AmyTuteurMD

AmyTuteurMD
Bio
Dr. Amy Tuteur is an obstetrician-gynecologist. She received her undergraduate degree from Harvard College and her medical degree from Boston University School of Medicine. Dr. Tuteur is a former clinical instructor at Harvard Medical School.

FEBRUARY 11, 2009 9:31AM

Everyone agrees: we're outraged at Nadya Suleman

Rate: 27 Flag

  money down the drain

Our country may be fractured along political and economic lines, but we can all agree on one thing: we’re mad at Nadya Suleman, the mother of the newborn octuplets.

Ann Curry, who recently interviewed Suleman on the Today Show, referred to her as the “most vilified” mother in America. That’s a bit hyperbolic; most people will readily concede that they consider the actions of women who deliberately harm or kill their children to be far worse than what Suleman has done. However, Suleman has become a lightning rod for anger, resentment and disgust. There are a number of reasons why this has happened.

The first and most obvious is that Suleman expects, indeed feels entitled to, massive financial support for her children. Suleman has already bankrupted her enabling parents, and is making a good faith effort to bankrupt the rest of us. Such behavior would be unacceptable at any time, but in harsh economic times such as these, it adds insult to existing financial hardship.

Suleman is surprisingly childlike in her approach to money. She just assumes it will come from somewhere, as if by magic. Evidently, it always has. She seems to have no sense of what it will cost to raise her children, let alone any realization that she will never be able to support them, even if her fantasy of getting a master’s degree ever comes true.

One of the most difficult tasks of adulthood is to support oneself and one’s children, particularly if you are a single parent. An adult has to go to work whether she feels like it or not. An adult has to take and keep a job that she may despise because she and her children need the money. An adult has to put up with a bullying boss, annoying colleagues and boring tasks simply to continue putting food on the table for her children. Those are the basic rules of life for the millions of parents trying to survive in this economy. Nadya Suleman obviously thinks those rules don’t apply to her.

The resentment of Suleman’s indifference to the basic rules of adult life are increased exponentially by the fact that she clearly expects that the rest of us are going to support her family. The estimated $1.5-3 million cost to hospitalize the octuplets for 6 weeks or more? California will just have to suck it up and pay, or the hospital will just have to write it off. They money needed to buy food for 14 children? No problem; the taxpayers will just have to send more food stamps than they already do. Early intervention and educational support for any delays or disabilities her children might have? Nothing to worry about there either; there are mandates in place that will force the taxpayers to provide those services to her for free.

Second, Suleman has behaved in an extraordinary reckless way, ignoring the well being of her existing children, and the octuplets that she deliberately conceived. Children are separate, individual human beings and they deserve to be treated as such; Suleman clearly does not understand that.

Her stated reason for having so many children is both bizarre and narcissistic. She has been creating and accumulating children in an effort to make up for a childhood that she describes as lonely and dysfunctional.

People have children for many different reasons, good and bad, or no reason at all. But after having one child, most parents realize that the child is a person, separate from themselves, with his own needs that must be acknowledged and met. Suleman has failed to make this basic transition to responsible parenting. Her children are merely collectibles who exist to satisfy a psychological hunger that cannot be assuaged. Simply put, it’s all about her.

Third, and most importantly, Suleman exists in a fantasy world where actions and consequences are entirely disconnected.

Suleman hired publicists to improve her image, with the ultimate hope of profiting from her story. It is difficult to imagine that any public relations people, no matter how gifted, could extricate her from the hole that she has dug herself into. Neither Suleman or her family realized how their actions would be received by other people who live in the real world. While Suleman may have hired publicists, she is apparently ignoring their advice.

Eclipsing the foolish and bizarre statements she has already made, Suleman claimed that she has never been “on welfare.” When, as was inevitable, the press found that she has been receiving Food Stamps for the 6 children she already has, Suleman compounded her mistake, and revealed her penchant for fantasy, by asserting that Food Stamps are not welfare.

Suleman does not feel responsible for her choices, because she refuses to acknowledge the connection between her choices and the consequences: Yes, she has had 14 children, but that’s not her fault because she was lonely. Yes, she has no means to support those children, but that’s not her fault because she is going to get a master’s degree that will magically allow her to support them. It’s true that she receives Food Stamps, but that’s not a problem, because they are not “welfare” and she is entitled to them.

Nadya Suleman is not the most vilified mother in America, but she is sparking anger, resentment and disgust. That’s not because of her mothering, though. It is because of her narcissism, irresponsibility, and penchant for fantasy. As the financial hardship of these tough economic times impacts ever increasing numbers of families, as more and more parents give up their dreams and desires to provide whatever they can for their children, it is painful to listen to the prattle of an immature, selfish woman and it is almost unbearable to consider that we are paying for her folly.

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I was separated from my husband before my daughter was a year old, and divorced before that calendar year was up. He was not at all involved in her upbringing and that was okay with me, given his habits.

Being a single parent with only one child was difficult enough. Making ends meet, coordinating acceptable child care, still breastfeeding. Fortunately, I was in my 20's and had more energy then.

Perhaps if Suleman had had some younger siblings, she might have had a greater appreciation for the amount of work involved. I was the oldest of six, and most of my friends while growing up were only children, or else lived as if they were.

I don't mean to criticize Suleman's parents for not having more children... but I wish she'd had some kind of Reality Check somewhere along the way.

