Advice about Triplets

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  • Pregnant with triplets -- selective reduction?
    • Childcare cost for triplets
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      Pregnant with triplets -- selective reduction?

      Jan. 2003

      My husband and I recently received the astonishing news that I'm spontaneously pregnant with triplets. This is my second pregnancy, and it came after much deep soul searching over whether or not to try for a second child. We finally concluded that we solidly did want a second, but we're a bit overwhelmed by the abundance of riches of having 4 children (we never planned to have more than 2) and triplets at that. I have several friends who went through IVF and other fertility treatments to conceive; all of those who fertilized triplets had a reduction to twins. I had understood one of the primary reasons for that was significant health risks to all three. We've had several consultations with OBs, Perinatologists and Neonatologists and to my surprise it seems that the only inherent complication to bearing triplets is the increased risk of prematurity, and the gestational risk to me (hypertension, anemia, gestational diabetes)-- not to downplay those risks, but it has really changed my thinking. While I do feel the MDs are trying to present a balanced view of our options, the ''trend'' seems to be that parents in this situation choose selective reduction. I'm wondering if people tend to make this choice because triplets are just so hard? I am strongly pro-choice, but the thought of a reduction is absolutely heart breaking. It has really tapped into our spiritual sense of wonder, and we both sort of feel that we should not walk away from a miracle. On the pragmatic side, I was rather overwhelmed and probably somewhat depressed after the birth of our first, and the thought of raising triplets (as incredible and exciting and miraculous as it is) is completely daunting. It's a struggle to feel like my toddler gets the attention he deserves, and I can't even imagine what it's like to have triplets. I'm also concerned about the effect on our older son--he's excited by the idea of a younger brother or sister, but how can we possibly prepare him for the changes to come--even with twins? This is complicated by the fact that I will have to go back to work, full time, at a fairly demanding job, and probably will have only a few months of maternity leave. I would love to hear from others who have passed through this situation, what they decided, how, and how it looks on the other side of things. And any resources, books, websites or helpful hints would be appreciated. I understand this is a deeply personal decision, but so appreciate this community and would welcome your thoughts. anon

      WOW! What a situation! There are no easy answers, but it seems to me you should go with your gut. If you are moved by a sense of wonder and miracle at having conceived 3 lives at once, why consider sacrificing one of those lives, in the absence of clear evidence that it is necessary to save the other two? (I, too, am fervently pro-choice, but I don't kid myself that abortion or ''selective reduction'' is anything but the loss of a life. The question is whether there is another life at risk that makes the decision justifiable.)

      And you are right to worry about the effect on your life of having 3 small infants to take care of--no one could receive the news you've gotten without having a healthy dose of fear and sadness about what it will mean for you and your older son. Also, your pregnancy will probably be a hardship just as you are trying to give your son the benefit of his last days as your one and only. But I can't see that having twins will be that much easier. Your son is still going to have trouble adjusting, and your life is still going to be hell for a while after the birth. So why set yourself up for the guilt feelings of having the selective reduction for so little gain? Good luck, whatever you choose...

      I can't address most of the points in your letter except sympathyze but I can say that another consideration of selective reduction is that about 20% of triplet pregnancies spontaneously abort at about 20 weeks because of the pressure on the uterus with 3 babies. For many IVF couples who have paid in time, tears and money to get pregnant a 20% risk of losing all the babies at once pre-term is not a good option and that might be why so many choose selective reduction. As to whether you are willing to take that risk you have to decide but I thought I should let you know that additional fact. --Just something else to consider
      To the woman who finds herself suddenly pregnant with triplets ... in addition to collecting information from parents of triplets, etc., you might try this exercise:

      one day, get up, and pretend ALL DAY that you've decided, for sure, on selective reduction and to only have (one? two?) of the babies. Don't worry, don't try to decide, just pretend the decision is made. See how you feel.

      The next day, get up, and pretend ALL DAY that you've decided, for sure, on having all three. See how you feel.

