Twins: The Bad and the Ugly. Hold the Good.

At 17 weeks pregnant with twins, I really can't complain (although I do reserve the right to do so later when I can no longer fit behind the wheel of my car and getting up from the couch requires a combination of petroleum jelly and a forklift). I've been feeling well, taking an almost two-mile walk every day that the temperature isn't soaring into the upper 90s, and doing a pretty decent job of ignoring the fact that I have a LOT of preparing to do before the fall rolls around.

And then a friend sends me this article about twins, which has made me simultaneously terrified and royally pissed off.

The author, a mother of twins (born "spontaneously" and not as the result of fertility treatment) rightly describes the challenges of raising twins: the sleepless nights, the very real health problems resulting from premature birth, how even a quick trip to the store with two same-age toddlers can quickly turn into mass chaos, how everything associated with caring for a child requires double the effort. She talks about her isolating post-partum depression following the birth of her sons. Having two babies at once isn't all round, sheer-draped cribs, nursery chandeliers, and beatific well-rested newborns as most of the world sees the "twin phenomenon" depicted in magazines by the recent spate of Hollywood twin mothers. For this part of the article, I respect her candor and her honesty. This kind of writing takes guts.

But here's where things turn South. The majority of her article is spent lamenting the burden twins have placed on Massachusetts, the state with the highest rate of twins in the nation, its hospitals, school districts, and even its sidewalks (twins require massive space-hogging double strollers, of course), and her personal life and budget. I get the "I miss my old life and the former state of my bank account" argument. Truly, I do. But the author seems to find nothing redeeming at all about having twins. It's this part of the essay that really scared me. Will I feel about my twins as she does? I say "no way" now, but the possibility is there nonetheless.

And then she takes IVF to task, and as I began to read this part of her essay, my blood pressure started to rise.

The author, along with several doctors she interviews for her article, advocates single-embryo transfers to reduce the chance for twins, triplets, or more, and to alleviate the myriad and far-reaching potential problems caused by a multiple gestation. Now, in theory, I agree with her. Would I prefer to be pregnant with a singleton right now? Yes. Am I terrified about the potential health problems my babies may have if they're born prematurely, as many twins are? Definitely. Am I worried that we'll have to sell the naming rights of my children to a major corporation (meet my twins: iPhone and Netflix) in order to afford to raise them for the next 18 years? You bet.

But here's my problem with her argument: Massachusetts has the highest rate of twin births in the nation because it has comprehensive and mandated insurance coverage for infertility treatments. I'm lucky in that here in NY, I didn't have to start auctioning off platelets and vital organs for cash until I hit IVF, the cost of which came entirely out of my pocket, but many infertile couples in the nation have to start paying out-of-pocket at the IUI stage. It's quite easy for a Massachusetts resident who would have been afforded the luxury of multiple insurance-paid IVF cycles should she have been unable to conceive naturally to contend that IVF should be restricted to single-embryo transfers.

When I reached the IVF stage, I was afraid of having no babies, not one or two too many. The hubs and I would never have opted for a single-embryo transfer during either one of my IVF cycles, given the enormous cost, and the rigors of injections, drugs, ultrasounds, bloodwork, and procedures involved in a typical cycle. For us, that option was never on the table. And so, now that I'm pregnant with twins, we adapt to the hand we were dealt when we sat down at the table to play. We wanted the best possible chance at one baby, which is also the goal of every fertility doctor working today. Contrary to the author's argument, I believe ethical doctors don't try to create multiple gestations to boost clinic success rates.

And her argument that the "twin problem" in Massachusetts will "overburden our medical and special education systems, and quite possibly require either cuts to other programs or tax increases to help pay for their care" seems callous and cold-hearted. Is the subtext here a message to infertile couples to continue on their gut-wrenching path to parenthood with never-ending single-embryo transfers, instead of boosting their odds with a multiple-embryo transfer, because the author doesn't want higher taxes?

This author makes several valid points in her article. Twins or triplets or more aren't a walk in the park for many, many reasons. I would be lying if I said I wasn't scared at the prospect of having my babies. But while I believe her words were exaggerated to generate interest in her article when she said she "would no more wish multiples on a couple than I would bubonic plague," I think she desperately needs to come to terms with her situation. Yes, it's hard raising twins. Yes, parts of it suck. Yes, health problems are traumatic and awful. And yes, it's expensive.

But doesn't this describe parenting a single baby too?

17 Responses to “Twins: The Bad and the Ugly. Hold the Good.”

  1. # Anonymous Ness

    She likened having twins to having the bubonic plague? Ok not quite - but she seriously said that? She needs psychiatric help. Stat.

    I think that having twins whilst hard (I have no idea, I have never had or been pregnant with twins), is probably one of the most unique and special (and of course hairraising) and down right miraculous things that a mother can go through. Many moms out there with singletons will always wonder what that special gift is like. Including me.  

  2. # Anonymous Lis Garrett

    Multiples or singletons, raising children is difficult (period). I'm really not so sure it matters if you have a toddler and a newborn, two newborns, older children and a newborn (you get my point). Any combination of the number of children and their ages requires adjustment (but you get used to it).