It is painful just to consider what those 14 children have before them.
It sounds to me as if Suleman is crazy, and actually a contender for having her children removed from her care. I did read that her mother said she is moving out. I don't blame her at all. And it does make a strong case for sterilization. She is not responsible, then she should lose all of her children, and not be able to conceive more.
ktm:

"I don't mean to criticize Suleman's parents for not having more children... but I wish she'd had some kind of Reality Check somewhere along the way.

It is painful just to consider what those 14 children have before them."

It is very painful to consider what awaits those 14 children.

I'm not sure that the problem is that Suleman didn't have enough siblings. That could have led to the birth of her first child, but reality should have intruded soon after that.

Her parents do seem like enablers, however. They have already bankrupted themselves to help her, and as well as care for her children.
C Berg:

"It sounds to me as if Suleman is crazy, and actually a contender for having her children removed from her care."

The second does not reliably follow from the first. Simply being crazy or even moderately neglectful does not constitute a reason to remove children from a parent. There must be documented abuse or very serious neglect.

Even if we could take the children away, who could possibly care for them? They'd have to be separated, which would be devastating for the 6 older children, and they'd be deprived of their mother and grandmother, which would probably be even worse.
Who was the Dr. who thought a single mother of 6 is a good candidate for fertility treatment?

When I got pregnant with my 2nd and then my 3rd the first questions my midwife asked me during my first prenatal appointment were how I felt about these pregnancies, how these children would fit into our existing family, and if I felt financially, emotionally and metally ready for the new kids. Wow, don't you wish this woman was asked these BEFORE she paid through the nose for fertility treatments?

Maybe the fertility Dr. would have done this woman much more good signing her up for psychological counseling. I guess he decided that the money he would get for the IVF was much more important than this woman or her existing children...

"First, do no harm."
Karen Crow:

" I guess he decided that the money he would get for the IVF was much more important than this woman or her existing children..."

The story about the doctor makes no sense, either. The doctor that Suleman claims treated her runs one of the poorest rated fertility centers in the country. The clinic reported that it has a pregnancy rate of less that 5%, far below the national average.
Superb. I am pleased to see an article taking this position and doing so in an articulate fashion.
My wife has spent 30 years in a career on the frontlines with children, working in residential treatment centers and public schools now for 17 years. It has always been an extremely low paying career as society has not and does not value the work to the extent that a true living wage can be earned. 2oK after 30 years.
This selfish, narcissistic motherbreeder has now added to the pool of children who will be forgotten mostly, helped briefly and then turned loose on society for the rest of their confused and deficiently nurtured lives to be assisted by bankrupt government programs that cannot and never will be able to meet all their human needs.
I'm glad you wrote this Amy because I get so sputtering mad at this entire non-sense system. Some blogger here wrote recently asking what is wrong with selling her eggs? This is what is wrong. This and every other test tube in-vitro whatever the heck they are called artificial inseminations meant to create children when bazillions go without basic needs. We were childless and many times in our lives some thoughtless person told us how lucky were to not have "had to raise a couple of children". No thought or concern of course ever expressed for why it was like that for us. The reality is that those people had no idea what it was like for us to make a decision early in our lives for my gifted wife to give up the high paying sit in an office careers she might have chosen, so that she could spend a lifetime on the front lines working with the most damaged and neglected children in our society. Kids that she worked with 20 to 30 years ago still find us somehow and try to reconnect.Don't know what it is like to raise a couple children?!?!?! Try raising a couple thousand !
Now it seems that she has a website asking for donations: no shame?

http://www.momlogic.com/2009/02/nadya_suleman_octuplets_mom_starts_website.php

Talk about pouring salt in an open wound, sheesh!
Please, don't speak for me. I am part of "everyone". I for one am neither outraged or encouraging of this action. It's not my body.
alsoknownas:

"the pool of children who will be forgotten mostly, helped briefly and then turned loose on society for the rest of their confused and deficiently nurtured lives to be assisted by bankrupt government programs that cannot and never will be able to meet all their human needs."

Amen.

Suleman's children are the real victims in this situation. They exist merely to fulfill her needs, and she doesn't even consider that it is her responsibility to meet theirs.
Greg Harris:

"It's not my body."

That's a cop out.

Reproductive rights encompasses the right to end a pregnancy. It does not include the right to demand irresponsible medical care. There is no medical justification for implanting six embryos; there's no moral or ethical justification for demanding improper medical care.

Most importantly, there is no moral or ethical justification for having children you cannot support. Just because you "want" to is not a justification. Reproductive rights have nothing to do with it.
Amy, I don't know what to think of Suleman. I'm not outraged, though, at least not at her.

I mean clearly, she's not sane in the pedestrian, man-on-the-street sense. But beyond that, who knows?

Was it shockingly irresponsible of the IVF doctor to create the pregnancy in the first place? I think so. (If I have any vitriol to hand out here, it goes first to the IVF clincial staff.)

The story is just bizarre and depressing.
Ironically, you are required to receive some kind of counseling before terminating a pregnancy, the intensity of it varying with the state in which you live.

Yet, there does not appear to be any kind of similar requirement before receiving fertility treatment (though some centers may offer it). Surely, actually continuing a large multiple pregnancy has more impact than terminating a pregnancy?
Leigh Bailey:

"The story is just bizarre and depressing."

Agreed!
ktm:

"Surely, actually continuing a large multiple pregnancy has more impact than terminating a pregnancy?"

