Random header image... Refresh for more!

Twin Reduction

The problem with doing a sponsored post is that it’s on someone else’s time line.  So that REI post — which I wrote with a happy heart — is sort of thrust between two pieces of heavy, bready posts like some slapped on peanut butter.  And I apologize for jerking you from one serious post into a giveaway and back into a serious post.  Though perhaps your crankiness with me is that I’m taking you away from a happy giveaway post and writing yet another heavy post at all.

A warning that this post will be difficult to read if you have lost a multiple.  It may be difficult to read if you have used selective reduction.  And it totally ruins the end of Harry Potter.  So three heads up that you may want to skip this post if you fall in any of those categories.

You’ve been warned.

The New York Times recently had an article on reducing twins down to a singleton pregnancy.  Like all NYT articles concerning anything related to infertility, adoption, surrogacy, donor gametes, ART, it clearly showed its bias through word choice.  When I read a NYT article about infertility, I use my special decoder ring (don’t you think that Cracker Jacks should make a special NYT infertility article decoder ring that comes in specially marked boxes?) that usually eliminates their agenda so I can look at the information objectively.

And I found that I couldn’t approach this article objectively.

On one hand, I am unequivocally pro-choice.  The decision to terminate any pregnancy should rest with the woman.  I’d take into account the feelings of the not-yet-father and the medical staff, but other than that, I believe the decision needs to rest with the woman; not the government.  I am also widely accepting of reasons for termination.  I trust that few enter into termination lightly.  It’s a hard decision to make, and I believe that if someone tells me that it was the right decision for them, then it was the right decision for them.

On the other hand, I couldn’t read the article without feeling vaguely nauseated, especially as I listened with half-an-ear to my own twins chattering on in the room across the hall.  They had been together the entire day — from sun-up to sun-down — and yet they still need to spend an hour or two talking at night before bed.  I thought about all these children who could have had that experience going through life alone.  About all the parents who very much wanted their twin pregnancies and lost one of the children either prior to birth or soon after.  And perhaps that plays into the reason why I couldn’t look at the article with the same detached stance I bring to all other NYT articles: because I’m just too damn close to the subject matter.

And also worlds away.  I was never scared of a twin pregnancy, never scared to raise twins.

I think that people romanticize twins, both rightfully and wrongly so.  The reality of twinhood or twin parenting is somewhere between the magical relationship you imagine between the two children and the mundane rationalization that people use to point out that twins are just two siblings.

It isn’t the same as any two siblings, at least not from my vantage point.  And their relationship also isn’t this amalgamation of every strange sideshow act smashed into two people.  They don’t have telepathy unless you count the fact that they know each other so well that they often can guess the other person’s wishes or desires.  They don’t have a secret language unless you count the nicknames and shorthand and made-up words that often arise in any close relationship.  They don’t move in tandem or have the exact same feelings about the same things.  They are two very distinct people who happen to have been born at the exact same time and have spent their entire life together — from the instant of their conception to this very moment in time.  They can comfort each other like no other.  They can push each other’s buttons like no other.  And they have a mutual sense of entitlement over each other, recognizing their individuality while also paying tribute to the fact that they are a pair.  Their relationship is like no other that I’ve ever observed or experienced; except within other sets of multiples.

The work associated with twins is also enlarged and reduced by various people, and the truth falls somewhere in the middle.  It is neither an unfathomable amount of work nor is it as easy as what I’ve observed with my friends who had singletons.  It just… is.  You get through the day and you get through another and you figure out how to do things in duplicate.  Until you’ve found your groove with each change, it’s challenging.  But once you find your groove, you figure out how to navigate two children who have the exact same needs at the exact same time.  You figure out shortcuts and tricks.  Most people worry that they won’t be up to the task of raising twins, and yet all those people who thought they couldn’t do it in theory do it in practice once the twins arrive.

We went to see Harry Potter over the weekend.  I had been putting it off both because I didn’t want the series to end and because I had found the end of book seven to be excruciating.  There was just a lot of death.  Even though George and Fred were not my favourite characters, it made me feel physically ill to read about Fred’s death.  It’s a scenario that I can’t mentally go to without making my stomach clench and my heart race.  The film thankfully raced over that part.

Just as Voldemort marked Harry Potter as The Chosen One based on how he understood the prophecy, I think the twin relationship is somewhat marked by how society treats twins.  We tell them they’re special, we make a fuss over them, and therefore, we create these island relationships.  They are reacting somewhat to what they absorb from those around them.

We’ve had many talks about this with the Wolvog and ChickieNob, and we’ve told them that people have a lot of strange ideas about twins, but that is their problem, not ours.  We need to be polite, we need to be respectful, but we don’t need to answer questions such as “who is the good one and who is the bad one?” or “who do you like more — your friends or your twin?” (Feel free to chime in with the bizarrely intrusive questions that your multiples are asked.)  They’ve definitely noticed the attention they garner, and their personalities have been shaped by that accordingly.  How can it not?

Ashleigh Burrows had a great quote in her panel at BlogHer where she pointed out that questions asked usually reveal more about the asker than about the listener.  And I can’t tell you how many times the first question the person asks in regards to the twins and elementary school is if I’ve separated them.  Which to me speaks volumes about the asker — perhaps they feel stifled by a relationship or they can’t wrap their minds around the duality of being an individual who is part of a pair — but regardless, it just goes so far as to point out how we mark twins.

The first question is not how they’re doing with kindergarten or how they’ve adjusted to a long day away from home or how they’re doing with the workload — all questions we’d ask about any individual entering elementary school.  It’s whether or not they are together or apart.  That is what others deem the most important information; the thing to learn first.  How can the twins not absorb that when they hear the question asked; take from it commentary on their relationship?  And in internalizing it, also change their relationship with one another?  I find that it brings my children closer together; almost an us-against-the-world mentality as it would for anyone if those around them acted strangely about their relationship with another person.  United fronts often come out of a perceived attack.

It is difficult to say how much of their relationship comes from the fact that they were in the same womb at the same time and how much of their relationship comes from living life with the other person.  If it’s the time outside of the womb that is special, then reducing a pregnancy from a twin to a singleton shouldn’t impact the living child.  If it’s the time inside of the womb that is special, then wouldn’t all multiple pregnancies that experience a twin loss result in shattered beings? (I’ve seen vanishing twin rates as high as one in eight pregnancies.  That would be a lot of shattered human beings.)  The truth, like all other things related to twinhood, is probably somewhere in the middle.

I cannot imagine the ChickieNob without the Wolvog, and vice versa.  I cannot imagine them not spending an hour before bed quietly talking (or, as it is sometimes, loudly talking).  They separate when they want to separate and they come back together when they want to come back together, often creating figure eights out of their day as they move between their individual wants, the requests of others, and their genuine desire to be together.  I’m sure those figure eights will grow larger as they age, with the desire or need to spend more time apart.  I hope that they never lose that special relationship, that they’re still best friends when they’re in their eighties, complaining over the phone about their respective children or technology today (in my day, we only had iPhones!  And we liked it.  We had to get our Internet connection from wireless transmission!).

