The slowest night of my life trickled slowly into a turbid, grey, airless dawn. I was still on Mag, weaving in and out of periods of lucidity and hallucinations. As I was practically paralyzed from neck down, any movement was out of question. Ganesh had spent the night crouched uncomfortably in a hard iron folding chair. Twelve slow hours had passed since the steroid injections. Thirty-six more to go before the steroids had their full effect on the lungs of my babies.
The wait was on!
My first visitor of the morning was my ex-perinatologist. He happened to be on duty in the hospital and therefore was forced to see me. A perinatologist is a super specialist who looks after the foetus while the baby is still inside the womb. Perinatologists are especially important in case of high-risk, multiple pregnancies like mine. I had visited this particular doctor early on in my pregnancy, but we had switched to another perinatologist a couple of visits later as we were not happy with him. He was a dour, humourless guy, not quite the person I wanted to meet, especially at that point, considering our chequered past.
He walked into the room with a tight smile that did not quite reach his cold, steel-grey eyes.
‘I have been through your reports, Shefali. I hope I am wrong, but I think these are going to be 26 week babies’, he said. ‘Let us just hope Mag will give us the desired window till the lungs develop.’
He then walked out of the door, giving me one last parting glance. He did not say it out loud, but his cold eyes screamed, ‘I told you so’!
He was right. He HAD told us so!
I shut my eyes and travelled back in time. It was week 12 of my pregnancy and we were at our first appointment with the perinatologist. After he did the ultrasound, he had said, ‘Considering your age, your small build and the size of the babies, I anticipate a pre-term delivery’. ‘Are you prepared for the risks?’
And then he went on to utter those dreaded words, ‘ Selective Reduction’.
In cases of multiple pregnancies where the number of foetuses exceeds two, the doctors sometimes recommend selective reduction, where one foetus is terminated inside the womb by administering a fatal injection that stops the heart from beating. Yeah, it is called selective termination or selective reduction and is perfectly legal before 16 weeks, but the fact remains that it is the same injections that is used when a convicted criminal is administered death penalty.
I had read about it of course, but did not really want to think about it. We had chosen not to find out the gender of our babies, but deep in my gut, I just knew I was going to have two boys and a girl. I had named them already in my mind. I was talking to them everyday. They were no longer a nameless bunch of cells. They were my babies.
‘It is a hard decision.’ The doctor continued in a dry, unemotional tone. ‘But sometimes it is necessary. It ensures that the remaining babies have greater space to grow in and it lowers the risk of a preterm delivery.’
Ganesh and I looked at each other. I instinctively placed my hands on my stomach in a protective gesture.
‘The final decision is of course up to the parents. But I would strongly recommend reduction. Sometimes, you need to make a painful decision for the greater good’, the doctor said.
My husband deals with information, even painful information, a lot better than I do. He took a deep breath and asked the doctor how it was to be done.
‘Well, we make the patient comfortable. Do an ultrasound scan and target the foetus furthest away from the cervix or if any foetus has a developmental anomaly, we target that foetus and inject this chemical in the heart. We then keep monitoring the foetus till the heart finally stops beating’.
The doctor said it completely unemotionally. He might have been explaining how one does a manicure! However, my heart was breaking into a thousand pieces each time a word escaped his mouth.
‘You can go home and think about it. But you need to make that decision quickly.’ He said as he washed his hands. It was symbolic. He was washing his hands off the decision-making process.
We drove home in complete silence. Fate had thrust a cruel dilemma in front of us. What was more important, sacrificing one baby to ensure a better chance of survival for the other two? Or let things take their own course and thereby increase the risk to the life all three kids, or worse, condemn them to a life with severe disabilities that sometimes occur as a result of a very early delivery?
Two whole days passed. Neither of us dared talk about this openly. We did not even meet each other’s eyes. We surfed separately, endlessly looking for information about selective reduction, looking for stories of other people who had gone through similar circumstances. We were on our own! No relative, no friend, no doctor could help us make that decision.
After two days, we finally mustered enough courage to talk about it. We talked, cried, screamed, shouted, held each other, but could not come to a decision.
How does one decide which child to kill?