Multifetal reduction lowers the number of fetuses in the womb and increases the chance you will have a healthy pregnancy. When my doctors explained the risks of carrying my triplets to term, my husband and I had to make the most difficult decision of our lives. We opted for selective reduction.

By Kristin Diversi
October 09, 2019
Illustration by Kasia Bogdańska

I wasn't sure if I would ever get married or have a long-term partner, but I always knew I wanted babies. After my husband and I got married, it wasn't long before we began trying. But I never imagined how difficult the road would be: I tried to get pregnant for four years without success.

We tried naturally for two years before consulting a fertility specialist. We attempted medically assisted intrauterine insemination (IUI) six times and then, when I was 33, in-vitro fertilization (IVF). Nothing worked. It was a huge loss and a tremendous blow.

If we wanted to have children, we were left with three options: Embryo adoption (adopting embryos already made from a sperm and egg), egg adoption (adopting eggs and using my partner's sperm to fertilize them), or old-fashioned adoption.

This is an incredibly personal choice, and different options are right for different people. But we chose embryo adoption—our baby would not be genetically ours, but I would carry and birth him or her.

We carefully chose our embryos from a selection through our clinic. Our doctor agreed to transfer two, since I had never been pregnant before and my chances of conceiving naturally were practically zero. We signed paperwork acknowledging that the chances of having a singleton (one baby) was between 60-80 percent. Twins were about 40 percent. The chance of having triplets? Less than 2 percent. I felt good about those odds. All in all, our infertility journey cost more than $80,000, but we were only focused on having children.

Pregnancy and our biggest nightmare

On May 20, 2019, I peed on one of many, many sticks. I felt my stomach clench and the blood rush to my head when I saw what I had been dreaming of for years: two pink lines. I practically pounced on my husband, peed stick in hand, and shouted, "It worked!”

We had our first ultrasound at six weeks. To our surprise, we weren't only having one baby, but two. We were thrilled, until a few weeks later, when we went for another ultrasound. This time, the doctor's face fell as the image came up on the monitor: "You've got three in there."

Our excitement quickly turned to fear (not helped by the doctor's reaction). I started to cry. My husband's face turned pale. We knew this was not good news—risky, at best, downright disastrous at worst.

We were immediately referred to a maternal fetal medicine specialist (MFM), a doctor with advanced training in complicated pregnancies. About a week or so later, when I was around nine weeks pregnant and already starting to show, we went to our appointment with the MFM. During the ultrasound, we saw all three of our beautiful babies on the big monitor.

Courtesy of Kristin Diversi

We found out I was carrying a singleton and a set of monochorionic twins—sharing a placenta—with one of the twins already a week behind, growth-wise. We were informed of the slew of risks of trying to carry these three babies to term. Some of them included pre-term labor (likely at around 26-28 weeks), a 40 percent chance of all or some of the babies having birth defects and organ issues, possible lifelong health issues, umbilical cord compression or entanglement, and increased risk of miscarriage or stillbirth.

Our doctor recommended a devastating solution: multifetal, or selective, reduction. And so did the next doctor we saw. And the next. Multifetal reduction lowers the number of fetuses in the womb and increases the chance you will have a healthy continuing pregnancy. It's considered a safe procedure for the mother, and chances of problems for the remaining fetuses or fetus are small. I asked the doctors if it were possible to reduce only one twin and keep the other, but the way our twins had developed, I was told they would both pass.

The news was heartbreaking. So I decided to turn to online forums to share my grief. But I received so much judgement, especially from strangers in online support groups. "How could you think of reducing?" "These are the babies God gave you, they deserve a chance at life." "I knew someone who knew someone once who had the same situation, she didn't reduce, and she was fine."

Ultimately, I placed my faith in science and decided to reduce. 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.

The day of our reduction

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.

The procedure cost us $14,000, an even bigger blow. We spent almost $100,000 to have these babies we so badly wanted. And now we had to pay for them to be reduced? Life felt spectacularly unfair.

Getting ready for our baby

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. As a mother, it was the only choice I had. It was a sacrifice beyond what I thought I was capable of making, but, as parents know, that's part of being a parent.

Maybe the most important part.

Advertisement

Comments

Be the first to comment!