The multiple 'epidemic': debating responsibility in US medicine, media and the law

This article examines the medical, legal and social discourses attached to the so-called multiple 'epidemic' in the mid- to late- twentieth-century USA. Such discussions were transformed by the development of the first hormonal remedies for infertility in the early 1960s and the debut of IVF in 1978. These debates, I propose, were shaped by racialised discourses of motherhood on one hand and the market imperatives of US medicine and fertility medicine on the other. These influences coincided to produce a unique emphasis on cost, responsibility and blame in discussions of the multiple 'epidemic'. In the absence of government regulation, a common response in many European countries, doctors and parents assumed unique ethical burdens in managing multiple pregnancies. Following the debut of multifetal pregnancy reduction in the 1980s, these came to include the difficult decision as to whether they should be brought to term at all.