I hope they never lose one another.

My special NYT infertility article decoder ring failed me, not giving me enough space to look at the situation objectively.  Because I both sympathized with the women in the article, wanted to support them on their choices.  And I also was frustrated that they based their decision on the mythos of twin parenting: that it is double the work or double the money.  When the truth — as you’ve probably guessed — lies somewhere closer to the middle.  And I would have loved to hear that they spent a lot of time with twin parents before making their decision; observing a day-in-the-life.  But I don’t get that sense.  I get the sense that the decision was based on what people believe about twins, which often lies fairly far from the actual truth.

What were your thoughts on the NYT article on twin reduction?

Thank you to Baby Smiling in Back Seat for sending this to the Prompt-ly list.


1 Kymberli { 08.17.11 at 8:06 am }

I was wondering if you would comment on the article. In truth, I couldn’t even stomach it past page two. I did not read the whole article, and I don’t care to, either.

Like you, I believe that every woman is entitled to her opinions about how she handles her pregnancy. I am staunchly pro-choice. But I just COULD NOT read that article and view the decisions the women made without viewing through my bitter lens of discontent, and I knew I had to put it away because it was making me too angry.

My opinions about the article were affected from two perspectives, and both led me to the same disgust: I have twins after infertility and like you, I can’t imagine one without the other, and more recently as a surrogate, I gave so much of myself just to help intended parents have ONE baby, and they would have considered having twins equatable to winning the lottery TWICE.

I recognize that not all women may feel this way about twins, and as much as I wish they *didn’t* feel like that, I accept it. I’m just too close to the issue to accept it gracefully.

Giving it more consideration now, I think I am more upset with their rationales for reducing more than I am the fact that they reduced at all. Would I feel differently about their decisions if it had been due to medical reasons? Without a doubt.

2 TracyOC { 08.17.11 at 8:21 am }

Long time lurker, first time commenter (I think).

My twins were spontaneous, identical twin girls. One of them died of NEC 12 days after she was born. We wouldn’t have delivered at 32 weeks if they hadn’t been twins. She probably wouldn’t have had the heart defect that set the stage for NEC if she had been a singleton. I know that I could have managed newborn twins–I think most people could. However, after watching my daughter die a horrible death from complications due to prematurity (that was arguably a side effect of a multiple pregnancy) I have to say that I’d support anyone who wanted to reduce a multiple pregnancy. An abortion has got to be better than the suffering she endured.

I recognize that I’m nowhere near impartial on this issue either and that there are a lot of differences between my situation and the situation addressed in the article. But, the elevated risks of a twin pregnancy are real and some outcomes can be devastating. I don’t think that my surviving daughter is a shattered person but I know that I was for at least 2 years (and still am in many ways).

On a lighter note, thanks for taking this issue on and providing an opportunity for thoughtful discussion.

3 Cathy { 08.17.11 at 9:15 am }

That was a tough article to read.

As a mom to twins via IVF, I am actually very vocal about making sure people KNOW the risks of twins prior to undergoing infertility treatments. In general it’s so romanticized, or “two for the price of one!”. In our case it was pretty glossed over with the “twins are usually fine!” and the embryos just weren’t great and there was such a slim chance of pregnancy to begin with – so we transferred two, got pregnant with twins, had a rough pregnancy and long-term issues that we will always question if any of it is from them being twins. When we wanted one more to complete our family – we did single embryo transfers, because we knew the risks, even though we also knew it would probably take longer and be physically worse for me.

And that is where I read that article from. Couples undergoing treatments – and especially in IVF where you have absolute control over how many embryos you use – who later decide “nope, don’t want twins”. I can’t stomach that. Spontaneous twins, identical twins, medical concerns – all that I can find more justification and sympathy for. But I cannot support the reduction of twins just because “we only want one” when they signed the consent form and underwent the procedure full well knowing twins were a real chance. And maybe the chances and risks need to be discussed more prior to the signing of consent (and I believe they DO) – but by the time you are pregnant with twins via treatments I believe you have already made your choices and should live with them.

4 Callie { 08.17.11 at 9:16 am }

I can’t and won’t read the article, because it hits way too close to home. I have faced this decision and made a choice I never in a million years thought I would make as it challenged everything I thought I believed.

I am currently 28 weeks pregnant with what was an IVF twin pregnancy. When we found out it was twins, I’ll admit my first reaction was one of fear. I already have a medically fragile 17 month old (also from IVF), and the thought of 3 under 2 was daunting. However, we quickly came to embrace the idea.

By 8 weeks into the pregnancy, we knew our Twin B was in trouble but just not to what extent. At 13 weeks, we received a devastating diagnosis – limb body wall complex. This is a horrific array of multi-systemic birth defects that is universally considered lethal. While many of these babies don’t make it to term, many do and die within minutes/hours after births. In other cases, the condition may cause very early premature labor, which would pose a significant risk to our healthy Twin A.

After tears, soul searching, prayers, and more tears, we decided that our best decision as parents for all of our children (born and unborn) was to selectively reduce. Twin B had virtually no chance and life and continuing the pregnancy would put Twin A at high risk of severe medical conditions he would otherwise not have faced.

The day of the procedure was excruciating. While our little Baby B had no opportunity for life, at that moment – 15 weeks into my pregnancy, he or she was still living in my womb. To know that that would cease to be in the case after a medical procedure lasting less than 60 seconds haunts me still.

I have 2 friends who have twins, and I have been unable to spend time with them since our choice/loss. I know that is unfair, but I can’t bear to see the connection between those children and know that my remaining twin will never know that outside the womb.

Before our experience, I would have jumped to a judgy place. I am ashamed of that now. What I have learned from this besides the depth of grief one can have from losing something you’ve never seen, held, or even felt, is a reinforcement of what I’ve realized more and more as I grow as a parent. That judging other’s parenting decisions (before or after birth) is a dangerous activity. There is always a story, a reason, and a why behind every decision, and mine is not to judge.

Thanks for bringing this issue to light in such a compassionate way.

5 Alexa { 08.17.11 at 9:17 am }

I couldn’t finish the article. And yes, you were right to warn me, this was a hard post, too. I wonder all the time how Simone will feel when she hears about Ames, and about how being a twin for more than 22 weeks affected her. I know that my grief over the loss of one of my twins was complicated partly because it was a twin, and my preoccupation with my survivor meant that it was years before the full force of it hit me. As you might imagine, I swing wildly on the issue of twin termination. I am fervently pro-choice, but just because I think a person should have a right to something doesn’t mean I think that choice is rendered morally neutral. Twin pregnancy does come with risk, more than I think a lot of people realize or want to acknowledge. I don’t know how I feel about any of it.

