Reducing Twins

As a mom who underwent fertility treatments and ended up with twins, this essay was difficult to read.

The writer is a mother to a three-year-old son, whom she conceived "naturally." She and her husband wanted one more child, and after trying for over a year, began fertility treatments. Neither she nor her husband wanted multiples. They struggled with the responsibilities, time, and finances associated with raising their son, and they knew they could not handle more than one more child. Her husband's insurance policy covered IVF, which the couple wanted to use to transfer just one embryo and decrease the chance for multiples, but in order for the policy to cover IVF, they had to try IUI (intra-uterine insemination) first.

Her IUI resulted in a twin pregnancy. IUIs actually result in more multiples than IVF does, because the number of follicles released by the ovaries cannot be controlled. This is how Kate Gosselin got pregnant with sextuplets, and how most higher order multiples happen.

The writer agonized over her decision, but ultimately elected to travel to a different state where she found a doctor to reduce the pregnancy to a single fetus.

She says this about her decision, "I know it sounds selfish, but I wanted to protect the well-being of the people already in my life — my son, my husband, and, yes, myself."

The author of this piece has been vilified.

"She used fertility treatments, and everyone knows what happens when you do IUI or IVF. You get twins, triplets, or more. Deal with it."

"She went into it knowing the significant possibility for multiples."

"She asked for it"

"Twins are not high-risk. Selective reduction should not have been an option - anywhere."

Here's what I think.

I'm pro-choice. I believe every woman has the right to decide what happens to herself, her body, and her family. As a result, I support this woman's choice, even though it's one I would not have made for myself. Even thought it's one that many, even those who say they are pro-choice, disapprove of. Was her decision selfish? Maybe. But who's going to make the call as to what is or is not a "reason" to have an abortion? She knew she was not capable of raising twins + her older son in a healthy situation. And she made a really difficult decision because of it.

Most women who undergo fertility treatments do not want multiples. We want the singleton our best friend, neighbor, co-worker, and cashier at the grocery store got pregnant with after a few months of trying, or no trying at all. While we may say, "hell, after two years of trying, I'll take however many I can get," we don't really mean this. We may be infertile, but that doesn't mean we're Michelle Duggar. Twins and triplets scare the shit out of us too.


But on an even more personal level, I give the writer a great deal of credit for taking into consideration her and her husband's limits, abilities, and their desire to grow their family the way they wanted to, and not the way most other people thought they should. She knew they could not handle twins, for myriad reasons. She knew that to bring two babies into her life would not be healthy for the babies, or for her three-year-old son, not to mention the housing, job, and financial considerations involved in raising three children.

Believe me, I know all too well what this is like. If you read this blog on a regular basis, you know too.

I did not ever consider reducing my pregnancy to one fetus once I found out I was carrying twins, even though I spent the months prior to the pregnancy freaking out over the possibility of multiples. I had always wanted two children. I never wanted more than two. I did not want twins because I had Isabella already. I believe I felt this way because I knew I was not equipped to deal with three children under the age of three. Frankly, I'm not equipped to deal with a 4-year-old and two almost-two-year-olds. A preschooler + high-needs toddler twins is too much for me. Most days, I am on the brink. I feel like a customer service rep at a high-volume call center, meeting one need after another, all day every day.

What defines "too many children" is different for every family. For this woman, a toddler son + newborn twins was too much. For someone else, that kind of family is a breeze. She had every right to have the family that was the ideal one for her, just as women who get abortions because they're single, or in school, or unemployed and living at home with their parents do every day.

In my opinion, to criticize the writer, as many have done, is unfair and it is wrong.

What do you think about her decision?

21 Responses to “Reducing Twins”

  1. # Blogger Rachel

    I really liked your comment and would certainly support a friend who decided to reduce. Before we proceeded with a cycle with 30 follicles we had a long conversation with our RE about SR (including cost and feasibility down South) because we knew that we were not ready to parent high order multiples. Of course, if our insurance covered IVF we would gladly have jumped straight to an eSet.  