      I am a single parent of an adopted child. Five years ago I got a call that my daughter's birthmother had had another baby girl, and did I want to adopt that child as well? All the thinking about it rationally ... e.g. however could I manage this financially, on my own, or energy-wise, on my own ... was useful. But for me, the most useful thing was this exercise ... pretending I'd made a decision and then living with it for a day. With one decision, I felt hopeful, joyful, and like somehow I could handle all the logistics. With the other decision, all I could do was cry. Thus, it became clear to me what I wanted at the deepest most core level. Action and decisions became easier once that clarity was achieved. Good luck! -- Mary Carol

      I have never come across a message like this one - this is huge. First, let me say that I have not been in this situation, and you may not want to read further. However, I do think I have some useful insight on issues to think about. The selective reduction is considered pretty safe from 3 to 2 now. Most docs won't do from 2 to 1 for ethical and risk reasons (risk for twins are not so bad). Preterm infants have a tough road in life despite ''miraculous'' stories you read (that never include the more common bad stories). Delayed development and risk for lung disease are real risks. I think your decision will mostly depend on your religiousness. If you look at this in a more secular manner, this is an accident of nature that has mostly difficult consequences for the entire family. You were not planning to have triplets and could benefit to have reduction for the sake of your family AND the babies remaining. My heart goes out to you for any decision you make and be sure you have emotional supports in place for either decision. Anonymous
      My heart goes out to you. A blessing and a difficult decision at the same time. As you stated it is a very personal choice. Also, a very involved situation that needs more than is possible in this format. One suggestion would be to contact RESOLVE (RESOLVE of Northern California 312 Sutter St # 405 San Francisco CA 94108 415-788-3002 788-6772 f 788-6774 http://www.resolvenc.org resolvenc [at] aol.com). Although this is a national organization for infertility, I believe they might be a great resource in your situation. They maintain a hot line which members staff ,which can put you into contact with other people facing, or have gone through similar choices. Perhaps, with people who have older children now. Hopefully, you will be able to talk to people with different thoughts, views and experiences. Also, perhaps a once or twice visit to a therapist that is very familiar with your situation. Dr. Wecksteins office in San Ramon had very helpful lady they where referring to several years ago. Although, you might find someone good by calling fertility specialists offices. Give yourselves time and space. All the best to you. anonymous
      The phrase in your message I'm focusing on is ''absolutely heartbreaking.'' I too am pro-choice, but I can easily imagine feeling as you do. What is right for others can be wrong for you, and if something seems heartbreaking to you, then I think you shouldn't do it. The other words ''overwhelming'' and ''daunting'' are important too, though. My sister's first two children were twins, and I know from her experience it is not easy. She was a marathon runner and determined that she could just guts out anything. If she had it to do over again, she says she would have dug deeper into her wallet and gotten more help earlier on. I'm hoping that because you mentioned that you have a demanding job, you have some financial resources and can get good people to help you - not only with infant care, but also shopping, cooking and cleaning, so you can still spend time with your older child. Or is a live-in nanny a possibility? Frankly, my sister also found work to be a sanity-saver. I know it is different for everyone, but your job might be a plus, not a minus in that regard. Anyway, whatever you do, I respect your choice, and wish you the best!! Fran
      I cannot imagine having triplets (!), but must comment on your sense of wonder and (although you did not mention it exactly), fate. We had stopped having children after our second son was born. Two children are enough! When I found out that I was pregnant with a third baby, despite being on the pill *and* taking additional medication for a medical condition which makes it almost impossible to conceive, I was totally shocked! This was NOT in our plans, and I was crushed. I actually wondered how I would even be able to love this baby, let alone care for it, along with my other two small children. BUT, this third miracle has proved to be such a joy in our lives, and I am so madly in love with her that I feel at times that I just might explode with happiness!