    As for the burden to society, I have issue with those who TRULY cannot afford to have children but continue to do so, and those who have 17 children because it's "God's will."

    I would NEVER agree to a one-embryo transfer either, for the very reasons you state. I imagine a couple suffering infertility needs to feel they've done everything possible to have a healthy baby, and that means transferring as many healthy embryos as you and your doctor deem appropriate.  

  3. # Blogger M

    Interesting post! I, on the contrary, IF (big if) I do IVF again I will only do a single embryo transfer. And it's purely selfish-- I fear twins. Ok..I don't fear the children themselves, I fear my emotional well-being if I were to have twins. Because, seriously, one extremely "easy" baby as everyone has named her-- has been pretty damn tough on me. And I honestly believe if I were to have twins it would put me over the edge. I'm just being real. I lack patience--majorly. And when sleep-deprived I don't even know the meaning of patience.
    However, my insurance does cover IVF. Up to $100,000. Granted, I would never ever want to have to do multiple rounds of those painful injections...but I would if it meant I would just get one baby.
    I can completely see your point of transferring two. We did that our first IVF.
    The twins themselves-- I think it's awesome. I've always been in awe of twins. The fact that some look identical-- the bond they have-- etc-- I love every bit of it! I wish Maddy's twin had made it. (The embryo took...and then stopped developing and resorbed)

    Anyway-- that's my book of the day  

  4. # Blogger Tracey

    Good Lord. I didn't read the article and now I don't really want to! So, essentially, twins are the reason for the breakdown of our society, right?

    Brush it off, hon. Yes, having twins will be hard, but so is having a singleton child. You get used to what you are presented. You're pregnant with TWINS, not high order multiples. This is totally doable.

    You just need extra coffee for the first 2 years...  

  5. # Blogger Marie

    Did you see how she got lambasted in the comments? Interesting that she didn't mention double the hugs, etc. Hope there's positive stuff out there to read too! Fascinating about MA -- didn't know about that.  

  6. # Anonymous Kim

    Congratulations on your twins ! You'll love it - if you have a sense of humor it'll be fine! Seriously - sure it's more work but it is double the fun, double the love, double the mess , double everything - but it's a great roller coaster ride!
    As a mom of twins ( 3yr old boy/girl) I gotta tell you that you're going to get 'opinions' on your pregnancy and what's ahead the whole time - along with a lot of not so intelligent questions -
    Most annoying and most repeated comment ? ' you're going to have your hands full'
    Yup - sounds like the author has a lot of opinions on a lot of things - but it's just one opinion. Make your own!
    You can stop by my site to see mine at http://www.raising-twins.com  

  7. # Blogger Pregnantly Plump

    That poor woman. She was given such a gift, and can only see the negative in it. I'm sure twins are much harder, but also just as rewarding. My dad and his brother are identical twins. To this day they do tons of things together and are the best of friends (they probably wouldn't use that terminology.) I'm sure my grandmother thought it was great that they always had each other and were always there for each other. She tells me she was worn out, but I know she was also extremely happy with her boys.  

  8. # Blogger My Wombinations

    Well, you are going to have your hands full (ha! Sorry, could not resist), but I know mothers of twins and both of them, while exhausted and sometimes stressed, would not trade the fun parts for a singleton birth. No doubt it will be hard, but it will also be manageable. Eventually. Once you have the routine down. The twins I know entertain one another as they get older and both moms have learned to relax and let go of some of the little things.

    Like you, I appreciate this article for its honesty. Any woman who has the guts to be real and to say things that may get her tarred and feathered is always someone I will defend. Brutal honesty is the heart of good writing.

    That said, you make some extremely salient points regarding the IVF portion of the article. It is an angle I had not even considered myself and is very important to consider.

    Hang in there. You are right when you say even a singleton birth is scary as hell. I may not be having twins, but I relate to your fears so well.  

  9. # Blogger Shannon

    she just sounds down on everything... so screw her... because she doesn't seem to be able to see the joy and gift that her children are... but you know what... I would send that story and your review of it to Kate of Jon & Kate + 8 if I was you...  

  10. # Blogger Damselfly

    Yes, it does seem callous and cold-hearted. Every child is a gift; it doesn't matter if s/he comes as a multiple or not.  

  11. # Blogger Chas

    I read this article several days ago when you sent it, and I've been meaning to respond.

    While she did have some valid points in her article, one of the things that bothered me most was that she's not IF herself. I don't particularly want to hear a fertile person spout out a bunch of information about how fertility treatments are costing everyone else so much money and inconvenience, whether it's true or not.

    Most of her points seem to be guided by money. Yes, of course, multiples probably do create a lot more cost at once for insurance companies, which trickles down to the people paying their premiums. But what about people who naturally have five or six children, just not all at once? Does this not end up costing almost as much as a set of twins, if not as much? Should we tell the Mormons, Catholics, and other groups known traditionally for having larger families to screw tradition, they're costing us too much money with all their children? Absolutely not. I doubt anyone would even consider it.

