LOS ANGELES — Public opinion seems to be cresting against her, her own mother is rattled, and now fertility experts are suggesting the case of Nadya Suleman and her octuplets constitutes a breach of medical guidelines.
Suleman, 33, gave birth to six boys and two girls by cesarean section Jan. 26 at a Kaiser Permanente Medical Center in Bellflower, Calif. The event — reportedly one of only two live octuplet births ever in the United States — quickly drew criticism after it was revealed that Suleman is single and unemployed, lives with her mother, and already has six children — including twins — ranging in age from 2 to 7.
Her daughter “is not evil, but she is obsessed with children. She loves children, she is very good with children, but obviously, she overdid herself,” her mother, Angela Suleman, told the Los Angeles Times. She decided to have more embryos implanted in hopes of having “just one more girl.”
“And look what happened. Octuplets. Dear God.”
Worries mount
The birth of eight babies to a woman who becomes responsible for 14 children is attracting a different set of worries from the medical community, particularly fertility doctors, who say it goes against the mission of their work: to minimize high-risk, multiple-birth pregnancy and safely provide a woman with a single healthy baby. It is also raising questions about the lax regulations covering doctors and clinics that provide such services.
“It was a grave error, whatever happened,” said Eleanor Nicoll, a spokeswoman for the American Society for Reproductive Medicine, which along with the Society for Assisted Reproductive Technology provides medical guidelines for fertility treatments. “It should not have happened. Eight children should not have been conceived and born.”
Suleman has yet to reveal how the babies were conceived or which clinic or doctor was involved. Her publicist said she has “reserved that part of her story,” and Kaiser said it was not involved in the conception.
Poorly regulated field
Typically, doctors use one of two procedures. One is in vitro fertilization, whereby doctors combine eggs and sperm in a laboratory, creating embryos, and transfer a small number into the uterus. The second is intrauterine insemination, in which doctors stimulate the ovaries to produce eggs and follow that with artificial insemination.
In both procedures, doctors said, they work with two to three embryos, or four at the very most. But never eight.
It’s standard for doctors to take a patient’s history — say, how long she has been trying to get pregnant or how many children she has — before beginning a fertility treatment, said Lawrence Werlin, medical director of the Coastal Fertility Center in Irvine, Calif.
He said there’s no specific number of previous children or hoped-for babies that determines treatment. But in Suleman’s case, he said, he doubted that she requested such a sizable brood.
David Magnus, director of the Stanford Center for Biomedical Ethics, said that if the octuplets were produced through in vitro fertilization, it would spotlight the poorly regulated infertility and reproduction field.
“This is a huge problem,” Magnus said. “You’ve got a virtually unregulated marketplace with tort law serving as regulation in the U.S.”
Suleman’s babies are expected to stay in the hospital for weeks. In the meantime, she has hired publicists to handle the hundreds of media inquiries from around the world. According to her spokesman, Mike Furtney, the “very bright, very engaging” Suleman has a degree in psychology and hopes to continue work toward a master’s degree.
As for some of the criticism aimed at her, Furtney said, “she’s hopeful that when she tells the story, people will change their opinion of her — for the good.”
