Double Something
by Melissa Ford

This week, the New York Times ran an article about the present-day era of twins and how the run of multiples will peter out as technology becomes more advanced and single-embryo transfers become the preferred choice of reproductive endocrinologists in America as they already are the preferred choice in many clinics overseas.


The author, a parent of twins, touches on the obsession the outside world has with noticing and discussing multiples. The author offers this simple explanation for the abundance of twins in New York City.

Of course, there’s nothing freakish or remarkable about how so many twins came to crowd the preschools of New York City. Older mothers are more prone to throwing off two eggs at once, but they’re also more likely to have trouble conceiving, and opting for in vitro fertilization. (The number of twins nationwide has increased by 65 percent in the past two decades).


Beth Kohl covers a similar thought in her recent book, Embryo Culture. She attends a fertility clinic celebration at the Chicago Botanical Garden. As she enters, a man asks her if a twin convention is taking place that day at the garden and when she answers that it is a fertility clinic event, he responds, "I figured it had to be something like that...I knew this wasn't normal--so many of them."

At first, she too wonders about the number of twins appearing at the event and the recurrence of multiples in the infertility community. But her focus is not on the multiples themselves but on the way the outside world gloms onto the idea of multiples as one of their stereotypical beliefs about fertility treatments.

And all that talk of an epidemic of multiples is, if you ask me, prejudiced. IVFist. You know, a cloaked bias against it or the people who undergo it or the doctors who perform it. As if we choose to have fertility issues! As if having children this way makes them less pure and us, their parents, less worthy or capable. Like the children equivalent of the mail-order bride.

The New York Times article received an interesting response from the twin-parenting community, especially since the author herself does not make any concrete statement about how she feels about the end of this era--though her thoughts are contained within the language she chooses. Instead, she simply comments that the current trend will probably change and how will this fifteen year span of multiple births affect both singletons and multiples down the line. The article is also brief, asking more questions and posing this idea more than it attempts to answer it or provide factual information for the reader to use when forming an opinion. One walks away from the article feeling as if they've had a snack of chips rather than a meal of substance.

As a parent of twins, I was truly of two minds with the idea posed in the article. On one hand, I know too well the health risks and prematurity that can come with a twin gestation. I was still vomiting daily up until the day I delivered--at 33 weeks--twins who were IUGR. One only needs to click through a few blogs on the required reading list below to see the long-term affects prematurity (a very real risk for multiple births) can have on children as well as their parents.

And in the face of that known risk, the idea of multiple births dropping off in recurrence made me worry about the treatment my children would receive as well as feel a strange sadness over what other people would miss out on in terms of the experience of multiples--all risks be damned. Because pregnancy itself is a risk and in my own case, I could have had the same IUGR and prematurity with a singleton birth. It may speak volumes about how people will rationalize risk within their own mind. But, perhaps, I see the benefits of multiples and the joy of multiples outweighing the risks of multiples when taken in context with the risk of any pregnancy.

What were your thoughts, reading the article?

Just a small smattering of my favourite multiples blogs:

Melissa is the author of the infertility and pregnancy loss blog, Stirrup Queens and Sperm Palace Jesters. She keeps a categorized blogroll of over 1100 infertility blogs and writes the daily Lost and Found and Connections Abound, a news source for the infertility blogosphere. Her infertility book is forthcoming from Seal Press in Spring 2009.

Submitted by Melissa Ford (view blog) on Thu, 02/14/2008 - 08:51

Comments

 

Double Something Thoughts

It's true, that you see so many multiples due to fertility treatment - my hospital, for instance, the one my twins were born at. There were 3 other twins delivered that day, and still yet 3 more in the NICU when my son was in there. The fact that this is the hospital closest to the local fertility clinic does not escape notice.

Everyone says they'd love twins, twins would "get the family done in one go", twins would be perfect. I am madly in love with my twins, I think I would go to pieces without them, but I knew it would be hard and it is. They say there are many very real risks in a twin pregnancy alone, and my pregnancy bore that out - pre-eclampsia, infections, hospitalizations, bed rest, then twins at 36 weeks who are behind developmentally, size-wise, and in pretty much every respect.

