Medical Miracle or Medical Mischief? The Saga of the McCaughey Septuplets

Abstract

The story of McCaughey septuplets is a quintessentially American story, combining many ingredients of modern life. The oftentimes uncritical celebration of dramatic, medical technological breakthroughs, romanticization of life in middle America, and growing influence of fundamentalist Christianity, along with its close relative, anti-abortion movement. And in later stages of story, growing visibility of bioethics and bioethicists. On 19 November, after thirty-one weeks gestation, babies--dubbed the magnificent seven by wide-eyed reporters--were born within six minutes. Their weights ranged from two pounds five ounces to three pounds four ounces. A team of forty nurses, respiratory therapists, perinatologists, neonatologists, and anesthesiologists officiated at delivery. All septuplets were placed on ventilator support for some days, but by end of November they were breathing on their own. The birth that captured and held attention of American media took place at Iowa Methodist Medical Center, just ten miles from small midwestern town of Carlisle, Iowa, population 3,240. Carlisle is home of Bobbi McCaughey, a twenty-nine-year-old seamstress, and her husband, Kenny, twenty-seven, a billing clerk at a local automobile dealership. They shared their small two-bedroom house with a daughter, Mikayla, aged two. Since septuplets' birth, Governor of Iowa made good his promise to build them a new--and much larger--house. This was most generous of a bewildering assortment of gifts showered upon family, including years of cable TV, university scholarships for all children, ten years of portrait photographs, and a lifetime supply of Pampers. And there were more meaningful and less tangible gifts. According to Time magazine (1 December 1997), response of other inhabitants of Carlisle bespoke a neighborliness that seems to have vanished from much of America. ... A brigade of neighbors and friends has coordinated meal preparation, laundry, transportation, baby sitting, and housecleaning. `They say it takes a village to raise children,' says city administrator Neil Ruddy. `We just didn't know it would be our village.' Lonely city sophisticates on both coasts turned green with envy. Bobbi had been born with a malfunctioning pituitary gland that produced too little follicle stimulating hormone (FSH) that normally prompts a few eggs to mature every month. She wanted very much to have a child and sought fertility treatment. After one year without success, her doctors prescribed a stronger drug, Metrodin, which is rich in FSH. Mikayla, a single child, was result. When little girl was sixteen months old, McCaugheys decided that she should have a brother or sister. Reluctant to wait a year, they asked that Metrodin be administered without delay. What happened next is somewhat unclear. There have been conflicting reports, but it seems that Bobbi was given a shot of human chorionic gonadotropin (HCG), which helped release her eggs and enabled them to unite with her husband's sperm. Bobbi became pregnant on first try and six weeks later an ultrasound revealed that she was carrying fetuses. A failure of medical judgment--or at least medical management--seems to have occurred, but much of media resolutely kept its eyes off this aspect of story. Most Americans believe that McCaugheys faced an inevitable choice between risks of this multiple pregnancy and what was for this family, as Fundamentalist Christians, morally untenable option of selective abortion. But abortion is a retrospective solution, and prospective remedies are always better. This multiple pregnancy simply did not have to happen. Good medical practice mandates ultrasound scans for women who have taken fertility drugs in order to monitor accurately number of eggs they produce. …