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April 21, 2009

Is There Such a Thing as Too Many Children?

Questions linger as last of Nadya Suleman's octuplets heads home.

The last of Nadya Suleman's octuplets has been discharged from the hospital and is now at home with his family. Following a three-month stay at Kaiser Permanente Medical Center in Bellflower, California, Jonah Angel Suleman - who weighed only a pound and a half at birth - now weighs just over four and a half pounds and has been deemed strong enough to survive outside the hospital.

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"This is an historic and a joyous moment for all of us," Kaiser Medical Center neonatologist Mandhir Gupta told People. "The birth of the octuplets on Jan. 26 was a special moment for each of the 52 doctors, nurses and other caregivers who brought them into the world. [Jonah's release] is the culmination of that dream - eight healthy babies who are strong and ready to thrive."

The Suleman babies' hospital stay may be over, but the many questions raised by their birth - questions about in-vitro fertilization, medical ethics, single parenting, and welfare, just to name a few - are still raging.

Nadya Suleman, 33, has become a familiar face online as the single mother of 14 children, the oldest of whom is seven. All of her children were conceived, Suleman states, through in-vitro fertilization. Amid talk that Suleman will soon be starring in her own reality show, is trademarking the name Octomom, and has cost the La Habra police department $4,000 in overtime fees for watching over her family since their move to the neighborhood in March, it's hard to sort out my feelings from the furor.

Suleman didn't ask me for my opinion before she chose to have six frozen embryos implanted simultaneously (purportedly to avoid their being destroyed), but I have to wonder: If she had asked me, what would I have said? The American Society for Reproductive Medicine (ASRM) has established guidelines for the implantation of frozen embryos, guidelines that were not followed in Suelman's case. But who really should get the final say in the matter? The ASRM? The expectant mother? Friends, family, society, the culture at large?

"Fourteen children is too many" is a reoccurring sentiment on chat sites and blogs - especially when the mother is single and a welfare recipient. But how many children is "too many"? And for whom? Can we put a limit on the acceptable number of children to have, and still claim to be pro-life? What would a godly response be to the reproductive choices of others?

"We are gifted with children, rather than entitled to them," Cynthia Cohen says in a recent article for Episcopal Life, "Being Fruitful But Responsible." Cohen, of the Kennedy Institute of Ethics at Georgetown University, served on the Canadian Stem Cell Oversight Committee for three years. She writes:

Is it possible for us to cherish and nurture children as creatures with their own uniqueness and integrity if we deliberately have more than a dozen of them who are very young? What are the limits to God's call to us to be fruitful and multiply? The Christian tradition teaches that we are to refrain from using our children as mere instruments to fulfill our own desires. They are not our possessions, products or projects; they are our trusts. . . . Children are ends in themselves whom we are to cherish and care for as God's creatures in light of our capabilities and circumstances.

In all the questions raised by the Suleman octuplets' birth, Cohen's thoughts seem like a good place to start our own response.

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Comments

This is an opportunity for every pro-life advocate who has ever stirred up a fuss about assisted fertilization. For everyone who has lamented abortion or the destruction of embryos created in an in vitro proceedure...to step up and help out. Because this is rubber-hits-the-road reality of dealing with the children that happen. When a mom chooses not to abort, there's a child left to raise. When a person chooses to have all those babies who were created in a lab, there are multiple children to raise.

It's time for the religious right to put it's money where it's mouth is.

I would agree with you, Tami, except this was not a case of choosing life vs. abortion.

While her judgment in even having the embryos created may have been somewhat hard to understand, once they were created, they were worthy of life-- unique individuals never to be replicated again. I think that the world is very harsh with Suleman. What ever opportunity she is given to financially support these children is beside the point. Many of the people criticizing her in the media are pro-choice, but only their choice is acceptable to them in her case. I don't know what the regulations should be in reference to possibly preventing this kind of situation in the future, but certainly society as a whole should not be given the voice.

