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Selective reduction refers to the practice of reducing the number of fetuses in a pregnancy. It is a form of abortion, with the difference that the pregnancy was quite apparently extremely wanted and planned, but the medical, practical, or emotional issues are of such weight that a couple decides to opt to reduce the number of babies to a more manageable number.

There is no doubt that selective reduction is a controversial subject, just like the termination of any pregnancy. This especially holds true among religious communities. At the same time, many doctors who have seen complications arise with higher multiple pregnancies for both the mother and one of more of the babies can recommend selective reduction as the most responsible choice from a medical standpoint.

Selective reduction for twin pregnancies is a relatively new process, but triplet, quadruplet, or higher multiple pregnancies are commonly seen as extremely risky. What if you and your partner have just gone through one or more rounds of IVF treatments, often very stressful, and are now expecting more babies than you aimed for?

Selective reduction is a personal decision. In order to make the right choice for you, you will need to weigh the pros and cons of both reducing and carrying your pregnancy for as long as possible. For many, selective reduction is simply not an option for religious or moral reasons. However, if you are considering this option, here are some questions to discuss with your healthcare team:

What are the risks of continuing your pregnancy with high order multiples for you, the mother? What are the risks of continuing your pregnancy as is, for all the babies? What are the risks of selective reduction for the remaining fetuses? What are the risks of selective reduction for you? What are the objective medical benefits of selective reduction, for mother and babies?

And some questions for you personally:

How do you really feel about selective reduction? How do you feel about accepting the risks if you continue your pregnancy? What do you want to do?

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