Not according to the religious right.

The counseling requirements that exist (many have been ruled unconstitutional) are a deliberate effort to prevent and discourage abortions. They have absolutely nothing to do with "counseling" as you or I would understand it.
Suleman is guilty of many things, none of them apparently having to do with any laws. That said, all of this is just orgiastic judgementalism. She made some bad choices. No doubt. Her kids will likely suffer. No doubt. But she did it in such a way that not only appears to be legal, it appears to be something that the law should have nothing to do with. There are a few, one news cycle, lessons to be gleaned from this, maybe. Maybe. But this is just piling on at this point and likely to do more harm to the children than is the ostensibly the point of the shocked reaction.
Bill Beck:

"But she did it in such a way that not only appears to be legal, it appears to be something that the law should have nothing to do with."

No, none of it is illegal, but all of it is irresponsible, narcissistic and unethical. That is why people are angry.

It also raises serious issues about whether "welfare" enables and encourages some people to make irresponsible choices. These are real issues that affect us all.
Has anyone considered that this could devolve into a Munchhausen-by-Proxy scenario once the attention has moved away from her? I believe that she did this for solely for attention. If she does not get the desired attention, or if the attention wanes, those children, I fear, are in serious physical danger. The death of one or more would bring the attention back to her. There is no solution to this problem. It has been created by her with the help of her doctor/enablers. It will end badly. It is the gift that will keep on giving for a generation and beyond.
crystalstrand:

"Has anyone considered that this could devolve into a Munchhausen-by-Proxy scenario once the attention has moved away from her?"

Almost anything could happen, but the most likely immediate consequence is just basic neglect of the children. One woman cannot possibly meet the needs of 14 children.
Dr. Fuckwit. Worry about your own kids and your own uterus. Not Rated. Not Appreciated, and I don't agree with anything that comes from your self-righteous pulpit.
Snap:

"Not Appreciated, and I don't agree with anything that comes from your self-righteous pulpit. "

Which tells us about you, and your ability to construct an argument, not about me.
LuluandPhoebe:

"I am having trouble with how the PR firm (hired by the hospital?) seems to be packaging her and the babies."

They must be ready to shoot themselves. She is certainly not taking their advice.

The latest news is that, of course, she has no medical insurance. According to MSNBC:

"Suleman’s spokesman, Mike Furtney, urged understanding.

“I would just ask people to consider her situation and she has been under a tremendous amount of pressure that no one could be prepared for,” Furtney said."

"I don't necessarily believe that the State will take the children away from her, but I think they should seriously consider appointing a guardian at litem for each child because it is quite likely that they will end up in the court system eventually."

I don't think that can legally be done in advance. The threshhold for interfering with parental rights is extremely high.

The saddest thing is, as you say, that the children are the real victims.
I don't know if I am outraged at her or the doctor. Maybe it's both. I am wondering what type of paperwork did she fill-in before having her procedure. I guess money can buy you anything.
The issue of Suleman, a personal conduct issue, says nothing, raises nothing, whatsoever about "Welfare". That is just a way to justify an action that you dont have the courage to advocate otherwise.

Welfare is not about what one deserves, and it has nothing to do with one's judgement, although the need for it may result from judgement, that is beside the point. Welfare is assistance for subsistence. That is all that it is. I dislike defending it because it is sticky, and awful, but the real problems with it are the small minds who seek to attack it based upon the selective actions of a few. It is a reprehensible tactic.

I guarantee you that I could follow you for a day and not only find errors in judgement, I could probably find reasonable suspicion and probable cause for a felony preliminary investigation report. That is the skill of a cop from a big city dept. You as a citizen are making judgement errors and breaking laws all time without knowledge or intent. That intent is usually present in indirect proportion to your wealth and connection. This is more the rule than the exception. This is not to say that you are a criminal. I fully believe that you are not. This is to say that a hyperbolic interest in judging another human for something that is merely, and admittedly, a massive error in judgement, is absurdly huge hubris in the case of the self appointed judge. You may be able to demonstrate that a poor, foolish person has acted in bad judgement. Congratulations. Not exactly a tough accomplishment. You can go further and apply that judgement to others who have not made this act of poor judgement. If you do, shame on you.
Clearly not everyone agrees with you on this one. But, I do.

I am outraged. It is not my body; these are not my children. BUT - I am outraged on behalf of the women who have lost babies at every stage of pregnancy, including full-term; mothers who have lost children of any age; and women who have spent agonizing hours and countless sums on IVF or adoption in an attempt to conceive.
I am outraged for all of the premature babies (crack babies, sick babies, babies holding on for dear life) lining the outside ring of the NICU in Children's Hospital in Washington, DC.

Children deserve more than half a chance to live and to thrive. Besides the monetary issues, the physical issues are seriously life-threatening and the medical care that these kids need will be tremendous, as Dr. Amy points out.

I am outraged that someone who does NOT even know that AFDC (Aid to Families with Dependent Children) = Food Stamps = Welfare has this outrageous sense of entitlement.

And, finally, I am outraged that the media is further enabling this woman and that, guess what, she is getting what she wants - her fifteen minutes of fame & probably a stupid book or TV contract that will validate her insanity.
Dr. Amy I posted how I felt about this before so won't again.