I would say that the "religious right" label is just that, a label. People who use labels for others often are prejudiced in their thinking and see people as "us" and "them", which is often what they criticize others for. Although I am pro-life, I am also pro responsibility for your own actions. My parents often said, "you make your bed, you sleep in it...". If that woman chose foolishly to have more children than she could reasonably afford to take care of whose responsibility is that? It is disrespectful of others to force them to take care of you for your decisions. That being said, it would be gracious and merciful to help this woman and her children in some fashion. Perhaps Katelyn has sent her a donation, or perhaps not. Our first and foremost responsibility is to our family, our church family, and those others whom God has put on our heart to assist, but it is not for someone else to judge whom God may inspire or not inspire to do so.

I apologize, it was tami not katelyn who had referred to the religious right, and wondered if they would donate to the childrens cause.

Now all we have to wait for is to see how many of the eight are autistic. Three of the first six are so perhaps we can say four might be. I can't wait to see Nadya take an outing with seven children having simultaneous meltdowns or tantrums.

I'm not surprised at the nastiness and hate that is directed towards this woman because she chose to have these kids and because she seems not mentally there. I'll bet if she was a good looking babe who could speak intelligently, she wouldn't be getting all this hate. It's her business if she wants these kids although I do wish she could finish college and support these kids. People forget that women are having this number of kids all over the world and not by choice but by their husbands and cultures demands, and worse yet, it's been this way for centuries. It's only recently in countries rich enough and medically capable of controlling their birth numbers and thanks to abortion, that birth numbers are controlled. It's still a free country and if she wants these kids, let her have them. With all the illegal children the taxpayer is forced to pay for, at least these are legal children and are wanted by their birth mother.

I don't believe it's the government's role to get involved with the intimate details of a woman's decision to bear children. Being pro-choice means I have to accept her decisions regardless of how immoral I believe them to be. I certainly believe her decision to bring 8 medically at-risk children into the world, in addition to the 6 she already had, as more morally culpable than someone who takes emergency contraception. But, the same constitutional principles that prevent the government (except in later stages) from interfering in a woman's decision to terminate a pregnancy are the same that prevent the government from interfering in a woman's decision to carry 8 embryos to term.

I also think that her decision to take her pro-life beliefs to their logical extreme only serves to point out that, at those extremes, even a sincerely-held pro-life position can cause more harm than good.

If only two of the implanted embryos had survived, no one would be talking about this family. But all six, made it and eight children who weren't antcipated a year ago. There are so many matters that can be addressed, but who are any of us to criticize this woman? - Look, Jesus writes in the dirt!

Ooh, and let's be sure to pick on her because of her autistic offspring.
Swell, what Christians we are!

"And the LORD said unto him, Who hath made man's mouth? or who maketh the dumb, or deaf, or the seeing, or the blind? have not I the LORD?" Exodus 4:11

She needs, the family needs, our love and prayers. I suspect she has known enough hatred in her life so far.

It seems to me the problem is with the doctor who agreed to implant that many embryos at one time. Before one can adopt there's significant due-diligence on the part of the adoption agency to determine physical, psychological, and financial readiness of the potential parent(s). Seems to me the same should be true in the in-vitro process.

I agree with Christian Lawyer.

I absolutely cringed when I learned that the mother of octuplets had 6 other children. I have a sister with twins, and they were a tremendous challenge as infants. I can't imagine the energy and resources which would be needed for 8 infants who are all going to have the same needs at the same time. I also have another sister who has 11 children -- all single births. And, I can see the losses that she and her children suffer because there simply aren't enough hours in the day or energy or resources to give those children the amount of love and nurture -- not to mention the basics -- that she wants to give and that they need.

But, as articulated above by Christian Lawyer, there's a distinction between my personal thoughts and beliefs and what the government should be able to do. Government ability to do anything has two sides. One of the reasons that I am firmly and happily pro-choice is that I do not want anyone else making decisions that involve my choice not to have children.

Beyond the choice debate, however, is the apparent reality that this woman was not prepared to support and raise 14 children. She is apparently not in a stable marriage or relationship; and, there is emotional discord and severe economic stress in her relationship with extended family. No one could do that job single-handed or, short of six- or seven-figure income, without financial help. Since Ms. Suleman has apparently opted for an alternative family arrangement, I suspect that some, if not much, of her economic support is going to come from the taxpayers in California and through the US.

My view is that a single woman, particularly on welfare, shouldn't have been allowed to have IVF in the first place. And who paid for all the IVF in the first place? This would have prevented this whole situation.

