- Email: [email protected]
Multiple Births Have Multiple Effects on Families’ Quality of Life
Multiple Births Have Multiple Effects on Families’ Quality of Life
R
Carolyn Davis Cockey, MLS, is executive editor of AWHONN Lifelines and Associate Director for Publications at AWHONN.
402
AWHONN Lifelines
aising a child is a joyful and sometimes exhausting endeavor. For parents blessed with the birth of multiples, the joys and the trials are compounded. In addition, they find themselves dealing with certain effects and social attitudes that are unique to their situation. In a study conducted by researchers from Massachusetts General Hospital and Harvard Medical School, 43 mothers, 29 raising multiple-birth children and 13 raising singletons, met in a series of focus groups to identify the aspects of family life that are most affected by having multiples. More than half of the participating mothers (58 percent) had undergone assisted conception; 78 percent of these cases resulted in a multiple birth. Since the experience of infertility had a continuing influence on these mothers’ perceptions, follow-up focus groups were convened with members who had all gone through assisted conception. It was noted that, while infertility treatment continued to be a relevant issue for all women who had experienced it, the other quality-of-life issues were more significant for the mothers of multiples. All mothers of multiples experienced social stigma—marked by a devalued or spoiled identity. They described experiences involving family, friends and strangers asking unsolicited, insensitive questions about their fertility status and making assumptions and expressing moral judgments about the conception of their children. The follow-up groups of infertile women also identified losses of pregnancies and young infants as a lasting influence on their well-being. Selective reduction for the mothers of multiples was identified as a particularly troubling experience. This was, for some patients, exacerbated by their health care providers not giving
sufficient information on the possibility prior to assisted conception, then giving too much information too soon after the identification of the multiple pregnancy and pushing for an immediate decision on reduction. Multiple births had a variety of different impacts on parents’ marriages. Some marriages disintegrated as husbands and wives lost touch with each other under the incredible stress of caring for multiple infants. However, other marriages grew stronger as spouses recognized the necessity of working as a team to care for their children and fathers participated more in childcare and household tasks. Researchers noted that health care providers need to give patients more information and try to help them to better understand the real risks of multiple pregnancies. “The idea of having twins or triplets is greatly appealing to a patient who has spent years trying to conceive, but she needs to know that this is not the best outcome and a high-risk pregnancy is only the first of the difficulties she and her partner will face with multiples. This study also gives health care providers valuable insight into the real-life results of multiple pregnancy and suggests some ways we can be more sensitive to our patients who conceive multiples,” they wrote. To read the study, access “Social stigma and compounded losses: Quality-of-life issues for multiple-birth families,” Fertility and Sterility, Vol. 80, No. 2, August 2003.
Volume 7
Issue 5
R
Carolyn Davis Cockey, MLS, is executive editor of AWHONN Lifelines and Associate Director for Publications at AWHONN.
402
AWHONN Lifelines
aising a child is a joyful and sometimes exhausting endeavor. For parents blessed with the birth of multiples, the joys and the trials are compounded. In addition, they find themselves dealing with certain effects and social attitudes that are unique to their situation. In a study conducted by researchers from Massachusetts General Hospital and Harvard Medical School, 43 mothers, 29 raising multiple-birth children and 13 raising singletons, met in a series of focus groups to identify the aspects of family life that are most affected by having multiples. More than half of the participating mothers (58 percent) had undergone assisted conception; 78 percent of these cases resulted in a multiple birth. Since the experience of infertility had a continuing influence on these mothers’ perceptions, follow-up focus groups were convened with members who had all gone through assisted conception. It was noted that, while infertility treatment continued to be a relevant issue for all women who had experienced it, the other quality-of-life issues were more significant for the mothers of multiples. All mothers of multiples experienced social stigma—marked by a devalued or spoiled identity. They described experiences involving family, friends and strangers asking unsolicited, insensitive questions about their fertility status and making assumptions and expressing moral judgments about the conception of their children. The follow-up groups of infertile women also identified losses of pregnancies and young infants as a lasting influence on their well-being. Selective reduction for the mothers of multiples was identified as a particularly troubling experience. This was, for some patients, exacerbated by their health care providers not giving
sufficient information on the possibility prior to assisted conception, then giving too much information too soon after the identification of the multiple pregnancy and pushing for an immediate decision on reduction. Multiple births had a variety of different impacts on parents’ marriages. Some marriages disintegrated as husbands and wives lost touch with each other under the incredible stress of caring for multiple infants. However, other marriages grew stronger as spouses recognized the necessity of working as a team to care for their children and fathers participated more in childcare and household tasks. Researchers noted that health care providers need to give patients more information and try to help them to better understand the real risks of multiple pregnancies. “The idea of having twins or triplets is greatly appealing to a patient who has spent years trying to conceive, but she needs to know that this is not the best outcome and a high-risk pregnancy is only the first of the difficulties she and her partner will face with multiples. This study also gives health care providers valuable insight into the real-life results of multiple pregnancy and suggests some ways we can be more sensitive to our patients who conceive multiples,” they wrote. To read the study, access “Social stigma and compounded losses: Quality-of-life issues for multiple-birth families,” Fertility and Sterility, Vol. 80, No. 2, August 2003.
Volume 7
Issue 5