      I, too, wondered why this happened to us. I am also pro- choice, but at the same time, I feel that at this point in my life, I was more prepared to accept what ''fate'' had in store for me. Good luck to you and the incredible road you face! FYI, there are resourses available for people like you, including nurses that are paid for by the state to come in to your home and help you. So, no matter what you decide, you will have some help and support outside of your immediate family. Another mom

      No one can tell you what to do about having three babies when you expected one. It is both a blessing and a burden, and only you and your husband can decide whether to keep them all or do a selective reduction. It's very unfortunate that the question of abortion has become polarized so that the possibility of choosing to keep all three somehow does not seem ''pro- choice''. ''Pro-choice'' means that you search your heart and choose. In the end, it has to be a decision from your heart and your gut. There is no other good way to do this. Good luck. Louise
      I read your posting to my husband last night (we have three children--all close in age, but certainly NOT triplets!), and he said, ''Three, four--what's the difference?'' I had to laugh. Anyway, it's a thought.... I love my little dumplings, but just sign me: Three is a lot, too!
      There is an anonymous internet website for women discussing their decisions about selective reduction. It is very supportive. They also have a password-protected forum (to keep the discussion safe from people who would otherwise flame the participants). Go to: http://www.inciid.org/forums/heartbreak/index.html Congratulations on your pregnancy, and good luck with whatever you decide! anon.
      Good luck! I'm sure you will make the decision that is right for you. I am a mom who was depressed after my first child, and my husband and I have recently decided to start trying for our second. While I have no experience with multiple births, I can speak to depression and say take care of yourself! Talk to your OB if you have fears concerning being depressed after the birth. You have many options, from excercize and diet change to hormones to antidepressants. It might be helpful to know about these in detail before hand, because when you are feeling bad it is difficult to ask for help or understand the options clearly. Don't be afraid to help yourself get through this-- a happy mom means happy babies (and husband.)Your life is about to change in a major way, whether with twins or triplets! You may have to change a lot about your original game plan. Don't be afraid to do that. Rethinking your ideas about nursing, childcare, going back to work, etc. is only natural upon finding out you will have more children than you planned. Sit down with your husband and talk about your fears and what to do to make it better this time. Keep what you like and change what doesn't fit. Try to welcome the chaos and keep that sense of wonder and don't be afraid to plan for and ask for *lots* of help. From your husband, family, in the form of childcare (duola, au pair etc), from your OB, etc. Think about what was difficult after your first child and try to plan to alleviate that with the next little ones. As for your first little guy, it may be difficult for him in the beginning but think of the richness it will add to his life. You sound like truly supportive parents and that's the best thing a child can ever hope for. My thoughts are with you!

      p.s I'm sure there are local mom's groups centered around twins and triplets where you can get experienced advice and support! Ask your OB or look it up on parent's network. A supportive mom

