best they can. These parents do not want to write about their journey, explore it, join any bereavement groups to look their feelings nor offer any one-on-one connection or support to other families who also may be struggling with their decision. Understandably the decision to “forget and move on” becomes their main focus.
Selective reduction is not something that one would discuss around the dinner table, nor would parents have necessarily shared the quandary with family members or friends. There is an inherent feeling of guilt and shame associated with this decision and families considering it may have stuck to discussions only with the healthcare professionals looking after them. So even sharing what Mom or Dad is feeling with caring family or friends is out of reach. Others may not even see their grief as real grief because, after all, they made the decision to reduce.
Struggling and grieving families need to be encouraged to look for supportive help and counselling in order to assist them in coming to terms with their decision and looking for ways to cope with what they are feeling. It will not be an easy journey, and as I said, I think is a very lonely journey as so many others will not understand or have cruel judgements about what has happened. We cannot judge what another’s journey is. The decision to reduce is made with, I believe, love for all the babies, including those reduced. A decision where the head and the heart are in conflict.
Nothing about the decision is easy, even when the decision is made regarding reducing a fetus with anomalies. It may be the loneliest loss decision to be made.