  2. # Blogger Mom24

    I completely disagree. I think it's awful. I think you don't know what you're capable of until you do it. I can understand not wanting twins, but if it's what you get, you deal. You may not "want" a child with DS or CP or any number of things, they may stretch you financially, emotionally, in every way, ditto a child with autism or learning disabilities, or even giftedness, but there are no guarantees with having a child.

    At 17, I may have had my moments where I "knew" I was not ready for a child. I would have been wrong. I'd hate to think of what I, and the world, would have missed out on.

    I believe a child is a blessing from God and you rise to the occasion. That's a choice too.  

  3. # Blogger Jesser

    I cannot imagine making this decision and as a purely gut-reaction, it just sounds selfish. I would imagine my own two precious babies and cannot imagine making an arbitrary decision between them. And my head keeps saying "It's just two and they wouldn't be babies forever!" But I have not been there.  

  4. # Anonymous Ness at Drovers Run

    While I personally, could not have made the choice that she did, I would certainly not condemn her for it. I'm always amazed how quickly people judge people like her. This is one of those things that I file (in my brain) under "First World Problem". We get so bombarded down here in SA with things like basic human needs and poverty is IN YOUR FACE all the time, EVERYWHERE you go, that even a simple trip to the grocery store you're faced with it. So being faced with a dilemma like this is a whole new ball game. Like I said earlier, I would not *personally* have made the decision she had, and would have chosen instead to 'deal' purely because I'm probably insane on some level and just assume that I will cope. But again, I say that I will not judge her for her decision particularly since she made a very careful choice, considered her other family members, and I'm sure she didn't take the decision lightly either. In the words of "Addison Montgomery" in Private Practice, "it stays with you forever" and I'm sure this mom knew that.  

  5. # Blogger Melissa

    Wow. It's really hard to say what the right decision is and, like you pointed out, what's right for one family might not be right for another. Some families can handle multiple kids with no problem, but I know having a fourth would push me over the edge. I'm aware of my emotional, mental, and financial limitations, and we took steps to ensure that wouldn't happen. Even though I'm pro-choice, I don't think I, personally, could end a life.

    I can only speculate what I would do in the same situation, and there would be many factors that went in to making my decision. I feel sorry that she was even put in the position of having to reduce, but I can certainly understand others' reactions to it. People are going to have a very strong opinion either way.  

  6. # Anonymous Anonymous

    This topic is hard. Really hard. Having multiples is more difficult than I ever realized and completely different than most people expect.
    I agree with you Kristi, it isn't the choice I would have made but I am glad that this mom had the ability to make that choice.

    I think it is very easy to condemn someone for their decisions if you haven't stood exactly in their place. And really had any one of us stood in the same place as anyone else? I may have twins but I certainly wasn't faced with the same situation as that mother. I couldn't begin to understand her life and reasons, precisely because it is not my life.

    I am strongly pro-choice as I am sure that people need to make the choice that is right for them, and not for me and not for their neighbor but for their family...

    Mom24- yes there are a variety of choices to make "I believe a child is a blessing from God and you rise to the occasion. That's a choice too." but your choice is not the same as someone else's and isn't it our job as humans to show compassion and support of other people's difficult choices? Shouldn't we band together rather than call each other awful?  

  7. # Anonymous Anonymous

    I find it sad that in this circumstance, she didn't adopt a child.

    I'd support either decision (to reduce or not) in higher-order multiples, but twins aren't such a high risk. It's her decision, though, so I wouldn't attack her for it. Not to her face, at any rate. ;)  

  8. # Blogger Veronica

    Because I am staunchly pro-choice, my thoughts on the matter is that it's her choice.

    If you believe in being pro-choice, then it shouldn't matter that she has an older son or that she will have a baby. A choice is a choice and ultimately, it's HER choice and HER body and HER family and HER future.

    I don't believe that just because you want to have children that you should be happy you're going to get 3 or 2 at once. I think most people will accept it, but it wasn't necessarily their choice to have multiples. Acceptance is not the same as making an active choice.