6 mash { 08.17.11 at 9:25 am }

Oh so interesting! I’m absolutely scared out of my mind of having twins. But then, I’ve realised that I’m also absolutely scared out of my mind of becoming a mother, and am now taking the approach that what will be will be (I went through a stage where I was very certain I would not allow an FS to transfer two embryos).

I’ve realised that you can’t know anything about being a mother to either a singleton or twins until you are there. And therefore all terminations are probably based on false information to some extent. I’m also a big believer in choice, and a friend of mine who was recently considering a termination, got some advice from a psychologist about keeping the child, which I found to be extremely biased and unfair (he told her she would never get over it and would become hardened to the world). She has children and knows what it takes to be a parent, so he zoned in on what she doesn’t know – his opinion on what it’s like to have a termination.

I guess a decision like that is never made from perfect information, and will always be tainted by opinions, our own and others.

7 mash { 08.17.11 at 9:31 am }

Unless of course it’s for medical reasons!

8 SS { 08.17.11 at 9:44 am }

I found the writer established his/her stance, or the prejudice they wanted to relay, but starting the article with Jenny, perhaps the most unsympathetic fertility patient imaginable. Was she actually real or a creation of the author. Her quotes were vile. I don’t know whose stomach doesn’t turn reading about her consumer-designed pregnancy, it was as if she were talking about a laptop almost. I don’t think they presented any cases (prior losses, uterine issues, special needs sibling) where readers could on many levels understand the decision. I am pro-choice, but I found Jenny’s and the army wife’s decisions to be morally wrong. Why did Jenny not to a single transfer? I am not sure how I feel about the lesbian couple. Both partners going through IVF at the same time and transferring two embryos seems like too high a risk. I potentially have a FET in my future, and I would never ever consider transferring more than one embryo. Call me judgmental, but also call the writer’s angle disturbing.

9 Kristin { 08.17.11 at 9:47 am }

I don’t have the twin connection you have but I found it hard to look past the bias in the article and the comments to form a coherent opinion about it.

10 a { 08.17.11 at 9:54 am }

I also don’t know how to feel about this article and couldn’t get past the second page. I believe choice must be available but…wow. This idea floors me. I can’t stop myself from judging someone who thinks there would be a significant difference between 4 children and 5 children because if that’s the case, why didn’t you just stop at 3? I can’t reconcile the view with my life experiences, so I must just put my blinders on and accept that I can’t make other people’s choices for them.

11 Meredith { 08.17.11 at 10:05 am }

It is really moving to read about the relationship between ChickieNob and the Wolvog. The other day I listened to the NPR piece “Learning Your Sister is Someone Else’s Twin” and it was on my mind while I read your post.

Reading the NYT article made me feel strongly that we need to increase the support for parents of premies and children who are medically fragile and/or who have special needs. It’d be even better to increase support for all parents, of course.

12 Searching for Serenity { 08.17.11 at 10:18 am }

I have never been in these people’s shoes, so I have little to add. But I will attempt to mimic Cathy’s comment above.

When we discovered our infertility, I made the conscious choice to not use fertility drugs purely out of fear of getting pregnant with multiples. I have a congenital heart defect and I knew that carrying a multiple pregnancy would put me at great risk. I made this choice despite my overwhelming desire to have a biological family of my own.

Our issue was male factor. So I convinced my husband to go on Clomid (after the urologists suggestion). It is a decision that I believe ultimately helped us conceive our first son. However, I am a complete hypocrite for demanding he do so. However, we know it wouldn’t have had any impact on the number of eggs I released. It is a regret I still live with because we won’t know for many years if it had any long term effects on him.

But I digress. My point is that I knew the risks a multiple pregnancy would have on me BEFORE we started taking aggressive measures. We wanted a family so badly, but we had to keep a level head about at what cost we were willing to make that happen. I knew I would never be able to make the choice of selective reduction and my heart goes out to those who have been faced with such a decision. Even after years of infertility and the recent loss of our second son, I remain pro-choice. But I’m having a very difficult time aggreeing with the choice that family made.

Thank you for triggering this discussion.

13 Lacie { 08.17.11 at 10:20 am }

First, I’d like to hug Tracy and Callie. I am so sorry for your losses.

Second, the article made me mad. I, too, am pro-choice, to a certain extent. I do not and will not ever understand the use of abortion as birth control. I simply cannot wrap my brain around it. I know that there are circumstances where the woman is in an abusive relationship or marriage, for example, and it would be detrimental for her health and safety to become pregnant, yet she’s not able, for whatever reason, to use any form of birth control. I have to believe, however, that this type of example is extreme. I feel that it’s not the norm. The abortions that I know of are direct results of irresponsible behavior. Period.

How this relates to the article is the use of the same logic I apply to semi pro-chioce stance. Twins are a blessing. Can you imagine how you would feel if you were told that you started out life as a twin and your parents CHOSE do stop the beating heart of your twin? I, for one, would be devastated. If you are going to transfer multiple embryos, you might get multiples. There’s risk in the reward and we all go into ART cycles fully aware of the risk.

I, too, am biased. I am writing this through tears. I should be in my third trimester with my twins right now. I miss them every single day. How I wish I was preparing to hold them in my arms and finally welcome them into the world in a few short weeks. I wanted both of them more than I have ever wanted anything in my life. They were so very wanted and loved.

14 Alexis { 08.17.11 at 11:07 am }

The article made me fume (hardly a unique outcome for NYT lifestyle pieces, it must be said).

It cut close to home for different reasons. My husband and I hashed it out before I took that first pill: What were we willing to take on? We discussed it, I thought about what kind of pregnancy I could handle (I had already had a complicated first pregnancy) and I laid it out bluntly for my RE. If I had said, “No, I cannot handle twins,” then I would have had two choices: Save up for IVF with eSET, or give up. I’m not morally opposed to reduction, but it seemed foolhardy to rely on it in advance. The article seemed to ignore that aspect–that multiples are a very real possibility that you have to think about. I just can’t fathom going through 6 years of treatment and never thinking “Gosh, I might get twins, would that be okay?” I know that after a while, you start not believing you can get pregnant, period. But never confronting that possibility at any stage in the process?

I do think that we need more honesty and hard truths; I think money and success rates lead people (REs and patients alike) to be too welcoming of twins and discouraging of eSET. (I realize that it’s not always an option, but I also see it never even being suggested to women who may be excellent candidates.) I see women planning twins, because it’s Instant Family. And it’s just not that easy. I don’t want to seem anti-twins, but it sometimes seems as if they’re treated too casually.

And yes, Jenny was probably the least sympathetic person they could have chosen. “Natural” twins are God’s plan, but her DEIVF one was expendable.

