by Jamie Schenk DeWitt
Next time you are walking down the street or jogging in the park, notice how many double or even triple strollers there are. I was at the park yesterday with my 21-month-old twin daughters and saw three pairs of twin strollers and one set of triplets!
Based on figures from the American Society for Reproductive Medicine, approximately 30% of couples that undergo ART (Assisted Reproductive Therapy) will give birth to twins versus 1-2 % of spontaneous pregnancies.
Below are two of the reasons why:
1. Fertility drugs that are prescribed to patients encourage the ovaries to release more than one egg during ovulation.
2. During the embryo transfer of an IVF (In vitro fertilization) cycle, doctors often implant more than one embryo in the womb. (Ever since the infamous Octomom debacle fertility doctors have been under fire for implanting more than one embryo, but -- needless to say -- depending on the woman’s age, infertility diagnosis and doctor’s medical evaluation, sometimes it may make sense to implant more than one embryo).
The first consultation that my husband and I had with our fertility doctor he asked us, “How do you feel about having twins?” Spontaneously I responded, “Great! I would love it.” Our physician went on to inform us that there was a greater chance of having multiples when using assisted reproductive methods. Because I was so distraught over not being able to get pregnant naturally it seemed like a blessing to get pregnant with one baby, let alone twins.
8 months after our initial visit with our fertility doctor, I was pregnant with twins. It was one of the most joyous days in my life. After all of the failed treatments, it felt like a miracle that I was pregnant. And since being pregnant with twins put me in the high-risk pregnancy category, I was consumed with staying healthy, and the reality of what it meant both physically and financially to take care of twins after they were born did not faze me right away. Yes, we bought two cribs, two car seats and a double Snap-n-Go stroller (an essential item) in preparation for their arrival. Yet, the notion that we would have to do two of everything at the same time, -- two diapers, two feedings, and two baths – did not hit me until the morning they were born. Literally, my life changed in an instant.
The challenges of their first three months, from trying to figure out how to simultaneously breastfeed two babies, to consoling two hysterically crying infants, to learning how to synchronize their schedules, so I could get some sleep at night were tremendous. I can still remember the first night that I was alone with both of them. The baby nurse and my mom had left to go back to their respective cities and my husband was working late. I had successfully positioned both girls on each breast in the football position for their evening feeding. However, when it came time to give them each a bottle (I had to supplement with formula since I didn’t produce enough milk for two babies) all hell broke out. They were both crying. I couldn’t figure out how to hold both of their heads up at the same time to give them their bottles. It was a disaster. By the time my husband came home, I was bawling.
Needless to say, I ended up figuring out how to manage that situation, but in the process I felt awful. It would take several months of trial and error for me to feel like a “mother of twins.” Taking care of my daughters was the most difficult job that I had ever encountered, but with each new challenge that I conquered, I found my voice as a mother. I learned how to trust myself, rely on the advice of other parents of twins, and use parenting experts in my community. I also drew incredible strength from observing my spectacular girls grow and develop. I was proud of who we were becoming as a family and with this newfound confidence, I never shied away from taking them to the park, classes, play dates or the grocery store by myself, which believe me, felt like quite an accomplishment at the time.
Over the course of the first year I can still clearly remember the comments and looks that I got from other parents or strangers when they would see me out with my twin daughters.
“Wow twins! You’ve got your hands full.”
“Are they twins? So adorable!”
“Twins! Two for the price of one.” (If they only knew how much IVF cost)
“A boy and a girl?”
“Are they identical? Wow, they sure look identical don’t they?”
“You sure have a lot of energy for having two babies.”
“They must keep you on your toes.”
“Agh twins.” (Insert look of desire) “I wanted twins, but I didn’t get so lucky. I only have one baby.”
“Agh twins. How’s that going for you?” (Insert look of terror)
“Two babies. Bet you’re busy.”
“I can’t believe you have twins!”
Dead silence. (Insert look at the babies, then look at me. Enough said.)
“Are you enjoying both of them?”
“So precious!”
“Do you have help?”
“Oh my God – Twins! I could never imagine.”
“She looks so much like you.” (Pointing to the daughter who looks exactly like her father)
“They are so adorable. You must get sick of hearing that? They sure must keep you busy? Okay I’ll leave you alone.”
“A boy and girl? No. Two boys.” (One is dressed in purple and the other in hot pink.)
“You are so lucky and blessed.”
“That’s a lot of work.”
“Do twins run in your family?”
So whether you are taking care of one baby, two or three babies, motherhood is a journey and not a destination. Enjoy the ride because it all goes by so fast! And just realize that if you need fertility treatments, know if you are willing to have a multiple birth, and know all the facts, both medical, emotional, and practically speaking.
Even though we did not plan on having twins when we began our fertility treatments I have learned from my own experience, as well as that of other mother’s of twins that the question of whether or not it is safe to have multiples is one to be taken very seriously. There are tremendous risks to both mother and babies when someone attempts to have a multiple pregnancy and you should make sure that you discuss this in depth with your doctor prior to conception being attempted..
According to the Society for Assisted Reproductive Technology (SART). the objective of infertility treatment should be the birth of a single, healthy child. Multiple gestations, meaning twins or greater, can pose significant health concerns. These include but are not limited to:
- Increased Rates of Miscarriage
- Increased Rates of Fetal Death, Even After Birth
- Cerebral Palsy:
- Increased Levels of Nausea, Heartburn and Vomiting during Pregnancy
- Pre-eclampsia (High Blood Pressure)
- Gestational Diabetes:
- Placenta Previa
- Heart Problems, Including Heart Attack for the Expectant Mother:
- Increased Need for Partial or Complete Bedrest, and Limited Physical Activity:
- Emotional Issues, including the possible need for Mutifetal Reduction
- Increased Rates of Caesarian Section Delivery
- Complications after Birth such as Development Delays or Autism
A sobering, and partial list. It is important to note that not all twin pregnancies are problematic, many like mine, only posed temporary challenges that we as a family were able to overcome. The American Fertility Association will be publishing several significant commentaries on this issue during 2011, as well as a fact sheet and video on elective Single Embryo Transfer, later on this month. In depth information on all aspects of mutliple birth will be covered.
A thirty percent incidence for twins is very high, and the risks you point out are significant. With so many couples having to pay for infertility treatments out of pocket, the costs grow higher still when complications arise: extra medical expenses, along with unplanned lost income for mom.
Couples should investigate hospital indemnity insurance before starting any ART. Many twins are born early and require special care in the hospital. A hospital indemnity policy will cover mom's labor and delivery, and extra benefits for each child requiring special care.
Posted by: Kevin H - Infertility Coverage | 02/01/2011 at 04:53 PM