Selective Reduction: A Painful Choice

Maureen Doolan Boyle, the executive director of MOST, said would-be parents need to make sure they consult the right people and do what's right for their pregnancy in the middle of such emotional upheaval. "These are not unplanned pregnancies," Doolan Boyle said, noting that nearly 90 percent of the people pregnant with more than two had infertility treatment. "There has been a tremendous heartache that has brought them here. The decision is made out of love."

Many of the women who call her are bullied by infertility specialists into reducing their pregnancies to twins, Doolan Boyle said, but those women need to make sure that they're getting their advice from people like perinatalogists who are trained and experienced at dealing with high risk pregnancies. Patients should scrutinize the statistics they are given, she said. For example, Doolan Boyle said,"In the vast majority of triplet pregnancies, it isn't necessary to reduce . . . because the outcome isn't statistically significant." In other words, there's no statistical difference between twin and triplet pregnancies when it comes to positive outcomes, she said. Connie Agnew in the book Twins! concurred, saying, "[T]his is a gray area because the data shows the risk of a triplet compared to a twin pregnancy is not much greater."

For women pregnant with higher order multiples, these are some of the recommendations made by Doolan Boyle and moms who have faced reduction:

• Ask your doctor for objective statistics on the ranges of gestational ages, weights, and health of any higher order multiples that he or she has dealt with.
• Consult at least two or three perinatalogists to assess the likelihood of a successful pregnancy.
• Get an assessment of how healthy the fetuses are and whether it's likely one or more might not make it through the entire pregnancy.
• Call support groups like MOST, The Triplet Connection or Keeping Pace with Multiple Miracles. They will put you in touch with other moms who've been in the same situation.
• Seek counseling through your clergy and mental health professionals. Consult the Center for Loss in Multiple Birth if you believe you need specialized counseling.