The Two-Minus-One Pregnancy: Other Choices
August 17, 2011
As Jenny lay on the obstetrician’s examination table, she was grateful that the ultrasound tech had turned off the overhead screen. She didn’t want to see the two shadows floating inside her. Since making her decision, she had tried hard not to think about them, though she could often think of little else. She was 45 and pregnant after six years of fertility bills, ovulation injections, donor eggs and disappointment — and yet here she was, 14 weeks into her pregnancy, choosing to extinguish one of two healthy fetuses, almost as if having half an abortion. As the doctor inserted the needle into Jenny’s abdomen, aiming at one of the fetuses, Jenny tried not to flinch, caught between intense relief and intense guilt.
“Things would have been different if we were 15 years younger or if we hadn’t had children already or if we were more financially secure,” she said later. “If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner — in a test tube, choosing an egg donor, having the embryo placed in me — and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.”
For all its successes, reproductive medicine has produced a paradox: in creating life where none seemed possible, doctors often generate more fetuses than they intend. In the mid-1980s, they devised an escape hatch to deal with these megapregnancies, terminating all but two or three fetuses to lower the risks to women and the babies they took home. But what began as an intervention for extreme medical circumstances has quietly become an option for women carrying twins. With that, pregnancy reduction shifted from a medical decision to an ethical dilemma. As science allows us to intervene more than ever at the beginning and the end of life, it outruns our ability to reach a new moral equilibrium. We still have to work out just how far we’re willing to go to construct the lives we want.
Jenny’s decision to reduce twins to a single fetus was never really in doubt. The idea of managing two infants at this point in her life terrified her. She and her husband already had grade-school-age children, and she took pride in being a good mother. She felt that twins would soak up everything she had to give, leaving nothing for her older children. Even the twins would be robbed, because, at best, she could give each one only half of her attention and, she feared, only half of her love. Jenny desperately wanted another child, but not at the risk of becoming a second-rate parent. “This is bad, but it’s not anywhere as bad as neglecting your child or not giving everything you can to the children you have,” she told me, referring to the reduction. She and her husband worked out this moral calculation on their own, and they intend to never tell anyone about it. Jenny is certain that no one, not even her closest friends, would understand, and she doesn’t want to be the object of their curiosity or feel the sting of their judgment.
This secrecy is common among women undergoing reduction to a singleton. Doctors who perform the procedure, aware of the stigma, tell patients to be cautious about revealing their decision. (All but one of the patients I spoke with insisted on anonymity.) Some patients are so afraid of being treated with disdain that they withhold this information from the obstetrician who will deliver their child.
What is it about terminating half a twin pregnancy that seems more controversial than reducing triplets to twins or aborting a single fetus? After all, the math’s the same either way: one fewer fetus. Perhaps it’s because twin reduction (unlike abortion) involves selecting one fetus over another, when either one is equally wanted. Perhaps it’s our culture’s idealized notion of twins as lifelong soul mates, two halves of one whole. Or perhaps it’s because the desire for more choices conflicts with our discomfort about meddling with ever more aspects of reproduction.
No agency tracks how many reductions occur in the United States, but those who offer the procedure report that demand for reduction to a singleton, while still fairly rare, is rising. Mount Sinai Medical Center in New York, one of the largest providers of the procedure, reported that by 1997, 15 percent of reductions were to a singleton. Last year, by comparison, 61 of the center’s 101 reductions were to a singleton, and 38 of those pregnancies started as twins.
That shift has made some doctors in the field uneasy, and many who perform pregnancy reductions refuse to go below twins. After being rebuffed by physicians close to home, Jenny went online and found Dr. Joanne Stone, the highly regarded head of Mount Sinai’s maternal-fetal-medicine unit. Jenny traveled thousands of miles to get there. She still resents the first doctor back home who told her she shouldn’t reduce twins and another who dismissively told her to just buck up and buy diapers in bulk…
The Pink Hijab : How the Arab revolts of 2011 have transformed the image of the Islamic world
August 17, 2011
The Arab revolts of 2011 have transformed the image of the Islamic world. One young Egyptian woman’s struggle reflects the scope of change—and shows how long it has been in coming.
The greatest wave of empowerment in the early 21st century has produced a new political chic. It has been shaped by conditions conspicuously ripe for unrest. A youth bulge altered the generational balance of power. Rising literacy spurred aspirations beyond daily survival, especially among women. And new technology tools—cheap cell phones with video capabilities, Internet access, social media, and some 500 independent satellite channels launched since 1996—gave ordinary Arabs a larger sense of the world and then allowed them to connect at a crucial juncture.
The new chic has been fashioned by a yearning for change that is at once democratic and indigenous. The restless young chafe at old ways and old leaders, but many who turned out in Cairo’s Tahrir (“Liberation”) Square this year do not aspire merely to imitate the West. They reject militant jihad and the rigid formulas of the Salafis, yet they fervently embrace their faith as a defining force in their future. They want new systems that are both fully representative and true to their religious values. Their quest, which began quietly long before the so-called Arab Spring, also helps illuminate what lies ahead.
The 21st-century believers are establishing their voice in hip-hop lyrics and bold comedy, subversive poetry and satirical plays. The cultural uprising is as critical as the political upheaval. The young in particular have been encouraged by a new generation of popular televangelists who preach a softer and more flexible form of Islam. The militant Muslim Brotherhood and its allies may play a powerful role in the new Egypt and elsewhere in the Arab world, but they will face strong countercurrents among young Muslims who have their own ideas. They will encounter people like Dalia Ziada.
Dalia Ziada was 29 when she joined the revolt against President Hosni Mubarak in Egypt. She had a particularly long journey to Liberation Square. It started when she was a little girl.