15 Quiet Dreams { 08.17.11 at 11:47 am }

Others have touched on this, but I think that the NYT bias comes out in the people they chose to profile and the quotes from them they chose to use (I couldn’t finish the article, either). Why didn’t they profile someone like Callie? My impression is that whoever decides these things at the NYT has a bias against any medical interventions in pregnancy, against any ART.

16 Alexa { 08.17.11 at 11:58 am }

I meant to note: aside from the personally upsetting subject matter, the other reason I stopped reading the article was this paragraph:

“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.”

To me, this made it clear that this was not an attempt at an objective piece on the issue, because the author does not even MENTION the difference in risk between twin and triplet pregnancies as a possible reason that twin reduction is viewed differently than triplet-and-above reduction, and that seemed so revoltingly disingenuous to omit. I mean come ON. The risk differentials may well be the *primary* source of the disparity of discomfort between HOM reduction and twin reduction, and is certainly a more likely source, especially for doctors, than idealization of the twin relationship. There is also the perception of level of difficulty to contend with, not to mention difference in how “natural” HOM and twins are perceived to be.

17 Melody { 08.17.11 at 12:13 pm }

Before I had my daughter I would have given anything to become pregnant with twins. Like most infertiles, I thought a twofer would be the best possible result of ART. Now that I have what has been, though isn’t so much any longer, a medically challenging 2 1/2 year old, the thought of trying what it takes to get me pregnant again and ending up with twins strikes fear in my heart. I often doubt I could handle just one more child, let alone two. Because I know its highly unlikely I’d become pregnant without fertility drugs and because I’m a lesbian so its expensive no matter how I attempt to conceive, I’m very wary of trying to become pregnant again. If I were to become pregnant with twins, I cannot imagine the on-going emotional agony a selective reduction would cause, but I also cannot imagine maintaining my sometimes tenuous sanity with three children. As much as I’d love to be pregnant and give birth again (would give birth again tomorrow if I had the chance– the most amazing experience of my life!), I’m much more likely to adopt a second child specifically to avoid being faced with that choice. I support the rights of all women to choose how and when they have children, but I ache for any woman who bears the weight of this decision.

18 Sharon { 08.17.11 at 12:45 pm }

This article comes at an interesting time for me, as I am currently 12 weeks pregnant with twins after DE IVF. Although I have been concerned about the higher risk of complications with a twin pregnancy since before our embryo transfer (and continue to think about it from time to time), we never would have considered reducing to a singleton. To me, we knew that twins were a possible outcome (our RE told us 40% of his DE recipients who got pregnant conceived twins) of the procedure we chose, and we were prepared to accept that outcome.

I understand the reasons why many couples choose not to do eSET–chief among them, fear of a failed cycle–but to me, that’s when your choice should be made in this situation. IVF gives you that choice. Once the embryos you chose to transfer become living, growing future human beings, I feel that the choice has already been made.

Oh, and I found it more than a little offensive of “Jenny” to imply that it was OK to reduce one of her fetuses because they were created “in such an artificial manner.” Our fetuses were created in an equally “artificial manner,” and yet we still look forward to the day when they are born into this world, nothing artificial about them.

I might feel differently about reduction if I knew I had a specific health issue which would increase the likelihood of complications, but I personally wouldn’t feel OK with reducing just because I didn’t think I could handle two babies at once.

19 michelle { 08.17.11 at 12:56 pm }

Thanks for writing this. I read the article after seeing a couple of IF blog posts about it. I get home delivery for the Sunday paper only but it usually takes me til Wed to get through it. I haven’t been brave enough to blog about it and in reality, I needed time to sort through my feelings about it.

I, too, am staunchly pro-choice and I am 12w5d with twins from donor-egg IVF so I tried to be aware of the lens in which I read the article. I found the article to be rather biased in the beginning but felt by the end the author balanced it out with her own story about fearing twins but ending it with “And yet the thought of not having any one of them is unbearable now, because they are no longer shadowy fetuses but full-fledged human beings whom I love in a huge and aching way.”

After days of mulling it over, I am concluding that I still support these women’s choices to terminate half of their twin pregnancies. I personally would not and am not doing so but feel that if I support abortion at all, I need to support these women’s choices.

I hope the article will bring awareness to this issue and RE’s will walk through their patients’ risks (as mine did) and make them think through what might happen and have them own up to the outcome afterward. We did not want twins and we were freaked out when both stuck but we immediately joined a local twins group and realized it was completely doable.

Thanks again for writing this!

20 Nicole { 08.17.11 at 12:58 pm }

I want to preface this with I am pro-choice but this doesn’t sit well with me because these women did do ART and in the case of the first one she did DE at 45 and I could understand why at 45 you would be scared to carry a twin pg but at the same time they had a choice of how many embryos to transfer. It seems completely irresponsible that they transfer more than one knowing that they would not or could not carry a twin pg. When we discussed how many to transfer I was willing to accept the consequences. The other part the irks me is that all three of my pg have started as multiples. The first time I lost both twins, the next just one, and my current pregnancy started as triplets and I lost two. These are IVF pregnancies not IUI or natural and there is more control on the outcome. I too was offended that it was rationalized as ok because the pregnancy was “artificial.” There is nothing artificial about my ART baby. She is a valid person just like any other conceived. Perhaps even more so because she was so desperately wanted.

I just hate seeing people throw away what I wish wasn’t taken away from me without my choice.

21 electriclady { 08.17.11 at 1:25 pm }

I was waiting for you to post about this. I read the article with interest because it’s an issue I’ve been thinking about a lot lately. As a woman with unicornuate uterus, whose first pregnancy ended with a healthy baby but was plagued with problems (contractions starting at 14 weeks, bedrest starting at 22 weeks), for whom a twin pregnancy would be very risky; and as an infertile woman who wants another baby, has done 7 medicated IUIs (despite the risk of multiples) in pursuit of that goal, and whose partner is struggling with the philosophical implications of IVF as well as those of reduction–let’s just say that if I were to become pregnant with twins, the issue of reduction would almost certainly be raised.

I would have liked to have heard from women who contemplated twin reduction for medical reasons like mine–where there was both a real risk to the pregnancy, as well as a possibility that it could all turn out fine. I have wrestled with this possibility again and again and I believe that if I got pregnant with twins we would continue the pregnancy, but would reduce HOM. But I don’t know that for sure. If a doctor made a good case to me for reduction, I would take that seriously.

I guess I’m just saying that the Times had the opportunity to explore this more deeply and subtly, but the writer’s choice of anecdotes undermined it.