You know, I gotta wonder, if she were so "prolife," would she have really implanted all those embryos knowing what a high risk of pregnancy loss, the pressure to reduce, the risk of disability. Sure, once you are in a pregnancy, a "prolife" person is willing to shoulder those risks, but to put the embryos in danger from the go, for what appears to be very selfish reasons, is not a "prolife" mindset.

I actually feel bad for her. I don't agree with her, but the person I believe should be held most accountable is the physician for performing such a irresponsible, and perhaps greedy, procedure.

Interesting to see people rejecting God's assertion that children are a blessing that He gives us.

Of course children are a blessing from God. Having more of them in your womb than your womb can likely bear without exploding, is, however, as we've seen with both Ms. Suleman and the 9-yr-old Brazilian rape victim pregnant with twins, too much of what otherwise or at another time might be a good thing. When Jesus healed on the Sabbath he put the lie to the fundamentalist notion that every Biblical injunction must always and everywhere be taken to the extreme, especially when those extremes take or endanger a life.

Mother Teresa once said something like asking if there are too many children in the world is like asking if there are too many flowers. How can there ever be too many flowers?

To even ask the question if there can be too many children is embedded in a deeply arrogant control over human life - and since we are already alive to do the asking we are not asking it about our own lives but have the audacity to ask it about others - whether they should be alive? How dare anyone who has been allowed to survive themselves ask that question of others? It is mysogynist, anti-child, a deeply offensive if not cruel concept, the symbolic killing off of childhood. That kind of question alludes to birth control verging on a eugenics programme where the target is the unborn, the yet to be born, the newly born and those too weak to defend their own right to life. Whose children would you like to kill or prevent? Yours? Your neighbour's? Poor people? Half Iraqi immigrants? Mothers without husbands? People who have larger families than your contemporary post modern, nuclear western society is used to? In your mind, when you ask the question, who do you suppose should be limiting their children? This is the ugly side of birth control - it is eugenicist by implication of the kind of arguments aired so much regarding Nady Suleman. Too poor, too unstable, too single, too many children already, too many special needs children, too small a house, too this, too that, any and every spurious argument, much of it presumptious if not fictitious. I apologise to Nadya Suleman and her 14 children for even repeating any of this cruel nonsense.

We already kill children to reduce their numbers. Its called abortion and the morning after pill. A world that rejects children rejects itself. It is so screwed up that little girls are born now with the legal right to the systematic removal of their own boys and girls from this world by abortion.

Jesus said "let the little children come to me and do not hinder them for such is the kingdom of God". He also said the Kingdom of God is within you. Women, when you carry life within you, the spiritual in you and in that life form is so closely akin to the creativity of God in reproduction, that to even talk of numbers of children is to limit God. When we limit ourselves, we limit God. When we limit God, we limit ourselves.

Great comments Capice, let me add to them by pointing out that not only do we seek to limit God, we also seek to push beyond the boundaries of God's control. One of these boundaries is life--God controls the womb. He promised Abraham and Sarah a son and yet made them wait 25 years for that son to arrive. The Bible is very clear; however, He opened Sarah's womb and she conceived. In an age of in-vitro fertilization, we often lose sight of this truth.

Perhaps we as Christians should reconsider our whole-sale acceptance of in-vitro fertilization. After all, are we really accepting the boundaries of God's sovereignty in our lives when we do? If God has closed a womb does He desire us to push beyond the boundaries of normal reproduction or does He desire us to instead learn contentment? The Bible has many examples of those whose wombs were opened by prayer (Rebekah is one). Hannah prayed and wept to God and He answered with Samuel. Sarah miraculously gave birth to Isaac when she was 90 years old. All life glorifies God; but even more importantly, in each of the above instances, He had a particular reason for both the closing and the opening of the womb. Yet in our determination to always get our way we forget that God may have other plans for us. Selfishness drives us to insure that we never lack for anything we desire, forgetting that sometimes what we desire is not what is best for us.

God's call to Christians is to walk by faith. This means that we should never allow our own arrogance to supersede God's truth nor our own selfish desires to turn us from God's will. It also requires us to live life one step at a time. Each journey begins with a single step and each journey will look completely different. As you walk with God, He might lead you to in-vitro fertilization and others away from it. The key is to live your life in faith so that you know God and not your own selfishness has led you to it; and then to allow others their own journey of faith, even if they stumble along the way.