This is about your fourth post on this subject. Consider writing a book.
I just hope someone keeps a close eye on those children. Nadya Suleman seems as if she could be mentally ill. She does not appear to be in touch with reality. When asked what she was going to do for income, she responded that since her disability has run out, she's going to go to school. On my planet, school costs money, it does not provide money.
I don't know, I'm pretty outraged. As someone who has put "trying to conceive" on hold because of a recent job loss, I think it's irresponsible to have children on purpose without have a plan to pay for them. My husband just lost his job in January. We had started trying to conceive in December. Of course the minute he lost his job we started on barrier bc, but I guess according to Suleman not only should I keep on trying to conceive, I should get some Clomid from Canada and hope for multiples. Yeah that makes complete sense- NOT.
Bill Beck:

"the real problems with it are the small minds who seek to attack it based upon the selective actions of a few."

No, the real problem with it, in my judgment, is that a program designed to help those in need has too many loopholes for those who won't take responsibility for themselves.
Easywhitten:

"but those 14 are no worse compared to the 14 million children of illegal immigrants that our medical tax dollars pay for"

In both cases, it is not the fault of the children.

Frankly, though, I have far more sympathy for illegal immigrants. They are just trying to feed their families by working at low wage jobs. This woman has no intention of ever supporting these children. She just assumes that we will do it for her.
Lisa Kern:

"On my planet, school costs money, it does not provide money."

How right you are. Here's what Suleman told NBC:

"In the NBC interview, Suleman said she will go back to California State University, Fullerton in the fall to complete her master’s degree in counseling, and will use student loans to support her children."
lpsrocks:

"Children deserve more than half a chance to live and to thrive."

Absolutely. And they certainly deserve more than to be treated like collectibles. They are people with their own needs; it is appalling that Suleman thinks they exist simply to meet hers.
hollycomesalive:

"As someone who has put "trying to conceive" on hold because of a recent job loss, I think it's irresponsible to have children on purpose without have a plan to pay for them."

What's even worse is that she expects YOU to pay for them.
You are a twat doctor, period. (no pun intended) I am published and have written for Discovery Channel and PBS. You can find me in the Library of Congress and on IDMB, so, yes, I can write, think and most, of all disagree with all of your ranting about running other people's lives. All you can do is diss me by telling me I'm a twit. That is Dr. Twit to you!
I think this post pretty much sums it up. Nadya is a fruit loop. I saw a photo of her from a few years ago and it is very obvious that not all of that disability money went for her IVF treatments. There was some serious I wannabe Angelina work done. Guess that was more important than feeding her kids, oh, that's what the food stamps are for! She even chose Ann Curry to give her first interview to because Ann has been Angelina's favorite journalist.

Apparently she has qualified for permanent disability, two or three of her "existing" kids will be on it permanently, and then the rest of the premature brood get it to the tune of nearly 10k a month! And Kaiser has already sent in paperwork for mediCal to cover the hospital bills well into the high six figures now and will no doubt be in the millions before the last one is released.

All of her children should be made wards of the state. The octups should get adopted out immediately to individual homes. It is doing these children an injustice.

Nadya S. becomes stranger and more frightening mother material the more she reveals about herself.

Well done Dr. Amy. I too have been called a fuckwit by the poster I shall not name; welcome to the club!

Deliberately implanting multiple embryos into one's uterus with an existing brood of six at home is malpractice on the part of the Doctor and certifiably insane on the part of the "mother."
Agreed, this is an appalling case of narcissism, anyone who has grown up with a narcissistic parent will recognise the signs.

I don't have much to do with kids, but I am big on Animal Rescue, people go through much more through checks for adopting animals that people get for having children. No one would allow a single parent to adopt 8 children in one go, the idea is ridiculous. Yet for some, apparently having a litter of them makes it all different.

Also, in Australia couples on IVF are required to have counselling, to enusre they know what they're getting into.
Ablonde:

"Nadya S. becomes stranger and more frightening mother material the more she reveals about herself."

I wonder how long it will be before the publicists will quit in frustration. And how does a woman who can't afford to feed her children afford a publicist?
Blackpaw:

"anyone who has grown up with a narcissistic parent will recognise the signs."

The worst part is that there is apparently nothing we can do about.
Amy, my guess is the publicist is working like a lawyer with a contingency deal. This presents an ethical dilemma of its own: does the publicist get a percentage of the cash/credit card donations AND a percentage of the corporate sponsorship dollars? Likely it's the latter, only because people would have a heart attack if they thought 30% or more of every dollar they send to Nadya will go to her publicist, but who knows..
Dr. Amy, although there are elements you write about that I don't fully agree with on the whole I enjoy your posts as you are an extremely intelligent and thoughtful woman. You're dead-on on the Suleman topic, as you well know, and your contributions here are greatly appreciated.

Now, to Snap: being published doesn't make you intelligent. Lots of morons are published. Hell, Adolf Hitler is published. So that does perfectly nothing for your credentials. While everyone is entitled to their opinion, and a fair percentage supports Suleman and her reckless hobby of making babies she can't provide for, not near so many are quite the asshat that you are. 'Twat doctor'? Really? So all that education and publication and King's English can't help you be any less patently offensive.? Oh, I get it, its a cute play on words, but it doesn't change the fact that you are an insufferable prick.
OK, there are some aspects of in vitro that I am a confused about. Do the doctors that have IVF clinics also have hospital affiliations? In other words, do they operate totally outside of hospital settings?