22 CJ { 08.17.11 at 1:40 pm }

As someone who has failed 5 fresh ivf cycles and is still in the hell that is the infertility roller-coaster, I too, was unable to read the article completely objectively. That being said, I have always considered myself “pro-choice” and truly feel every woman has the right to make these decisions. That being said, I also feel like even though we have the right, it should not be taken lightly. Because we have undergone a fair amount of ivf treatments, there was a cycle when embryos were so slow and they did transfer more than the recommended amount and the doctors had a serious discussion with us about reduction should a higher level multiple pregnancy (triplets or more) ensue. We never got pregnant. However, my husband and I had some serious discussions and were both committed to carrying the babies we would be fortunate enough to get pregnant with therefore we were very careful when determining the number of embryos to be transferred. The issue I was having in this article is the concept of reducing from 2 to 1, especially for reasons such as “I am too old to have twins” or “I already have a child.” What I am more perplexed about is that if someone is using a donor egg (and we are headed there in the spring) as the first person mentioned was, and you KNOW that you want a singleton pregnancy right off of the bat, why would you ever transfer more than one embryo? Your chances with donor are so high… My same concern lies with the same sex couple who transferred 2 embryos to each of them. Yes, the first time resulted in a singleton because one miscarried her twins. But, when going back for a 2nd child, I remain perplexed as to why 4 embryos were transferred yet again. I truly hope the physician counseled on a different recommendation. I guess I get upset because there ARE times when a reduction might be necessary and I am sick for the women (and their partners) that go through so much to get pregnant then have to make the decision out of a medical necessity. But, when people don’t think things through to begin with and then reduce for reasons that were mentioned in the article, it makes me sick as well…. as a previous poster stated, pregnancies from IVF or IUI are NOT ” artificial and I am offended that someone feels that validates terminating a pregnancy. I also fear that an article like this taints the perspectives of those who read it and are unfamiliar with ART.

…alas…perhaps I am still a bit bitter from dealing with this crap for almost 4 years, failing all treatments, and at 31 am trying to accept not having my genetic child….and trying to embrace the idea of donor egg…

23 stephanie { 08.17.11 at 2:38 pm }

Had I only one child and not two, I would have likely answered differently. I would have said that I support the choice to reduce without a second thought. And I would have been correct at the time. Now, however, seeing how my non-twin sons interact, it is hard for me to think about it without a second, third or fourth thought. Terminating a pregnancy is not an easy decision, so I really make no judgment there. It’s an excruciating process. And yet, there is a part of me that says “caveat emptor” – multiples were always a possibility. Can you not find a way to make this work? But I am not in the shoes of the person having to make this decision, so it feels presumptuous of me to say that. I was so desperate for a pregnancy to stick all those years that I would have grown a circus in my uterus and liked it. So maybe I can’t be so objective in this case either. But I’ve always been of the “make lemonade of lemons” mindset and I wonder if this plays a role in how I would proceed.

24 Esperanza { 08.17.11 at 3:20 pm }

I read the article too and being staunchly pro-choice, I was trying to figure out what bothered me so much about it – definitely the cavalier attitude that most of the people interviewed seemed to have. I realize that they only chose people who did selective reduction for non-medical reasons because that was the point, that it is available to people without medical necessity and that we are more judgmental of that than we are selective reduction for the safety of the mother or other baby. But they obviously could have found someone for whom it was a difficult and heart wrenching decision. That didn’t seem to be the case for any of them, the most reason they seemed to have to be upset was judgment from the outside world.

I have to admit, I used to think having twins wouldn’t be such a big deal but after having my daughter I think differently. It’s not that I don’t think I could handle it as a mother but I truly doubt my relationship could handle it. We’ve had a rough time getting through this first year and as a couple I think twins might have broken us. I’m not surprised that so many more marriages with multiples end in divorce than marriages without them.

We’d also be in very rough shape financially and while it might not be twice as much to have two babies at once, it would come pretty close, especially for child care. We would be in seriously debt right now if we’d had two infants at once.

Having said that, even if we found out we were pregnant with spontaneous twins when we start trying again, I don’t think I could terminate one. I just couldn’t do it, even though I know it would put my marriage and my financial stability in jeopardy. I believe that if there is a chance that you can make it work you owe it to your children to at least try. Also, the idea that you are choosing between two just seems so much more upsetting to me. I don’t know. I’m not saying my feelings make sense, but that is how I feel.

Of course if medical situations arouse I would feel 100% differently. Not that it wouldn’t still be hard but it would be so, so different. And I think that is the case for most people, which is why that wasn’t included in the piece. That piece was meant to create outrage and anger. That was the point. Or at least it seemed like the point to me.

25 Infertility Doula { 08.17.11 at 4:48 pm }

What I found fascinating was the language used by most of these women about wanting to be “the best mom” and how having twins would prevent them from being that “best mom.” What have we become? What are these parental standards that we think we need to meet?

As a parent of a singleton, I don’t think I do a better job at motherhood than my fellow moms-of-twins. We all are going to mess up our kids in some fashion. But while parenting, most of us, just truly aim to be the best we can be and in the end that should speak volumes.

I’m expecting my second and worry about how much time I’m going to have for my first while dealing with the newborn stages. Will having to nurse and change constant diapers make me less of a “best mom” to my first? I certainly hope not.

26 Marissa { 08.17.11 at 4:58 pm }

I hated the article, mostly because it’s “bad science”. Heavy on annonymous annecdotes, very light on actual fact. At the end, I was able to conclude that very few doctors will reduce twin to single (and I have to assume that’s when they’re both healthy, right? Because TTTS or other, awful things sometimes require a reduction in order for one, just one, baby to live, since the other will, without a doubt, die, and will very likely take the healthy twin with it.) And that, for the doctors who do, where patients fly in from all over the country, WITHOUT STATING WHETHER IT’S FOR MEDICAL REASONS OR NOT, twin-to-single is less than 15% of the reductions they perform.

I can’t get up in arms. I have read more blogs than seems possible about losing one twin, or about delivering early because of twins, with one or both dying. I’ve read the words of those women who reduce after discovering one twin is incompatible with life. It is HEARTBREAKING.

Are there, maybe, women out there who reduce just for fun? Perhaps. Do I think we should focus on them? Absolutely not. I do not want to give the anti-choice side any more ammunition than they already have, quite frankly. When I think of the people I know who have had 2nd-trimester abortions…they were all, ALL for medical reasons. Same with people reducing pregnancies. I do NOT WANT that right taken away. Will someone make a choice I don’t approve of, because that right exists? Perhaps. Does that come into play for me? No, not at all.

I’m almost 12 weeks pregnant with twins. I am so, so worried my NT scan will show Trisomy 13, or something else incompatible. the thought that I could let one of my babies go is…awful. But the thought that one baby could unwittingly cause the demise of its healthy sibling is something that cannot happen, not if I can prevent it. And because I need this choice to exist, I need that choice to exist for everyone else.

27 Heather { 08.17.11 at 5:12 pm }

What Marissa said.
Seriously Marissa, you nailed my thoughts exactly.