    As for pushing to only transfer one embryo. Ugg...so easy to say for someone whom has never gone through it herself. If there was a guarantee of pregnancy, then sure people would do it. However, speaking from experience, IVF is not a guarantee, and I want the best odds I can get while still being safe. I personally probably wouldn't ever transfer more than two. However, to say that you can just transfer one and then do an FET if that doesn't work, which is kind of what they're saying...well, FETs didn't work for me. I had 8 embryos frozen,all in good shape when frozen, and none of them produced a second baby. After spending nearly $18,000 for the first fresh cycle (including meds) and having so many leftover embryos, I thought we'd be set for a second baby...and it didn't work that way. So, I'd have been extremely upset if my doc has said he was only willing to transfer one embryo with this second fresh cycle. If I lived in Massachusetts or some other state that covers IVF expenses, maybe I'd have different thoughts on this, but I'd think it'd end up costing the state even more money if they start only transferring one embryo at a time. I'd say a lot of couples that end up with twins first probably don't go back for more. If couples have one at a time, I'd think they'd be more willing to go back and do it multiple times...I know I would. So, they can either eat the costs for all of those twins, or they can eat the costs of IVF cycles that might not have ever occurredo\ had they transferred two embryos the first time.

    I'm kind of rambling, which is what I tend to do when something makes me mad. I think what's most important in reading this article is to read the comments. The reactions from other twin moms shows that there really is something very special about twins, and most twin moms do not share the feelings of the article's author. I feel like the article's purpose was to be persuasive, but the only thing it persuaded me to do is to pray that she learns to see more of the bright side of being a mom to twins.  

  12. # Blogger Christine

    Blech to her. Really. Granted I'm not infertile or wouldn't actually know, since I'm not trying...but I'm willing to bet that twins aren't the cause of Massachusett's woes. Frankly, if the idea is: twins = too much money = let's limit IVF; why not take it to its logical extreme which would be that: too many people = too much stress on our states, countries, world = let's just get rid of IVF and maybe impose regulation on how many children one can have or how about who can have children at all.

    What a twit.

    Kids are work. Sure we should all probably have less children in the name of our environments, but who gets to decide this? Our governent? HA!

    I'm going to go hit the bottle of wine downstairs...I hear it calling to me.  

  13. # Blogger Mom24

    Wow! I feel really sorry for her babies. I hope her feelings change, and quickly. Years ago, when we were considering adoption, I read a book about a woman who described herself as DESPARATE for a baby. Yet, when she was presented with the opportunity to adopt a healthy baby, she turned it down. Why? They were twins, and she did not want twins. I've never understood that. I understand being daunted by it, but it's the chance all of us take when we decide to have children, and I would think that most people (artice writer excepted), are happy to have twins once they're here. I know I don't really "know" you, but with what I have learned about you, I can't ever imagine you being like that woman. There's another woman's blog I read who lost her twin pregnancy a few months back, I KNOW she would give anything to trade places with that woman. It drives me crazy when people can't see how lucky they are--until, God forbid, it might be too late.  

  14. # Blogger Five-Browns

    Twins! What a blessing.

    Dont even read crap like that. Here's to an awesome pregnancy and many wonder years ahead!  

  15. # Blogger Jesser

    Ugh. Debbie downers. That's why I don't watch the news ... and to blame twins/IVF for issues like that?? Ridiculous!! How about the people who irresonsibly get pregnant when they don't have the money/maturity to support a kid? Let's talk about them and the burden they place on society.  

  16. # Blogger sher

    What a pill that woman is. I hope her kids never read that when they're older.

    And I loooove the names iPhone and Netflix!  

  17. # Blogger Thalia

    I can see I'm almost the lone dissenter here. What you're not figuring in is that the success rates for single embryo transfers for women under 35 are the same as transferring two embryos in one go - so long as you figure in the frozen cycle if the first single transfer doesn't work. Now I can see that if frozen cycles are expensive and you don't have coverage, that this isn't a helpful statistic, but if you do, there is absolutely no reason to take the risk of having twins - which has a higher toll on your body not to mention the stuff you already know about in terms of the risk to the babies. I do absolutely believe that US doctors are driven to transfer high numbers of embryos because of the way they are judged on success rates - the subsequent frozen cycles are not included in their fresh cycle success rates. This makes no sense for maternal or fetal health, but they do it anyway because it's the highest chance of getting a pregnancy. So don't rail at the suggestion that single embryo transfers are the way to go - they are for women like you who got pregnant on the first IVF try twice in a row - instead rail at the lack of insurance coverage and the way clinics price frozen cycles, and the way clinics are evaluated. If we can get those issues straight, then SETs are absolutely the way to go for women under 35.

    On the other stuff, clearly this woman is suffering from some kind of depression. I can only imagine how tough twins are, but I am equally sure that the rewards are tremendous. I'm often jealous when I see the closeness of the salsa twins, for example.  

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    mother to a daughter
    born in August 2006 following
    IVF and girl/boy twins born in October 2008 following FET. Come along as I document the search for my lost intellect. It's a bumpy ride. Consider yourself warned.

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