The reason I ask that is because, let's say there was a surgeon with operating privileges at a hospital who pretty much does whatever surgery a patient requests. As an outlandish example, let's say a patient wants both his kidneys removed because he thinks it would be neat to be on dialysis for the rest of his life and the surgeon removes both kidneys. I would think that would only happen once, since, when the hospital got wind of it, the surgeon would immediately lose his OR privileges.

Also, isn't a fertility doctor still bound by the "first, do no harm" part of their oath? Isn't implanting six embryos doing harm, knowing what we know now about the liklihood that a goodly number of them might "take?" I'm talking here about medical harm. Is a woman pregnant with multiples at greater medical risk than a woman who is only carrying one? I would think so.

I know that life is not fair, but I am wondering about the ethical and legal implications of a clinic creating a massive and complicated medical "case" (in this instance, a woman giving birth to 8 babies) and then dumping her delivery and the care of the babies on a hospital that had nothing to do with creating the pregnancy.
Hang on Dr A. You are for universal healthcare, if I am not mistaken. I'm not as worried as one girl with 8 kids. It's the millions with 3 and no way of supporting them. That adds up.
Do we have any more facts on how the pregnancy was achieved? I was intrigued by your earlier post that fertility drugs were more likely than embryo implantation.
Nahhh. Casey Anthony has Nadia beat by a mile.
The most dismaying part for me is the bad reputation these sorts of cases give to others who are going through fertility treatments. Not everyone struggling to conceive is insane, needy, or ignorant. And please, people, spare me the inevitable "just adopt" comments. Adoption is not like walking into the Animal Shelter and picking the perfect kitty, and it's not for everyone for a variety of reasons. But idots like Suleman make taint everyone else.
Oops, I should have edited that a little more closely before hitting "post". Sorry! I meant that idiots like Suleman make all infertility patients look bad.
Ablonde:

"This presents an ethical dilemma of its own: does the publicist get a percentage of the cash/credit card donations AND a percentage of the corporate sponsorship dollars? Likely it's the latter, only because people would have a heart attack if they thought 30% or more of every dollar they send to Nadya will go to her publicist, but who knows.."

That's a really interesting question. Certainly, if they are working for a monthly fee, they could be paid from the proceeds of personal donations.

I suspect though that they would not work on a contingency fee basis unless they thought that there would be much more money involved than personal donations.
flyover52:

"Do the doctors that have IVF clinics also have hospital affiliations? In other words, do they operate totally outside of hospital settings?"

They may have hospital affiliations, but they do the infertility work in their offices or local surgical centers, which have much fewer regulations than hospitals.

"isn't a fertility doctor still bound by the "first, do no harm" part of their oath?"

Yes. That's why, if that doctor actually implanted 6 embryos, Nadya Suleman is going to sue him for millions of dollars, claiming that she "didn't understand" the risks, and asking that he (and his insurance company) pay for the medical care of the octuplets and any special services they might need.

It's happened many times before. The landmark case is actually a California case. Patty Frustaci had septuplets, four died, and the other three are significantly handicapped. She won a fair amount of money.
jimgalt:

"You are for universal healthcare, if I am not mistaken. I'm not as worried as one girl with 8 kids. It's the millions with 3 and no way of supporting them. That adds up."

You're right. Nadya Suleman is really a poster child for the many women who make irresponsible choices on a relatively smaller scale.
Blackpaw:

"I was intrigued by your earlier post that fertility drugs were more likely than embryo implantation."

It made a lot more sense to me. It's difficult to believe that any doctor would incur the legal risk of implanting so many embryos.
zumalicious:

"Casey Anthony has Nadia beat by a mile."

That's exactly whom I had in mind when I was contemplating most vilified mother.
zenfoodist:

"Not everyone struggling to conceive is insane, needy, or ignorant."

Hardly anyone undertaking advanced fertility treatment is any of those things. Most women who are like Nadya Suleman collect babies the old fashioned way.
One thing I haven't seen anywhere is who paid the Fertility Clinic in the first place to do this procedure. I wouldn't think that Public Assistance paid upfront for this. How did this happen in the first place since she surely didn't have money to pay for this. Do you know who paid for the procedure? Or, am I wrong in thinking that the clinics or Doctors get their money before doing the procedure.
Could we please stop saying "implant" embryos? Embryos are transferred to the uterus during IVF. What you hope for is implantation. It is up to the embryo whether the factors are correct for it to implant.

I've had several embryos transferred during my infertility treatments but only one actually implanted. This may seem like a nuance, but understand that transfer does not equal implantation.
"Could we please stop saying "implant" embryos? Embryos are transferred to the uterus during IVF. What you hope for is implantation. It is up to the embryo whether the factors are correct for it to implant."

Curiously enough, the technique that the doc who supposedly treated Suleman used is actually considered "implantation" instead of "transfer." At least, according to the doc. Here's an excerpt of an interview with him:

Hugo Verhoeven, MD: “Okay. So what are you doing exactly: you are bringing the hysteroscope and you told me before you’re imitating the implantation, so you do not do a transfer, you do an implantation of the embryo. What are you doing?”

Michael N. Kamrava, MD: “Right, exactly. What we do is introduce the hysteroscope, and as you introduce it inside the cervix you can actually see it on a screen. So you can actually guide the tip of the hysteroscope as you go in, so in difficult transfers it has helped actually quite a bit because you will minimise injury to the lining of the uterus as you introduce it because you can see it on the direct visualisation.