28 Ellen K. { 08.17.11 at 5:13 pm }

My thoughts are pretty much the same as yours, Mel. I’m a mom of twins after IVF and I’m also the sister of identical twins, who are my only siblings. The twin relationship is somewhere between soul mate and sibling. I think it’s rather too much idealized, but there’s no denying that my brothers’ bond is very intense.

I am very strongly pro-choice and am not opposed to selective reduction for higher-order multiples. (I would prefer that patients elect for no more than 3 embryos, ever; that REs exert more authority; and that IUI cycles be extremely well monitored and cancelled to prevent the risk of high-order multiples in the first place.) In cases of twin-to-twin transfusion or similar medical emergencies in twin pregnancies, I can also understand it. But most of the families interviewed in the article had some damned weak reasons and — I usually do not say this — “really should have thought about it beforehand.”

I am the first to acknowledge that a twin pregnancy can be risky, and having twins can be rather expensive and certainly can strain a marriage. It is also a risk factor for PPD, as I well know (although I feel mine had a lot more to do with infertility). HOWEVER… the support network is often larger. Relatives help out more; people are sympathetic and interested. Twin dads generally help out more, and they are often extremely proud of having twins. Also, a lot of twin families do qualify for some assistance or early intervention programming. Most metro areas have twin clubs. You’re not stranded.

I do think there are great psychic implications to twin loss. I know several people who had a stillborn twin or whose twin died early on, and they all say they often feel haunted, and that their parents sometimes looked at them strangely, trying to see someone who wasn’t there. I had forgotten about Fred’s death. That really was upsetting.

So, yeah. Those parents really should have thought about it beforehand.

29 V { 08.17.11 at 6:43 pm }

I also had a hard time with this article. As I am trying to figure out what to do for my next TTC outing, I already knew that I would not be doing a two embryo transfer because I did not want to risk twins. For health, financial and practical reasons I don’t think I could handle it. However, I would not reduce for any reasons other than health. My choice. Now I’m considering IUI and should I end up with twins, I knew the risks, and again, I couldn’t live with myself if I reduced because it was inconvenient.

30 BigP's Heather { 08.17.11 at 6:49 pm }

I didn’t read the article. I’d rather be ignorant of it than to be frustrated (CD1).

I find the twin/school thing interesting because growing up I lived in one school system who refused to let siblings be in the same class. In high school, I moved to a different school district who encouraged twin/siblings (not necessarily twins but if one was being held back a year they could be in class with a younger sibling) to be in the same class. One was a city school and one was a rural school and the differences were intriguing to me, not just this one thing – but several differences.

31 loribeth { 08.17.11 at 9:14 pm }

I read the article, & I agree with just about everything that’s been said so far. I am very much pro-choice, but this does bother me. Makes a good case for ART funding & SETs, I think.

32 JessPond { 08.17.11 at 9:44 pm }

Reduction of twins for anything other than medical reason…tsk tsk. What IS this world coming to? The only thing I was left thinking about most of those women was….how selfish and evil. Perhaps it’s judgey, but…they MADE the choice to transfer more than one embryo, you know? They knew the (reasonably high) twin statistics, or they should have. And then, basically because it’s INCONVENIENT and “not how they wanted their life” they kill one of their children. I’m offended as a mother, a Christian, and a child who has no siblings. Pete’s sake.

I’m intrigued by the twin bond because my non-twin same-age children seem to have many of the same bonds that I observe in twins. They have a language, they are intensely bonded, they rely on each other, they seem to know what the other is thinking and understand each other better than others, etc. I think that the “specialness” that twins are often seen to have is two fold…genetics like any sibling set (after all, many brothers and sisters have a special bond) and then also the sharing of developmental milestones at the same time. Or, at least, that is how it seems from my observation.

I think that the double-baby/child thing is certainly wonderful in many ways, and it’s hard in others (on children and parents). It’s really the best of siblinghood and the worse of siblinghood. However, I would not change what my older two have, even if it meant having the same two children a few years apart. You (and they) make do and survive, and it’s not THAT BAD….and in the end, it’s like all else…there are great parts and not-so-great parts.

33 jjiraffe { 08.17.11 at 9:47 pm }

This post really spoke to me. Maybe it’s because you put into words so eloquently what it is like to be a twins mom. Maybe because you put into words how I feel about my own twins.

And it made me think I have over-complained about my twins and I hope I never scared anyone away from parenting twins.

One thing that comes with being a twins mom is my own status as a quasi-celebrity. My kids’ school, weirdly, has very few twins. So parents are always making comments to me about how hard I have it. I have developed my own sort of stand-up routine with stupid one-liners (“Two for the price of one!” “One pregnancy, two kids, we’re done!” “I’m outnumbered!”) which I really need to take a hard look at.

The truth is I can make a big deal about how hard twins are. And I should re-evaluate that, for many reasons.

34 Kate (Bee In The Bonnet) { 08.17.11 at 10:13 pm }

I want to be all neutral and “oh, everyone has their own great reasons, and who am I to judge!”, etc., but I find it hard as a twin parent to be that way. I feel much like you do, that the truth of twin parenting is somewhere in the middle. I HATE the “I don’t know how you do it!” comments, because while I understand that it’s meant respectfully, it ignores the realities of life. People rise to the occasion that they are presented with. I’m not saying that everyone should glibly accept multiple embryo transfers for no good reason, but at the same time, twin parenting is not as extreme as people think it is. I mean, yes. Of course it is more difficult than a singleton, but it’s also more rewarding than a singleton, so doesn’t that mitigate some of the hardness?

Ugh. Anyhow, yes, that was really bothersome to me in the article, that people seemed to be making the decision from the POV that they simply couldn’t handle it when it appeared that they had no real solid idea of what “it” entailed. I strongly believe in encouraging eSET where appropriate, but I don’t think I could ever advise someone to reduce a twin pregnancy to a singleton, simply because things are difficult sometimes.

That, and I really hated this article, because as it discussed selective reduction, I kept picturing being on the ultrasound table and watching while one of my babies died. I kept getting this image of my Jack with a needle in his heart, injecting poison, and feeling sick to my stomach and on the verge of tears. I seriously want to go wake up my sleeping boys and kiss their faces and smell their heads. I just want to hold them tighter, thinking about how someone could have made a decision that on the surface seems so incredibly wrong to me. (Yes, yes. Her decision. Her rights. Her thoughts. Her situation. Just thinking about it as it applies to my situation is incredibly upsetting.)

35 Baby Smiling In Back Seat { 08.17.11 at 10:29 pm }

You’re welcome for the article, I guess, though I wasn’t entirely happy to share it with Prompt-ly knowing that it would bother many people.

Neither of my REs ever brought up reduction, during drug, injectable, or IVF cycles. Ever. During the cycle that ended up producing my twins, the RE was clearly worried about higher order multiples after my large number of follicles and insane betas, and when he found two on the ultrasound (which he did himself — totally unheard of in that office) he was almost as relieved as we were.

I would have reduced HOMs, but it would have ripped a permanent hole in my heart.