    What I think IS really awful is the flack this woman has received for speaking openly about her choice. I'm glad she has, because I think these options should be considered.

    But no one deserves to hear what she's heard.  

  9. # Anonymous Anonymous

    Seocnd Anon-
    Do you have any idea how much it costs to 'simply' adopt a child? My BFF adopted a beautiful baby girl just to have the mother change her mind 3 days in. The social worker came to the house and took the baby from his arms, and that was after he had paid the reduced adoption fee (there are circumstances where they reduce the fees if you adopt 'unfavorable' children) of $19,000 most of which was legal fees.  

  10. # Anonymous Christine

    What you said. I am firmly pro-choice and think what she did was fine. Really. I don't know if it is what I would do, but I don't think she had any obligation to rise to the occasion. If she and her family weren't ready for twins, then the better that they didn't have them. I applaud people for choosing what is right for them and their family and I wish more people had the guts to do so.  

  11. # Anonymous Stephanie

    I guess I'm in the minority here. Although I fall to the left on most issues, I am pro-life. The original feminist movement was not pro-choice, they saw abortions as harming women. I used to be soooooo pro-choice, but have grown to a different understanding.

    I feel really sorry for that mom. She will probably spend the rest of her days wondering about that other baby. Each time her child has a birthday, she'll think about the empty chair. And that baby never got a chance at life - which is what she was trying to create in the first place. She didn't just kill an embryo or fetus - she killed everything that child could have been. This isn't like going to McDonald's and picking and choosing what to eat, or sending back something because it wasn't exactly what you ordered. This isn't like a case of rape or incest, she went in with eyes wide open about the possibilities.

    It is really, really sad. People who are all "MY BODY MY RIGHTS" fail to see that once your body becomes nurturer and steward to another life, you now have a duty and responsibility to a second life as well. Your life, at least for those nine months, is no longer just yours. It is one of the unique and amazing things about being female. Abortions demean women, they don't empower them.  

  12. # Anonymous Christine

    Stephanie,
    I appreciate the comment and understand what you mean, and yes, she may always wonder what that other life might have meant, but that doesn't mean I don't think she had the right to do what she did. That's the difference. You can be sad about it afterwards, she can regret it, she can choose not to have a reductive procedure; but at the end of the day it should be HER choice. Not mine, not yours, certainly not the government's.

    At the end of the day it's up to adults to make decisions, tough decisions, for themselves. Whether or not you disagree with it.  

  13. # Blogger kenju

    I think anyone who uses IVF and knows that multiples are possible should not seek to reduce the number of fetuses, and I don't think any medical person should agree to do that procedure. I am pro choice also, but I think it is unethical to use this technology to get pregnant and then ask to have one or more of them done away with.  

  14. # Blogger Kristi

    There are some very honest and insightful comments here, on both sides, so thanks everyone for this.

    For those of you who commented and are pro-life, I can obviously see why what this woman chose to do would seem wrong to you.

    For those who are pro-choice and oppose her decision, I have to agree with what Veronica said. Why does it matter how she became pregnant, or why she chose to have the reduction?

    Being pro-choice means you believe every woman should have the right to choose what happens to her body all of the time, right? And even if it's not a choice we would have made for ourselves, ultimately, as a pro-choice woman, we need to support those who do. We start on a slippery slope if we agree with some abortions or reductions, but not others, isn't it?  

  15. # Anonymous Anonymous

    Quite frankly, this is just a mess. Science, biology, shoot, human evolution-has dictated that this couple should have not had children after their first - it is my understanding from the article that they could not get pregnant w/o artificial methods after the first. There is a reason for these things - not a popular opinion I know, but I believe in nature and what it allows to take place...or not. If you are unable to handle, in any way, having children...do not have them. If all you can handle is one more and you've been told that there is even one in a billion chance of having multiples...do not go through the procedure. How selfish can you be? You are creating life and then choosing to destroy it - it is murder in this case, absolutely. I do not know how this couple lives with themselves each day. This story just makes my stomach turn. And if my husband and I had encountered fertility problems, we most definitely would not have sought treatment. It is nature, biology. There is a reason.  