Looking back, would I put one embryo back or two? You know, when I was pregnant and suffering, before I saw ultrasounds of them moving and got to know who was where inside of me, I'd have said "I wish I'd put one embryo back". Now? I put two, and those two have become my children. It's a tough road, but like you it's one that I am glad I'm in.

My children, on the other hand, are going to get awfully tired of the "Ooooh! Twins!" comments.

Submitted by everydaystranger on Thu, 02/14/2008 - 11:23
 

Family History of Twinning Changes Things

Which would you rather?

Passing one 13 to 15 lb baby or passing 2 7-lb. babies? That's the choice a lot of women in my family have. We have an ungodly twinning rate. Family reunions look like a Fertility Clinic gathering - and, thus far, only one set is from IVF.

The generalizations about twins leading to complications is alarmist and does not serve to help matters. Each person's history is different and it bothers me that such generalizations are thrown around.

Oh, and according to both my grandmothers (both twins), my mother (twin), her cousin (twin with 3 sets of twins), twins are easier to raise once they get past the infant stage. Singletons need more attention. It is actually kind of weird that I have a lower chance of twins because I am doing IVF than most of my family...

MLO / Melissa

Submitted by MLOKnitting on Thu, 02/14/2008 - 11:43
 

ivf twins

Thanks for the mention in your post!!

I may be a little biased, having twins myself, but to me there is nothing more rewarding. Yes, it is the absolute hardest thing I have ever done, but it is also the absolute best thing I have ever done. A multiple pregnancy, while it does have it's risks, does not always involve bedrest and prematurity, I was extremely luck to make it to 38 weeks, and give birth to two 6 pound babies. I think if I had to go back and do it again, I wouldn't change a thing, after waiting so long to have children, I feel so blessed to have two! And if we ever go back for a frozen embryo transfer, I think I would let them transfer two and see what happens.

As for the article, I thought the author was a bit cheeky about the whole thing, I'm not sure how to take it.

Submitted by xavier2001 on Thu, 02/14/2008 - 19:30
 

Fewer Twins Is A Good Thing For Society -
This Isn't About You

Mel, I'm not sure what warrants your worry. The end of the fertility twins era is surely positive without qualification. As you say, the risks of multiple birth are too well documented to necessitate further discussion. In some European countries, single embryo transfer has become law because these societies have made a good choice to try to eliminate the added health care costs that multiple births impose on all of society. (And yes, even if you have health care insurance, we all bear these costs in one form or another but that is a separate discussion.)

You point that pregnancy itself is risky is illogical and kind of dumb. Jumping out of a building is risky too but still, jumping from the third floor is still better than jumping from the sixth. Until we begin decanting babies a la Huxley, we still can't have one without being pregnant (excluding adoption and surrogacy, of course). To return to my original analogy, if the building is on fire and there's no way down the stairs, you have to jump out. But no one is going to argue that you may as well go up to the sixth floor since you’re on the third anyway. "But maybe the benefits outweigh the added risks", you say. But since you have never had the experience of being pregnant with, giving birth to or parenting a singleton, you are in no position to assert that there are any benefits to twins, other than ones that you subjectively believe are inherent in raising twins. This subjective "twins are better" mentality is understandable because you happen to love your children, who happen to be twins. But even a tiny bit of perspective here would inform you that how you feel is not a valid basis for social policy. The fact of the matter is that the majority of women have singletons and are quite happy about it too. They do not sit around lamenting the fact that the pregnancy did not produce a twin.

And your point about worrying about how your children will be treated by society when there are fewer twins is even more inexplicable. The last time I checked twins are not a protected class under Title VII. Unlike certain societies in Africa (read Chinua Achebe) we’ve never left twins to die in the forest. To put it bluntly, since we don’t have a history of twin discrimination, I’m not sure why you feel the need for some type of critical mass to insure the well being of your twins. Furthermore, unlike conditions like Downs Syndrome which are being aborted out of existence, there has been and always will be twins.

The fact that you have twins and enjoy the unique challenges and joys of raising them is lovely. But not everything is about you. As far as the well being of mothers and babies are concerned, taken together with the ever escalating burden of medical costs, society as a whole is unambiguously better off with a natural rate of twinning rather than the glut of twins that infertility treatments has wrought.

Submitted by Sandradginzburg on Fri, 02/15/2008 - 15:46
BlogHer

© Copyright 2009 BlogHer | Terms of Service