Thank you Swannelle - wise words about faith and fertilty & related questions. I agree, these infertile couples had limitations then overruled by God. But it is interesting to ask if a God who in nature sets boundaries yet breaks boundaries such as with Hannah, Sarah & infertility, would not have us do so too at times in principle. Some Christians are vehemently against in vitro, an argument not raised here. But every time we use medical interventions to survive the life cycle - women not dying whilst giving birth, low infant mortality into geriatric medicine, do we help or hinder Gods boundaries in the individual human's timeline, or enhance them? If we were to say he has closed a womb, should we not also have to say he has closed a tomb and that it is somehow questionable to perpetuate life by the widespread use of antibiotics, emergency intensive care and the endless medications that keep sick and dying people going past three score and ten. Does he allow us to play around with the human timeline or are we off the mark by having increasing power to start and prevent it all the way through? Are interventions in the human life cycle now routinely carried out by modern science in gynaecology, obstetrics and reproductive medicine counter to his will or in accordance with his mercy and grace? I wonder if he does not also then show mercy and grace to Nadya Suleman by allowing her invitro implanted children, such delightful, beautiful children, to be the first longest surviving octuplets in the world against every medical odd. Is that not a miracle of its time, different to those biblical women certainly but no less curious such as when Christians pray for someone on a life support machine to survive and they pull through against the odds? Can God not work hand in hand with human intervention to overturn the limits and risks of nature even when others may think it is going too far or doomed to fail, doubt also expressed in those biblical narratives of Sarah etc. According to reports of the time found in the gospels, Jesus healed when doctors within the limits of medicine simply could not. Medicine has come a long way since then but it still cannot raise the dead 3 days after rigor mortis. Yes, it's true that God in nature has created boundaries but in Jesus he also came to die then rise again bursting those boundaries forever. Nadya Suleman is a woman who has crossed the boundaries of womanhood and what is possible. She attributes it to medicine and miracle. Whatevert the complexities of the debate, I do too.

People talk a great deal about Ms. Suleman's selfishness but there is probably something deeply selfcentred in the drive most people have to self perpetuate themselves. Perhaps God allows for that selfish gene in the look of recognition when children mirror parents and vice versa, one of the first comments new parents make in reproducing themselves - who does our baby look like? Identification with others we most closely belong to or wish to belong to is part of the mirror effect, something we also do with God when we see him in our own image and him in ours. Me, me, me is probably deeply embedded for good and ill in the human psyche and who knows that we are not somehow wired that way. So that the notion of selfish reproduction is not solely attributable to Nadya Suleman indeed if at all, but to anyone who ever planned a family. Whatever we say about the selfish gene and some may want to point at who has more of it than the next person, we could turn it back to God to referee. If we say that God creates life as with Hannah, then is he selfish to want so many children of his on the earth when so many are starving, crying, miserable and ill used? Why did he answer Hannah's prayer? What does he want with all these people? What for? If made in his image, why does he need to keep producing more and more children, including Nadya's 14? I like God. I think he likes us. And I think he likes kids, whatever hell or heaven we make of their lives here. I hope we will make these 14 children feel more welcome and more at home. They belong to God and he has allowed them to belong here to us, against the odds, just as with Hannahs, Sarahs....and even, that Nadya's?

The IVF facility and the doctor should have been held accountable to the already established medical guidelines. This IVF facility may not have been currently accredited, and if they were, was there truly accountability? The doctor knowingly increased risk for the mother by implanting that many eggs.

Also, to someone who previously asked, the mother has said in several interviews that she paid for all IVF procedures herself. She said she saved money from working long hours and used money from a settlement toward the costs. It sounds like the welfare status came after at least some of the kids were born.

it sounds like all children may have been 'conceived' and stored as frozen embryos until gradually implanted over several years so that the one off conception procedure was paid for by herself as she has described and the implanting procedures paid for either before or after subsequent welfare. welfare is a nonspecific term which has been used on her but she states she was never even on welfare, just disability for the special needs kids and food stamps which is not the mainstream welfare programme whcih is why she said she never was on welfare.

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