Charlie and I both come from big or biggish families: he is the oldest of 4 and I am the oldest of 6 kids. One of the hardest decisions we had to make after finding out I was pregnant with quadruplets was whether or not to reduce from 4 down to 2 babies.
You don't have to be an obstetric genius to realize quadruplets are probably not an ideal situation for mom or babies' health. But I was pretty surprised to learn how commonplace "selective multifetal reduction" is in high order multiples.
As I learned from Dr. Barbara Luke's excellent book When You're Expecting Twins, Triplets, or Quads, "The rationale is straightforward: eliminating one or more fetuses may improve the pregnancy outcome for those that remain....Typically the goal is to leave behind twins."
Straightforward? Not exactly.
In the earliest stages of my pregnancy we spent a few weeks on our family vacation in Hanalei Bay, Kauai. It was my parents' 40th anniversary (pictured above) and we hadn't told anyone we were expecting 4 babies. I was secretly hopeful that by the end of our vacation, when we went back for an ultrasound, one or more of the less-viable embryos would have self-reduced itself and we wouldn't have to make this difficult situation about reduction.
But that was not to be. The only time I cried during this pregnancy was at that first post-vacation ultrasound when there were still 4 babies with their hearts beating away. By then I had read enough about the risks of pre-term labor associated with high order multiples, and the fact that these 4 babies might not be going anywhere on their own became a reality.
In August 2015, at the recommendation of our perinatologist in San Diego, we traveled to New York City and met with Dr. Joanne Stone at Mt. Sinai Hospital. She is an expert in high-risk obstetrics and chronic villus sampling (CVS) in high order multiple births, or super twins. Basically, she used a huge needle to draw out genetic material from each baby and we ran every genetic test under the sun to sample for a wide variety of congenital conditions.
Meeting with Dr. Stone was intimidating and enlightening at the same time. She is a no-nonsense New Yorker who methodically laid out all of the data she and her team had collected over the years about triplets, quads and quints. As a dietitian and nutrition educator, I appreciated the evidence-based of her information, but there was one statistic above all that stuck with me and Charlie:
THERE IS A 50% CHANCE OF MAJOR HANDICAP IN QUADRUPLETS.
Everything else she said didn't seem to matter: that 50% number was all we could focus on, and that that risk was due almost entirely to the harsh realities of preterm labor.
Could we really risk this for 2 of our 4 babies? What would be the point of relegating half of our kids to a lifetime of disability? Would moving forward with quadruplets be the most selfish move we could make?
But on the other hand, what if all 4 babies were as wonderful as our singleton daughter Molly? Having experienced the capacity of love we have for her, what if there is an even bigger opportunity to love even more children, regardless of their health status?
We spent 2 agonizing weeks on the East Coast waiting for the genetic test results. After endless discussion about risks and benefits, Charlie and I decided that no matter what the results were, we would move forward with quadruplets and hope and pray for the best outcome.
The tests eventually came back with no major genetic abnormalities and we declined to go through with a reduction.
At this point, being about a month out from their birth, we have no idea what life will hold for these 4 babies. But we feel confident that we made the right decision for our family in not reducing, and that our faith and fortitude will help us cope with whatever life brings...good, bad, or otherwise.