Then, as you go in you can see the inside cavity of the uterus expand very nicely so there is very little chance of the instrumentation to damage the inside lining of the uterus because of the expansion and the narrow diameter of the hysteroscope. And then we go all the way up in the top of the uterus in the fundus and then the hysteroscope is already loaded with the embryo, and then we advance the tip of the catheter through the hysteroscope and then go just slightly inside the lining of the endometrium of the uterus and then release the embryo.”
(Source: http://www.obgyn.net/displaytranscript.asp?page=fercenter/interviews_congress-reporting_ASRM2002_Kamrava)

Now, I don't know that the media was actually aware of that. More than likely they were using it ignorantly, as most people don't seem to understand the difference. :-)
"One thing I haven't seen anywhere is who paid the Fertility Clinic in the first place to do this procedure. "

Well, it's been reported that she received "more than $165,000 in disability payments for an on-the-job back injury. The payments made over six years to Nadya Suleman were disclosed Thursday to The Associated Press following a public records request to the Department of Mental Health. The payments were made between 2002 and 2008, during which time the single mother gave birth to most of her six other children."

And: "Asked on NBC how she was able to afford the treatments, Suleman said she had saved money and used some of the more than $165,000 in disability payments she received after being injured in a 1999 riot at a state mental hospital where she worked."

And her mother has said "The truth is that Nadya hasn't worked since she started having her children," Angela, charged, "while Ed and I battled to pay her bills.

"Nadya promised to help me with the bills, but she never has. I lost a house because of it and now I'm struggling to look after her six. We had to put in bunk beds, feed them in shifts and there's children's clothing piled all over the house."

So, it seems to me that the most likely explanation is that she used all (or most) of the disability money for the IVF treatments, instead of using it to provide for the children she already had. Despicable if it's true.
"So, it seems to me that the most likely explanation is that she used all (or most) of the disability money for the IVF treatments, instead of using it to provide for the children she already had. Despicable if it's true. "

An even more despicable use of those funds is for the Angelina-like plastic surgery it appears she had!

Sad story all around - she's living in Fantasyland!
I am a resident of the bankrupt state of California which, with tax payer money, funds the six children of Ms. Suleman , three (3!) of whom get added funding as they as handicapped....the youngest child of Ms. Suleman at home is TWO YEARS OLD. NOW she has EIGHT more.
These are facts, not speculation.
Why is it okay for CBS, NBC, The Today Show, ABC, FOX news, CNN and all of the local California stations, both radio and television, to report and to discuss this case but it is somehow abhorrent for a poster here on Open Salon to do so? I suggest it is because the poster is Dr. Amy Tuteur and that there is a clique of postured antipathy towards her specifically due to her previous posts on Israel and the Palestinians.
I personally have learned more (than I have on the above News sources of radio and TV) from the medical discussion of infertility treatments and its ethics that ensue from Dr. Tuteur's posts...
If one does not want to enter into this discussion nor read Dr. Tuteu's comments or post, then JUST DON'T DO IT! There are posters I no longer bother to read or waste my time on, such as the endless supply of Bi-Polar afflicted whinings and dramas that pose as intellectual discourse much less interested reading material. There is plenty to choose, to read and to discuss...if you don't like this poster or the topic, DON'T WASTE YOUR TIME! That is, unless you wish to mock and deride her personally and make attempts at sarcastic humor ...attempts...sometimes I sense I am reading the comments of some kids in the eighth grade..
Curiously enough, the technique that the doc who supposedly treated Suleman used is actually considered "implantation" instead of "transfer." At least, according to the doc.

Fascinating, Poogles. I've heard of embryo glue, but not this method. Thanks for the information.
Poogles0213:

"And then we go all the way up in the top of the uterus in the fundus and then the hysteroscope is already loaded with the embryo, and then we advance the tip of the catheter through the hysteroscope and then go just slightly inside the lining of the endometrium of the uterus and then release the embryo.”

Wow, I hadn't seen that. Thanks for bringing it to our attention.
Dr. Amy, this is an interesting read! Thank you.
However, I learned more from other OS member's comments. They remind me of one time when I was in a hospital with several women and there was this 50 years old woman who just delivered a baby via IVF. For over 2 hours when I was there, these women could not stop passing judgment on her action. Here, I also notice majority of the female OS members disapproved her decision. I guess it is because you worry about the welfare of those 14 children. I don't have a strong opinion on this octuplets matter, but just when I was just about to agree with you, Mr. Beck's comment reminded me not to jump on the bandwagon without knowing all the facts and circumstances. I thank you even I tend to view that Ms. Suleman's decision was more than just a of brief lapse of good judgment. Now, I am ashamed of myself because I have made the same mistake that I made when I was in that hospital talking about that 50 years old woman. I have so much to learn.
Poogles123, I don't think it's fair to consider what Kamrava does to be "implantation", given that only 5% of the embryos he "implants" actually begin developing into pregnancies. This is crazy-low -- most clinics have pregnancy rates between 30-50% depending on patient population -- which implies that his technique actually worsens the odds that the embryo will develop.

He may be sticking the embryo into the endometrium, but that's a far cry from the embryo attaching itself and beginning to grow. The odds are still vastly in favor that the embryo will die, which is quite the opposite from the popular usage of "implantation" (which implies a degree of certainty that an IVF embryo will become a pregnancy).