Even though DH and I didn’t want twins, as soon as we knew there were two, we both desperately wanted them both to survive.

I know one person IRL who was carrying twins after a singleton, all from injectables, who told me about her secret wish that one of the twins would die during the pregnancy. She wouldn’t have terminated, but she didn’t want two more. Eventually one of them got very sick and was expected to be stillborn, but lived, and is mostly okay now.

I know someone else IRL who lost one of her DE IVF twins soon after birth because they were so premature. And so many bloggers who have lost one or both. I have always been so aware of the risks with multiples.

Any impulses I had to do selective reduction were about increasing the safety for the remaining babies, not because I didn’t feel like raising multiples (even if I didn’t).

People don’t yet talk directly to my twins much, and certainly don’t ask them questions, but I do get endless comments about Two for the Price of One, or how easy to get it all over with in one shot, or how lucky to get only one pregnancy (I don’t correct random strangers about the miscarriages that preceded that pregnancy), et al. Many people have gotten an earful from me about how risky and hard it can be to bring twins into this world, there is nothing “easy” about a month in the hospital or months before that of bedrest. I don’t get into the part about my twin birth almost killing me.

I also get a lot of comments that people “always wanted twins,” to which I say that I didn’t because if someone really understood the risks involved in bringing twins into this world, they would wish for a singleton.

But oh, how I love having twins now.

36 Jo { 08.17.11 at 10:50 pm }

I read this article (well, the first few pages of it anyway) on the heels of my third IVF miscarriage. Needless to say, it upset me in a visceral way. As others have pointed out, the interviewees seemed almost cavalier in their decisions — the heartbreak that I know that others in this community have felt over their medically-necessary reductions was noticeably absent. And while I am very much pro-choice and do not support anyone’s right to tell a woman what she has to do with her body, I also want to tell every pregnant woman out there considering abortion (whether its a triplet, twin, or singleton) that I am more than happy to raise their baby. This article did nothing for our cause other than continue the stereotypes of those of us using ART as inherently selfish people who put our own wishes and conveniences above that of the natural “order.”

37 What IF? { 08.18.11 at 12:18 am }

As a mom to IVF triplets, I found the NYT article very hard to read. Most parents-to-be of Higher Order Multiples have to face the selective reduction discussion. I’m fiercely pro-choice, but when faced with the selective reduction option myself, I simply couldn’t get past the “potassium chloride to the heart” part. It haunted me to even consider it. I felt obligated to read all I could about SR in order to make the best possible decision for my unborn children, our family, and my health. The most torturous part of facing the SR decision is, “which one would you choose?”

It’s especially difficult not to judge someone who reduces from two healthy fetuses to one for non-medical reasons. The most disturbing part of the article is Jenny’s quote, “If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy…” This quote sums it up for me – somehow, to her mind, ART twins can be reduced more “easily” than spontaneous twins.

38 Chickenpig { 08.18.11 at 8:32 am }

I don’t think anyone should make a decision strictly out of fear. I think it is unfortunate when people avoid IVF because they are afraid of needles, or think it will hurt too much. It is certainly their choice, it’s just a shame. I feel bad when fear dominates any decision.

My clinic is going to show couples starting IVF videos of people who have had twins who ended up in the NICU and lost their babies. They’re doing this so they won’t elect to put back more than one embryo, I guess. I think it is cruel and biased. The truth is, that a twin pregnancy is only marginally more difficult than a singleton pregnancy. It is something to be prepared for, not feared. Not that my husband and I weren’t scared shitless at first, mind you 😉

My twins have experienced moments that are truly freaky, knowing what the other is feeling and whatnot. One time I pinched N’s arm while pushing in his high chair and D pulled back his arm, looked at me reproachfully and said “You hurt us!” among others. They have a very special relationship in so many ways, and I can’t look at them and think about having only one of them. As scared of a twin pregnancy as I was at first, the moment I saw two beating hearts on the ultrasound screen my greatest fear was that I would lose one. I’m as pro choice as I can be, but this issue is close to home. All I can say is I wish people lived with less fear.

39 Shannon { 08.18.11 at 10:57 am }

Callie posted one of the most eloquent comments I could have hoped to read on this one. There are many stories and many people’s feelings behind the stories. We don’t see those “behind the scenes” stories, even if they’re there.

I have IVF twins. It was my fifth and final try. I had a horrible cycle that produced just two (in the doctor’s words) “very average” embryos. My clinic is fiercely against multiple births and does everything they can to produce single births do to the complications of multiple births. My multiple-birth loathing doctor even suggested that we put both embryos back, explaining that they would never both take.

And guess what.

There I was with my partner, who supported the IVF route so long as it was always focussed on only having one child. An older man with teenage children, his one biggest fear was having twins. That was to be avoided at all costs. The cost, the medical danger, the issues around multiple births – all of it not of interest, not to mention twice the amount of work having two little ones at once. Let’s have one child, just the one, and then it’s behind us.

There we were, seeing two heartbeats for embryos no one thought would even make it, let alone both of them.

Our moods were not great. Yes, I (finally) might get to be a mum (miscarriage aside, and I’d had two of them in the past). My partner was distraught. The clinic was not happy either. I will admit it here – I phoned two clinics to find out if selective reduction was even possible in England, and in the case of non-medical need, reducing twins to one is not possible.

I can say this and mean it so it’s not just idle “I seem evil but I’m not”- I know I wouldn’t have reduced. I know my partner wouldn’t have wanted me to reduce, either. I was just wheeling my arms around, trying to understand our options. We went into IVF both of us not wanting twins and here I was. The pregnancy was incredibly hard, multiple hospitalisations, preemie births, developmental difficulties. I don’t think people honestly understand how difficult twins can be. A twin birth can be marginally more difficult than a single birth – for some. For others it is honestly a matter of life or death (I have in fact been told that I/future children might not survive another pregnancy due to the permanent changes my body went through due to a twin pregnancy).

I love my twins – both of them, equally – so fiercely that words do not describe it. They are the best part of my world and I cannot put into this comment box how grateful I am for them, how deeply I (and their father) love them, how wonderful it is having them. But I remember those early days of fear.

There’s always a background. We don’t know the background. But sometimes, we need to not judge. There is always more to the story than we know.

40 Cece { 08.18.11 at 10:58 am }

As a mom who lost a twin shortly after birth, I couldn’t even bring myself to read the article. I had a 3 month old when I found out I was pregnant with twins. So yes, I had huge moments of freaking out during my pregancy. But when they arrived? I knew I could handle it. That night nora died? When I walked away to go to sleep? I felt pike Aaron and I had it totally under control. And then our world got turned upside down. But. What I do have is two children 11 months apart, and man do they love each other. No one can make Maggie smile like her brother. Cam is always looking for ‘Mags’. I live it that they have that relationship, and it kills me that Nora is missing from the equation. I do acknowledge that our life is very very very different with two kids than it would have been with three – but it asnt a choice I was willing to make on my own. The fates decided it for me.

