“So… are your twins natural?”

by Brit Berg

During a glorious 4^th of July weekend at the beach with friends and family, I turned to one of my relatives, saying, “Sarah, how often do people ask you if your twins are ‘natural’ or due to IVF?” With a serious look on her face, she said, “All the time. All the time.” I started to imagine her at the grocery store, the playground, or the museum, a target for nosy strangers. In Sarah’s case, her twins were not the result of fertility treatments. She had several qualities often associated with moms of twins: she is tall, was over 30 when she got pregnant, and has a history of twins in her family. But I felt empathy for her, and the many parents of multiples that most certainly field this question. It made me wonder about multiples. Why are they so common these days? And why do we feel that it is our right to know how people’s twins and triplets came into this world?

Statistics

Sarah and I discussed these topics, and later, I decided to Google some numbers. Multiples have increased in recent years, although they only make up about 3 percent of today’s births. Here’s more:

• According to CDC statistics, the triplet birthrate increased 400 percent between 1980 and 2000.
• During that same time period, twin births rose by 50 percent.
• Singleton births, on the other hand, increased by only 6 percent.

Why the increase in multiples? One reason is that today’s parents are waiting until later in life to have children. Moms over 30 are most likely to become pregnant with twins or more, accounting for a third of all multiples. Fertility treatments like in vitro fertilization (IVF) bring about the majority of the other multiple pregnancies.

Higher-order multiples declining

How does the medical field view this phenomenon? After all, complications increase with each additional fetus in the womb. Well, doctors and scientists are making strides to reduce the birthrates of multiples after fertility treatment. Since a peak around 2000, birthrates of higher-order multiples (triplets and more) have declined. Now, more women are becoming pregnant with one child, and single embryo transfer (SET) is more successful than ever. Single embryo transfer, the transfer of a single embryo during IVF, is even the norm in some countries, helping women conceive without the increased risks associated with multiples.

Responsible embryo transfer

Yes, single embryo transfer helps many women get pregnant, which leads us to the case of Octomom. Why did Nadya Suleman’s doctor decide to transfer twelve embryos into her uterus during IVF? This practice led to the birth of 8 babies at once, putting a mom and her babies in jeopardy. If her doctor had followed medical guidelines, he would have only transferred 1 or 2 embryos, significantly reducing health risks and healthcare costs. Most people agree that this doctor acted negligently by transferring so many embryos. He has since lost his license and has been shunned by many in the reproductive medicine field, serving as an unfortunate example to protect future moms and babies. Current guidelines now recommend that your doctor transfer 1 to 5 embryos at a time during IVF, depending on your age and IVF prognosis.

Respect parents of multiples

I have watched several friends and family members raise twins and triplets, and respect the love, support, and sacrifices they often make. Think about it, these moms of multiples are pushed to the limit, carrying several sacs and placentas, creating ample fluid, and consuming enough nutrients to support three or more lives at once. I have not asked them if they used IVF or other fertility treatments, although I have definitely wondered at times. And as for our universal fascination with (and nosy questions about) multiples, my guess is that people are simply curious, amazed, envious, and perhaps sympathetic about multiples. My recommendation? Unless friends and family are forthcoming about their infertility journey, and how it led to the birth of their twins, don’t ask.

Could I have twins?

If you are wondering whether you might have twins, here are some characteristics of women must likely to conceive multiples:

• Over the age of 30
• African-American
• Tall or obese
• Family history of fraternal (not identical) twins
• Using fertility treatments (pregnancies from assisted reproductive technology (ART) procedures like IVF yield multiples almost half of the time)

Fun fact? Moms in New Jersey are more likely to have multiples than other women.

Britt Berg holds a Master’s degree in Counseling Psychology and is co-author of Making a Baby (Random House, 2010), a book on infertility. She works as a freelance health and medical writer in Atlanta, GA.

Sarah Braesch (aka Goon Squad Sarah) is all over the Internet. You can find her writing at Sarah and the Goon Squad, BlogHer.com, Draft Day Suit, MamaPop, DC Metro Moms Blog, Loser Moms and many other blogs depending on the day of the week. Sarah lives in the DC Metro Area with her husband and four year old twins. She is a freelance writer and she also works for the BlogHer Ad Network.