“I am a survivor of female genital mutilation,” Ziada told me as she stirred a steamy espresso in a Cairo café. “In 1990, when I was eight years old, my mother told me to put on my best party dress. It was supposed to be some kind of surprise, a celebration. I found myself instead in a doctor’s office. I shouted and refused, but the doctor gave me a shot. I woke up in terrible physical pain.”
Ziada’s first protest was within her family. As a teenager, she tried to prevent the genital mutilation of her sister and cousins. No female in her family had ever fought back. “And mostly,” she conceded, looking up from her coffee, “I failed.”
In Egypt, the practice of female genital mutilation spans millennia, dating back to the pharaohs. In 2005, a United Nations report found that 97 percent of Egyptian females between the ages of 15 and 49 had undergone one of four types of genital mutilation—clitoridectomy, excision, infibulations, or the miscellaneous pricking, piercing, incising, scraping, or cauterizing of the genital area. The practice is cultural rather than religious in origin, more African than Middle Eastern. Many Christian girls in Egypt have also been genitally mutilated.
In 2006, when she was 24, Ziada had a long debate with an uncle about her seven-year-old cousin Shaimaa, the family’s youngest female child.
“We talked most of the night. He was shocked at the blunt discussion,” she recalled. “I told him that he had no right to circumcise her. I said I’d cut off Shaimaa’s finger if he went through with it. He looked at me with surprise and said that would ruin her life—and I said, ‘Now you get it.’ I thought I’d lost. But he called me the next day and said I’d convinced him. That’s when I realized I could do things, because I had been able to save someone,” she said. “I decided to see what else I could do.”
Ziada, who comes from a traditional family, does not look the part of sex educator. She is doe eyed and wears no makeup, so her pale, chubby cheeks and colorless lips make her appear younger than she is. In public, she wears hijab coverings in bright florals, rich patterns, or fake designer prints; she changes her scarf daily. She is an observant Muslim, so not a wisp of hair shows. Judging from her eyebrows, her hair must be dark brown.
“Hijab is part of my life,” she told me. “I would feel naked without it.” She often jokes, with a robust laugh at herself, that her scarves are the most interesting part of her wardrobe. Yet her religious commitment defines her life.
Her goal, she wrote when she began her new blog in 2006, “is derived from the ultimate goal that any Muslim seeks; which is to please Almighty Allah.”
Ziada soon became a leading activist among the pink hijab generation, young women committed to their faith, firm in their femininity, and resolute about their rights. With three college classmates, she launched a campaign to educate women about genital mutilation and domestic violence. Then she moved on to human rights. And she ended up at Liberation Square.
“When I grew up,” she explained on her blog, “my personal interest in having more equal rights as a woman expanded to my country…”
Why they sang about John Brown: How a violent revolutionary inspired the Union’s great marching song
August 17, 2011
On May 12, 1861, a flag-raising ceremony was held at Fort Warren, an Army post on George’s Island in Boston Harbor. The growing ranks of the Twelfth Massachusetts surprised inductees with the first performance of a new song.
The “John Brown Song,” as the soldiers called it, borrowed the tune of a popular Methodist hymn – a melody you probably know today as “Battle Hymn of the Republic,” with its famous chorus of “Glory, glory, hallelujah.” But in May of 1861, Julia Ward Howe’s “Battle Hymn” lyrics still lay six months in the future. “John Brown’s Body lies a-moulderin’ in the grave,” the Massachusetts soldiers sang. “His soul is marching on!”
The song became a hit. Two months later, Boston newspapers reported troops singing the tune in the city. By the time the lyrics were printed by a local music publisher, the company announced that “one can hardly walk on the streets for five minutes without hearing it whistled or hummed.”
Why did John Brown, a violent abolitionist revolutionary hanged for treason in Virginia, inspire a stirring song first heard, of all places, on an island in Boston Harbor? The answer reveals something about the complexity of the North’s beliefs about why they were fighting the Civil War, and the surprisingly wide range of causes that Brown – a New Englander turned antislavery zealot – came to represent in the fractured America of the time.
By the 1850s, Boston was a stronghold for American abolitionism. Known as the “Cradle of Liberty,” it was one of the most welcoming destinations for free and fugitive blacks. When, in 1854, the Kansas territory was opened for a popular vote over slavery’s expansion, Bostonians founded the Massachusetts Emigrant Aid Company to send voting settlers to the territory under arms.
John Brown, a failed businessman then living in New York State, was similarly inspired by this opportunity. Originally from Connecticut, Brown had spent some formative years in Springfield, Mass, where he was heavily involved in the abolitionist cause. When Brown arrived in Kansas in 1855, the territory was in chaos. Proslavery and antislavery settlers clashed in a simmering conflict, whose outcome stood to swing the balance of votes in Washington.
In May of 1856, Brown and a small band of men carried out five brutal killings of proslavery settlers in Pottawatomie, Kan. Meanwhile, only a few days earlier, Massachusetts Senator Charles Sumner had been beaten nearly to death on the Senate floor by South Carolina Congressman Preston Brooks. To New Englanders, Brown’s action spoke volumes: Proslavery outrage was finally answered by abolitionist justice.
After fleeing federal troops, Brown headed to Boston, where he knew he would find shelter and support. In the Massachusetts Legislature, Brown delivered a speech about his role in the strife. Describing scenes of murder and mayhem, Brown took out the chains that had held his own murdered son and thumped them on a table…
Hats And Halos
August 17, 2011
This image has been posted with express written permission. This cartoon was originally published at Town Hall.
‘Prove it’
August 17, 2011
This image has been posted with express written permission. This cartoon was originally published at Town Hall.