41 Cece { 08.18.11 at 11:11 am }

Sigh. Sorry for all the typos – commenting from my iPhone.

42 Susannah Fox { 08.18.11 at 11:41 am }

Thank you, Mel, for writing this post and hosting this discussion. I read the NYT story quickly – the only way I could stand to get through it – looking for the details described here and hoping that you’d write about it. I look to blogs like yours to truly understand an issue like this.

What do you think of the 500 (so far) reader comments attached to the online version of the article? Some of them hit the same marks you target, but others are… how to put it? Read them quickly – and only with your blast shield down.

43 Suebob { 08.18.11 at 1:03 pm }

The comments here make one thing clear: this is a very personal decision that needs to be made my the woman in consultation with her partner and doctor. No one else should be able to decide or judge what is right because there are so many nuances.

44 Catherine W { 08.19.11 at 5:52 am }

Really interesting post, original article and comments.

I think I feel very similarly to TracyOC. I fell pregnant with spontaneous, fraternal twin girls. Sadly, they were born extremely prematurely at 23 weeks (which is actually before the legal limit for termination here in the UK) but both babies were resuscitated and transferred to the NICU. One of my daughters died there, the other remained there for four months, followed by five months of home oxygen. And obviously she ran all the very real, attendant risks of severe disability resulting from her premature birth. One of the causes of death listed on my daughter’s birth certificate is ‘twin pregnancy’ and having seen the suffering that both my daughters went through, purely and simply because they happened to be twins, I don’t think I could ever condemn anyone for choosing to reduce a multiple pregnancy. Not something I think I would contemplate myself but I am highly unlikely to fall pregnant with twins again.

I think the risks are often glossed over. In my case, what I thought was an amazing blessing, turns out to have nearly broken my entire family and, nearly three years and one healthy, singleton pregnancy later, we are all still in recovery. I know that I will grieve for my daughter for the rest of my life and feel sad and guilty that my surviving little girl’s early months were full of so much pain and isolation.

Chickenpig – I’m sorry but I would have to disagree with you. I think that what your clinic is proposing to do is actually a good idea. I don’t think it is cruel, it is realistic. NICU and the loss of one or both twins is a very real and possible outcome much as we would all like to believe that it isn’t. It is wonderful when it works out well but the fallout when it doesn’t leaves permanent damage and I wouldn’t want anyone to embark on a pathway that may lead to a multiple pregnancy without the knowledge that they don’t always result in multiple, living babies and that the NICU is not a pleasant place for anyone to be in. Not to frighten them, certainly not into something as drastic as selective reduction, just to let them know that sometimes it doesn’t quite work out as you hope or expect it to.

45 Chickenpig { 08.19.11 at 9:48 am }

Listing a twin pregnancy as your reason for a premature birth I think is irresponsible. Again with the fear. My husband and I are both surrounded by people, elderly people, who had twins spontaneously and brought healthy twins to term in the days before ultrasounds and fetal medical specialists. My husbands boss, my boss, two of my co workers, two of our neighbors, the list goes on and on. I don’t know if there is something in the water here, but there were a lot of twins going on in the 40’s and 50’s. One of my co workers even had an X ray of her twins, both born healthy.

I think the risks are exaggerated. Here in the IF population where women are already older than the rest of the population, or have health factors that affect IF AND a healthy outcome the numbers are a little stilted perhaps, but if you really look at the stats there is NO reason on Gods green Earth that a healthy woman can’t bring twins to term. I have no problem with the RE telling people about the risks involved with a multiple pregnancy, but having a twin pregnancy is not the cause of most of these premature births in the IF community, IF diseases and advanced maternal age ARE. Without being able to separate causality it is irresponsible to frighten these people. If they are going to scare the bejeezus out of people, than they should also show the flip side, which is actually a MAJORITY of the twin pregnancy stories. All the pictures of healthy twins on the walls of their clinic tell a story for themselves. Being prepared, getting the proper medical care, and being cautious are the way to be. Being scared and ignorant is not.

46 Catherine W { 08.19.11 at 2:18 pm }

Chickenpig – I’m sorry that you felt my comment was irresponsible and I hope I didn’t offend you. The neonatologist did list ‘twin pregnancy’ on my daughter’s death certificate and I can only work with what the medical professionals involved have told me not being medically trained myself!

I suppose I would include what your clinic is trying to do under the ‘being cautious’ umbrella. I don’t know what went wrong in my case but I couldn’t carry twins to term despite being in my twenties, healthy and able to carry a single baby to term. It’s a complicated issue and I’m sorry if you felt my comment was scared and ignorant. It’s just the way I see things after my own experience.

47 Myndi { 08.29.11 at 1:36 am }

I’ve always been a pretty sensitive person, and am infinitely more so since the babies were born. Recently, I decided I’m not reading anymore articles about SAHM vs. breadwinner or BF’ing vs. formula because I just take it too personally. It hits too close to home. As I began to read the 1st page of this article, I felt that nasty feeling rising up once again and reminded myself that I don’t have to read it all, in fact, I don’t have to read any of it. Maybe when the babies are a little older it won’t all feel so personal.

All I can say is, from a health perspective, with multiples, it’s all a gamble. You just don’t know what’s going to happen. When we found out we were having triplets, we knew what the risks were, but we opted to face them. I had a hard time with the pregnancy (understatement), but I made it to 34 weeks and gave birth to 3 healthy babies that came home in less than 2 weeks. There were some mom’s in my multiples group that were carrying twins and didn’t make it as far or go home as quickly. During my stay(s) in the hospital, which totaled roughly 6 weeks, I roomed with singleton mom’s whose waters broke at 23 weeks, another whose baby died at birth, and various other mom’s with issues…none of whom were carrying multiples. We all know from our exposure to the IF community what kind of horrors might await us. But we also know that miracles can happen. I don’t think there is a wrong or right answer. We did what was right for us, and we walked away from the table ahead. We were lucky. I completely understand not wanting to take that risk, especially when you’ve worked so hard to build your family.

As far as raising multiples, I’m only 9.5 months in, but I’m a SAHM with no outside help, and I’m doing it. It isn’t easy, but like you said, you find a groove and it works. Things change as they change, so you have to be adaptable, and there really is no such thing as a slow day, but you do the best you can and you love your children. Maybe it isn’t for everybody…but I didn’t know if I could do it, and here I am…doing it every day.

In the end, it isn’t anyone’s business why you choose to reduce or even IF you choose to reduce. I’m totally pro-choice. But the idea that such a decision would be made on a misinterpretation regarding the realities of raising multiples makes me kind of sad.

(c) 2006 Melissa S. Ford
The contents of this website are protected by applicable copyright laws. All rights are reserved by the author