It was the most difficult of many choices I've made as a mother to unborn children. But it was such a lonely and isolating experience without support from others. Multifetal reduction usually happens within the first twelve weeks of pregnancy, but because the doctor we chose was very busy being one of the most highly recommended doctors in the field , we had to wait until thirteen weeks. I had to wait four weeks while knowing all the babies I was growing were not going to ever be mine.
I would never birth them, hold them, nourish them. I would never know them outside of my belly, outside of these tiny movements, their images frozen on an ultrasound.
I felt powerless. I felt like a bad mother. I couldn't get pregnant naturally, and, now, I couldn't even hold a healthy pregnancy. I felt like I had failed. My heart was heavy. We had another ultrasound before the procedure which showed us that one of the twins was still way behind.
The doctor reconfirmed that the twin would never make it, quite possibly risking the other twin and the singleton. Using the ultrasound as a guide, the doctor inserted a needle containing potassium chloride through my belly into the placenta, stopping the twins' hearts.
I cried. One, because it really hurt. Two, because two fetuses died in my womb. Two fetuses I badly wanted, did everything within my power to have, would have done anything for. We had gone through so much to have these babies, and, so quickly, they were gone. And now we had to pay for them to be reduced?
Life felt spectacularly unfair. We were left with one singleton, a baby boy due in January. He is healthy. He is growing. I feel him kicking now, and I am so grateful for his little nudges on my belly. Separating loss and grief from my happiness for my baby boy is one of the hardest things I've ever had to do.
It's one thing to know that this was the right choice; it's quite another to live with the reality of two dead fetuses in your womb. They will eventually be absorbed into my body, which is what usually happens to a deceased fetus after multifetal reduction. But I could not, and would not, risk all of their lives when I knew one could thrive.
So parents often wanted two or more kids ultimately anyway," says Evans. But in , Evans published a paper that overturned his past recommendations, arguing instead for the safety of reducing to singletons, even if the original pregnancy was only twins. We now know that twins are not twice the risk of singletons, they are more like four times the risk.
For instance, there is a 1 in chance of cerebral palsy with a single birth, but 1 in with twins. If you define success of a pregnancy as a healthy baby and a healthy mother, it's safer to reduce to singleton.
Women should be aware that this is a possibility," he says. Though Evans argues that reducing twins is medically justifiable, this procedure remains highly contentious, especially considering that some couples admittedly choose to undergo reductions for personal, not medical reasons. Though the idea of reducing the number of viable fetuses based on personal preference raises hackles among many, proponents argue that if women are allowed to abort pregnancies based on personal preference, they cannot be denied the right to abort only part of a pregnancy.
After her own experience with unexpected multiples, Dr. Ross's concern lies not in the moral questionability of twin reductions, but in the psychological welfare of the couples. There was a way to protect the healthy baby, but it was almost unthinkable. This would kill the sick baby immediately, but it would cut off the vascular connection between the two brothers. On the other hand, if we waited for nature to take its course, it would be too late to save the healthy boy.
Lisa and Nick understood the gravity of the decision. If they chose to forego the surgery, they would lose both babies. No one should face such a choice. Several months later, I delivered Lisa one healthy baby boy and the precious little boy I could not save.
The bill, which already passed in the House, allows exceptions only for the life of the mother, rape or incest. As a fetal-therapy specialist, I have dedicated my career to treating babies with life-threatening conditions in the womb and to restoring hope where it seems lost. Separating twins at birth seems morally disturbing, but perhaps not as disturbing as the other solutions to the problem. The views and opinions expressed on this site are solely those of the original authors.
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