In general, IVF embryo transfer is about as reliable as throwing a piece of spaghetti at the wall to see if it sticks. What Kamrava is doing is the equivalent of scotch-taping the spaghetti to the wall instead. It's not a guarantee of pregnancy, far from it.
Also, assuming a 15% likelihood that a given embryo will attach and grow into a pregnancy, the odds of actually conceiving octuplets from an eight-embryo transfer are about 1 in 5 million. I've seen a lot of talk about how this woman deliberately set out to conceive octuplets, and it makes as much sense as saying you deliberately set out to win the lottery. Buying a ticket, or transferring eight embryos, is a necessary-but-not-sufficient condition, and random chance is overwhelmingly the determining factor here.
I'm not outraged. I'm inspired.

I'll be cloning myself 14 times as a showing of solidarity with this remarkable woman.

http://notnadya.blogspot.com/
This story falls under the category of "just because you can does not mean you should" For some people there is no restraint. It seems the mental component that says "what a minute this is a stupid idea" is just missing in some people.

Don't know the women, but her actions have crazy written all over it. I do wonder about the doctors though. Did they just want to see what would happen? Did they try and break a record? Did they think it would be good for business?

The end result is society (locally and collectively) will have to share in the cost of the decisions of what seems to be not very bright people. My concern is the media will fuel this story and people so desperate to make their mark on history will try to top it. What better way than create life with no regard to how are you going to raise these children to adulthood.

Sounds like the gauntlet has been thrown down, so all you mentally challenged would be mothers and fathers start your baby makers. Thanks to science we will soon find out the pressing question of the day. Just how many babies can a uterus hold?

Don't get me wrong, I am not judging those who have prepared for having children and because of the luck of the draw had quintuplets. God bless them and their children. It's the wing-nuts who "just because they can not because they should" keep having children without any regard to the having to having to financially provide for them.
"it is almost unbearable to consider that we are paying for her folly." -- Amy

That seems to happen a lot more than some people would like to admit.
I have a solution, let Rhonda Byrne author of "The Secret" pay for for the Suleman children. While I don't know if Nadya has read the book, she certainly seems to be applying its philosophy in terms of forethought and expectations.

That book sold millions! And how many people jumped on the bandwagon? Rhonda should have more than enough to support that family. Makes more sense for someone like that to pitch in than taxpayers who might have limited their own desired families due to financial planning.
"it is almost unbearable to consider that we are paying for her folly" Yes, it is - and this, this, in a nutshell, is why so many Republicans fear liberal policy makers.
I've been thinking about this ever since the octuplets came on the national radar, and even more as we learn about their delusional mother.

Just this morning, I got my kids ready for school. Two of them. It's Valentine's Day at school today, which means we did valentines for two classes last night. And all week they've been decorating shoe boxes at home. This is a big deal for them. Add in there that the yearly science fair forms are due today (think of a science experiment you can do at home with a variable and measurable data). Fill out the forms. Write two separate checks for $3 each to the science fair committee for cardboard display boards. Homework is also due on Friday. Can I find all the sheets? And weekly reading logs for two classrooms. Who read what on which day? For how many minutes?

None of this is rocket science. It's ordinary parenting for elementary school kids. But multiply that by 14??? These are the kids that will rely on others all the way through, because their mom will not be physically capable of handling it. Science fair experiments at home for 14 kids? New shoes for 14 kids? Weekly homework sheets in several grades for 14 kids? Brownies and cub scouts for 14? Soccer practice? Violin lessons? Trips to the grocery store? All the stuff of ordinary life are either not possible or so difficult to imagine that the mind boggles. These children will grow up dependent on the volunteer services of others at every step. When they're old enough to figure it out, they'll be mortified. Our mom was the idiot who had too many kids, so we have to get free lunch, financial assistance to go on a field trip, clothes from Goodwill, and there will be no one to help them build a science fair board, get their homework done, or be involved in any meaningful way.

I feel so terribly sorry for the children. They didn't ask for this. This woman brings to mind the people who collect 100 cats and get rounded up by their local Humane Society.
This is shameful for many many reasons the primary reason..the children. Clearly this woman is unbalanced and prone to fantasy and that her children are but mere living dolls that she breeds into a bizarre web. I'd like to know what insurance company paid for these procedures when women who have never had a child or want to add to their manageable families cannot afford IVF and their insurance companies refuse to pay? It's mad and at the end of the day we'll end up paying for her and her lot somewhere down the line and she'll dismiss it as her rights. It's people like this that often make me question if we're doomed as a species just waiting to be extinguished by way of the dinosaurs and those before them.
I'm more upset with the doctor than I am with her.
I find everything about octo-mom annoying, selfish and irresponsible. The costs that Californian's paid for the birth could have hired a police officer or teacher or librarian for 20+ years - for a whole career.
Instead of being outraged, I'm wondering what we can learn from this and how we can help these children and their mother.

It's easy to label her mentally ill; she appears pretty coherent from her interview. So, she may be mentally ill, but she's no idiot. She is not completely out of touch with reality. She has plans even if they are dumb ones. I was raised by mentally ill parents; it was interesting! But I'm here and they did a fine job. Lots of people deal with mental illness, not always gracefully. It doesn't make them incompetent.

I think she could be worked with. She at least appears at some level to have concern for her children, more than some people I've seen. If she gets her kicks from being a mom, then it's possible to work with that to help her to become a better mom, as she would respond to praise on her mothering skills when she does get it right.