      We have three year-old triplet girls (2 ID, 1 fraternal). We were, of course, offered the option of ''selective reduction.'' Like you, I am strongly pro-choice and support Planned Parenthood and NARAL, etc. In addition, I have medical problems that we knew would (and did) make the pregnancy and its aftermath extremely difficult, and caused our children to be born premature with very low birth-weights. Nonetheless, we have never regretted our decision to proceed with the pregnancy, in spite of the risks and the amount of work, stress and financial strain involved in raising triplets. It is very very hard, there is no question about that, and you need to have a strong marriage to weather the experience. But it is such a gift and a source of incredible, inexpressible joy. I would be happy to talk to you off-line. Please feel free to email me at LDaniels [at] tularik.com. I can also direct you to women who have specifically been designated as resources on the issue of selective reduction, through organizations such as Sidelines, Mothers of Supertwins or MOST (mostonline.org) and The Triplet Connection. I wish you all the best, regardless what you and your husband may decide. Louisa
      I just want to add the one thought that stuck out in my head after reading your post: You may have wanted only 2 children, but perhaps God wanted you to have 4! I don't mean to overly simplify your dilemna, but you did mention how wonderous and miraculous spontaneously conceiving triplets is. I was a mother's helper for boy/girl twins for several months right after I graduated high school, and I still remember how hard it was to take care of them. But if you decide to take on this challenge, I'm sure you will find support and help where you never new it could come from! These things tend to have a way of working themselves out, I think. The very best of luck to you and your growing family! Jennifer
      I can't give advice about triplets, but I can give advice about premature babies (most multiple births are premature). Our daughter was a relatively healthy 4-1/2 pound baby and was extremely difficult to care for -- luckily my husband was able to work part-time for the first four months and we also had a considerable amount of support from friends and family -- once, my husband remarked that it took 3 people to take care of this one baby. She had severe colic and for the first couple of months could only sleep lying on my chest. She also needed to eat every two hours which is pretty standard for premies. Nursing was painful until she reached 8 pounds because her mouth was so small. When I went to my new moms group I felt so self- conscious because she cried so much more than the other babies. It took until she was about 6 months old (and 10 pounds) to reach the point where she she was a ''settled baby,'' which I believe is where normal newborns are after about 3 months. The good side is that by a year or so she had totally caught up, and now her development is fine. I think you would need to really plan on both you and your husband taking time off work, or on hiring outside help if you were to have 3 very small babies, because premature babies take considerably more care than term babies. It seems unlikely that you would have much time or energy for your son in this scenario, though with enough ouside help you could work it out. anon
      Your e-mail was beautifully written and heartfelt. I have not stopped thinking about it and the choices you are facing. I think though that you have already made your decision. This sentence said it all to me: ''I am strongly pro-choice, but the thought of a reduction is absolutely heart breaking. It has really tapped into our spiritual sense of wonder, and we both sort of feel that we should not walk away from a miracle.'' Think about drastically changing your circumstances along with the fate that has intervened. You could consider quitting your job in the future, leaving the expensive Bay Area, or moving closer to family or support wherever you find it. You have one child so you have so much better of an idea of what is in store. Personally, I think it is absolutely inspiring. Good luck with your decision and I would be thrilled if you kept us posted. Heather
      Hello Wow, what incredible news. A lot of wonderful advice has already been posted and reminds me how wonderful this service is to this community. I would second the person who advised getting help, early and lots. Building your support now will only help you down the road. This is true no matter the outcome with this pregnancy. As a birth and postpartum doula I would encourage you to seek out antepartum (useful if you wind up on bed rest), birth support, and postpartum care. You can find resources for these people at Birthways (www.birthways.org) and Birth and Bonding. Good luck and remember to breath often and deeply. in peace Samantha
      To the parent expecting triplets: I have not been in your unique, wonderful, and terrifying situation, but I have some friends who have. I saw the father at a function about trhee years ago. He had his 11-month old son with him, and told me that his wife was expecting triplets within about a month. Wow. The triplets were born, all girls, and are now about 2, all beautiful and healthy as far as I know. The parents live in the South Bay, and are not part of this network. If you want to email me your email address, however, I could forward it to them, and put you in touch. They may be able to offer some advice from those who have been-there-done-that. One thing I do know is that you need to GET HELP -- as in, someone to help clean your house, someone to help take care of the babies, someone to help with the older child, etc. Kim xia

      Childcare cost for triplets

      Feb. 2003

      I'm expecting triplets this summer(gasp!) and have a 3 year old in preschool on a parttime basis. I've checked out the childcare survey, but can't tell what the going rate is for private childcare for three babies the same age-- the responses included care for 3 or more, but I presume most of those respondents had kids of different ages. What should I expect to pay for a reliable, experienced nanny, who speaks English (but we'd be delighted to have someone speak Spanish to the babes)? Is anyone in a 3-way share who can tell me what they pay? Also, any hints about how to make this work? We have limited resources, but think we can probably swing at least part time help until I go back to work. thanks. mom4

      Your question implied that you think triplet care should cost the same as what parents in a nanny share pay for 3 kids - I don't think that's quite right. Nanny shares cost more per child because there are at least two sets of working parents involved - sometimes 4 incomes! Plus the nanny has to deal with all the different parents, and their different schedules, needs, instructions, houses, etc. In my nanny share, we pay $7 per hour per child, and when the nanny has all 3 under her care, she does get $21 per hour, but that happens because 4 people are working. I don't think you should have to pay $21. I'm guessing more like $15 per hour. Fran
      If you want care in the home it would be best to have two people taking care of the triplets most of the time for at least the first year, and if possible later. I have triplets and would be happy to discuss childcare issues with you offline. Feel free to contact me at the email address below. Good luck and best wishes - Louisa