  16. # Blogger Kristi

    To the last "Anonymous" who commented: You do realize that you made your comment on the blog of someone who used fertility treatments to have her three children, don't you?

    While I respect your pro-life beliefs, to say that "there is a reason" and that it is "nature" and "biology" that some couples cannot conceive without assistance is incredibly cruel and insensitive.

    Infertility is a medical problem, and in many cases, a treatable one. If God or the universe made women infertile because there was a "reason," then don't you think he/she would prevent all the pregnancies that end in abortion? Or that God would not have allowed the development of the science that helps infertile women become pregnant?

    Bottom line: infertility is not a punishment from the universe. And you're right. Your opinion is unpopular and, thankfully, rare, at least in my world. Chances are pretty good that someone you know and love is suffering from infertility, whether you know it or not. I hope she doesn't turn to you for comfort.  

  17. # Blogger kimberly

    so, the topic is intersting and i am glad i had the chance to be exposed to it. i think i feel similarly to you. not a decision i would make, but glad the article's author considered her own abilities and made what she felt was the best choice. i'm not sure why kids at risk to be un or undercared for are a good alternative. mostly, though, i'm commenting because you so directly and poignantly stated what i have been mulling over for weeks now, about how frazzled and underequipped i feel. i have a 26 month old son and 3 month old twins. i love my children, but wow. it's SO hard and i definately feel underequipped. thank you.  

  18. # Blogger Kristi

    Kimberly-I was once exactly where you are now. When my twins were born (6 weeks early), my older daughter was 25.5 months old. It was beyond difficult at that time, to a degree I never imagined possible. If you want to read some true "in the trenches" posts, check out my archives from the fall of 2008.

    But yes, I agree with you. This writer knew her limits (in a way I really did not, I must say), and made the best decision she could for herself, her husband, and their older son. Did I make the same choice? Obviously not. But that doesn't meant I can't support her right to make her own choice. Thanks for posting.  

  19. # Anonymous Kell

    To the final Anon-
    Your comments don't make scientific sense. Science actually did dictate that this couple could get pregnant, as did the biology and biochemistry that made it possible. And unless there is some genetic linkage between infertility and maladaptation to our current human environment, evolution has nothing to do with it, and to state that it does shows a lack of basic biological understanding.

    I am with Kristi, I hope no one suffering the pain of infertility turns to you for help, clearly you would make their pain worse. Do you feel the same way about other treatable medical conditions? If you have cancer you weren't 'meant' to survive so we should shut off any research to treat it? Or maybe if you had a car accident you should be left to die in the road because that would be 'natural'. I am glad the God I believe in isn't as judgmental as you are, and isn't God the only one who is supposed to judge?!?!  

  20. # Blogger The Queen B

    Pro-choice does not mean you agree with every choice a woman makes with the outcome of her pregnancy. Pro-choice means you DO agree that a woman has a right to choose what is best for her with the outcome of her pregnancy.

    I certainly would NOT have made the same choice she made. It is NOT something I could live with which is exactly why I am pro-choice. She obviously has peace with her choice, and that choice is between herself and God, not me.

    And, to the last Anon: very very CRUEL and distasteful comment to make on a blog who's writer has experienced infertility. I'm sorry Kristi for that person's comment!  

  21. # Blogger Sarah P.

    To the last Anonymous commenter:

    You wrote, "Quite frankly, this is just a mess. Science, biology, shoot, human evolution-has dictated that this couple should have not had children after their first... There is a reason for these things - not a popular opinion I know, but I believe in nature and what it allows to take place...or not... And if my husband and I had encountered fertility problems, we most definitely would not have sought treatment. It is nature, biology. There is a reason."

    Does this belief extend to all medical advances, such as chemo? If you or your husband, God forbid, were to get cancer, would you also not seek treatment because it's nature, biology, and there is a reason?

    I know that some people do feel this way, and if that is your belief, then I respect it.

    Your opinion, the way you stated it, doesn't leave room for shades of grey. Nature is nature and that's that.  

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