I think instead of judgment she deserves help (not the publicity she is getting which I think is counterproductive). I also think that we need to look at how to prevent this from happening again. The attention she is getting will only lead to another.
I want to preface this by saying I'm in Europe and I don't know how fertility treatments in the states are managed.

I'm trying to understand how this happened and I just can't wrap my head around what the doctor was doing. For both of my children I had IUI. My doctor monitored me religiously in every aspect possible. Blood was taken so often I was starting to develop track marks on my arms. Daily after I began my injections my ovaries were observed via ultrasound. He told me clearly and with no room for argument that if there were more than three viable eggs he would not move forward with insemination. If I'd had four (not to mention eight) eggs he would have stopped treatment and told me we had to wait.

Both times I got lucky. I had two viable eggs and ended up with one child from each treatment. I'm so grateful that my doctor was as conscientious and able to give me the gift of motherhood.

How did this happen? What kind of fertility specialist would proceed under these circumstances?
she has done it for publicity
so the more we talk about it the better her chances are at making that plan work (and breed far more copy cats then kids even :-0)
very... unfortunate!
Can you use your inside doctor-knowledge to find out the name of the MD who did this procedure?

Since Suleman wants public funds to pay for the babies, would the medical records of the fertilization procedure, including the name of the MD, then have to be made public?
froggy:

"their mom will not be physically capable of handling it. Science fair experiments at home for 14 kids? New shoes for 14 kids? Weekly homework sheets in several grades for 14 kids? Brownies and cub scouts for 14? Soccer practice? Violin lessons? Trips to the grocery store? All the stuff of ordinary life are either not possible or so difficult to imagine that the mind boggles."

It is so sad, and still the mother doesn't have a clue. It's all about her and her needs.
Andi Lee Eames-Peck:

"It's people like this that often make me question if we're doomed as a species just waiting to be extinguished by way of the dinosaurs and those before them."

That's just what my husband says!
The Buzz:

"It's easy to label her mentally ill; she appears pretty coherent from her interview. So, she may be mentally ill, but she's no idiot."

She's not psychotic, but there are other forms of mental illness beyond psychosis.

She's certainly no idiot. She has assumed all along that others will pay for her "needs" and she is right about that.
Ruslan:

"Can you use your inside doctor-knowledge to find out the name of the MD who did this procedure?"

He has already been publicly identified as Dr. Michael Kamrava, a fertility specialist.
One thing that hasn't been mentioned and, as an immigrant, strikes me as almost funny - during our recent Presidential election, Obama was called (gasp) a "socialist" for his health reform pledges. Yes, many Europeans get "free' health care (except they don't because they are taxed on it). The fact that this happens every day in this country seems to have escpaed many Americans. You can give birth to fourteen children, have no visible means of supporting them, be assured of medical care for the many that will need it, and no one is utterint the word "socialism". There is no difference between this situation and the Eurpoean "socialist" systems. Wake up.
I hope we can get past the "being an only child made her do it" line.

Lots of us are walking around feeling just fine about our "only" experience, and not thinking we need to have huge families to make up for it.

To counter the stereotypical rap, see Bill McKibben's book, "Only One." Turns out only children are no more and no less well adjusted than everyone else. The planet though-- that's much better off.

Something else went terribly wrong here.
I think it is even more unbearable that Americans are paying for the folly of war that is killing children in Iraq and bankrupting many families and children's lives in America. I don't agree with what this woman did, far from it, but this argument is specious to me. Paying for 14 children is a mere drop in the bucket to the billions being squandered on such "essential" things as war and harassing law-abiding citizens and taking away their privacy under the guise of Homeland "security."
tanya m:

"I hope we can get past the "being an only child made her do it" line."

Of course being an only child did not make her do it. That's just what she tells herself to justify her immature, selfish choices.
emma peel:

"I don't agree with what this woman did, far from it, but this argument is specious to me."

She has attracted so much attention because she has become the symbol of what many, many women choose to do: to have children and expect others to foot the bill.
Dr. Amy, You disappoint me. You are treating this as not an ethical argument but an economic issue. Who will pay - for these children? Who did pay - for her fertility treatment, for her medical bills, for the children’s treatment, for her family’s ongoing support? Thank you, Bill Beck, for your reasoned defence of the charges against the ‘Welfare’ system. It is not the fault of the welfare system. Welfare did not pay for her treatment, an insurance claim did - in essence, she did (yes, I accept her parents are now bankrupted, etc. but that was their choice.) Please, let everyone take a deep, (not hysterical) breath and try to imagine the reaction if she were wealthy and not a ‘wannabe’ on Food Stamps.... Try to see that these are not financial burdens, these are children!
It should be VERY clear to everyone that Nadia Suleman is a BIG liar. It looks like the motive for having kids was fame/publicity/money. She is very clever and manipulative. (See her old videos with boyfriend, changing statements about EVERYTHING, reality TV show)
Clearly she is NOT fit to raise kids. So her kids should be taken by Child-Services and given for adoption immediately.
After that she is free to do whatever ... reality TV show, Porno,...
Here's a shiny new idea for you sorry people:

LEAVE HER the hell ALONE. Get your own life, stop trying to live through others. It's none of your business, or anyone else's for that matter, what this woman does or why she did it. It can't be undone.

Oh, also "Everyone agrees: we're outraged at Nadya Suleman" Thanks for speaking my mind for me. I'm sure 'everyone' love being included.
Very appropriate banner, Amy, you are kind of an SOB.