Friday, June 15, 2007

Sextuplet Followup

I've received a lot of insightful comments on the Sextuplet post. I've purposely remained relatively silent since my initial post because I've been thinking about it and trying to absorb all of your valuable insight. One sad, but unfortunately predictable update is that one of the Morrison Sextuplets died on Thursday.


Minnesota Sextuplet Dies
By AMY FORLITI
The Associated Press
Thursday, June 14, 2007; 9:21 PM

MINNEAPOLIS -- A sextuplet born prematurely to a Minnesota couple has died,
and his five siblings were in critical condition, hospital officials said
Thursday. Bennet Ryan Morrison died Wednesday night, and the other babies
remained in critical condition Thursday at the neonatal intensive care unit at
Children's Hospital in Minneapolis...


I know that the Morrisons must be suffering a tremendous grief right now while still fighting and praying for their five other children. I admit that my initial reaction to their story was disapproval, not of them as a couple but of their doctors. I knew that they had tried fertility drugs, and had assumed irresponsibility on the part of their doctors. But having read the information on their personal website, which is actually very well written, I see that this, was an unforseen error, not unlike my triplets, only on a much larger scale. Ryan Morrison writes:


After two failed cycles using Clomid, we tried the drug Follistim. Brianna’s first cycle with the new treatment looked great. She had two mature eggs that were ready to be released, and two immature eggs that probably weren’t going to be viable. There was a 25% chance of us having twins, a 3 % chance of us having triplets and anything else was laughable. ...

It was a month later when we discovered that Brianna was not carrying just one baby, but six.

Since then we’ve learned that Brianna had ovulated at least ten eggs. The doctors at our infertility clinic say that they’ve never seen anything like this before, and can’t explain why it happened. They strongly encouraged us to consider selective reduction, explaining that the risks of carrying and delivering six babies are too great. They said that reducing the number of fetuses now would increase the chance of survival for the the remaining fetusus as they develop, and would decrease the chance of long-term health risks for the babies that were carried to term. However, we knew right away that this is not an option for us. We understand that the risk is high, but we also understand that these little ones are much more than six fetuses. Each one of them is a miracle given to us by God. He knows each one of them by name and we will trust Him absolutely for their lives and health.

Oh, how I wish I had read that before I jumped to conclusions. Oh, how I wish I hadn't believed their doctors were so stupid and irresponsible. Oh, how I wish they weren't suffering watching their babies suffer. Oh, how I wish those babies had also made it to 30 weeks. And while I know that if I had been faced with sextuplets I would have reduced, I also know that it is because I probably would not survive a sextuplet pregnancy. I had to consult with a neurologist, a cardiologist and a perinatologist to determine whether it was safe for me to carry triplets, and the answer was triplets were probably okay, quadruplets would be pushing it. I know that if I'd been faced with sextuplets, I would have reduced. And I know I would have spent a lifetime wondering about the rest of those babies, even knowing that it was the exact right decision. I understand 100% why the Morrisons could not consider reduction, even though I do believe that by choosing not to reduce they accepted a risk to Brianna's life and to the lives of their babies. I hope that the very best outcome for the Morrisons can be achieved. I'm sure this is a tremendously difficult time for all of them.

The Masches, as you know, were luckier. Their babies made it to an astounding 30 weeks, 4 days. Jenny Masche, however, went into acute heart failure on Monday after the babies were born. She was stabilized and is not expected to have long term problems as a result, but I'm sure it was very scary for her and the rest of her family. I hope that she and the babies continue to do well. As lucky as they were, they have a long road ahead of them, as the hard part is only just beginning... once the babies are healthy enough to go home, they'll have to feed, and clothe and parent them. That's going to be a huge deal.

Someone brought this article: Babies Should Come in Ones Not Sixes to my attention. While a bit heavy on the vitriol, and obviously written by someone not familiar with the specifics of either story, it does raise a few points that no one else in the media seems willing to mention, so it might be worth a read. What bothers me most about the sextuplet stories, particularly the Masche story, is the glamorization it has received in the media. How fun it's looked in the eyes of the Today Show, and how "easy" they've made it seem. In her interviews on the Today Show, Jenny Masche has been wearing nice maternity clothes and makeup and looking stunning and healthy and happy and they've focused on crib building and other fun things, but have failed to mention the devastating possibilities of sextuplet pregnancies. I worry about the message that is sent with this kind of media coverage. People are already saying to me, "oh, don't worry about your triplets, I'll bet they won't even be in the NICU... look how big and healthy those sextuplets were!" I've had four separate people say that to me this week. I'm not kidding. I find this terribly problemmatic.

I want to address some of your comments, but this post is long enough, and I want to make sure that one comment in particular gets addressed. For the rest of you, if I don't get a chance to post about your comments specifically, please know that I've taken all of them to heart and I think about them constantly. I just am taking time to process it all. But this comment really does deserve to be addressed all on its own, from Anonymous:

I've been reading your blog ever since I found out I was pregnant with triplets. It was our first IUI cycle, they said I had one dominant follicle...then the u/s showed twins...one week later it was triplets. We decided to reduce, and our lives have been filled with anxiety and grief, but also hope that this is the right thing to do for us. Last week, at 11 1/2 weeks, an u/s showed quads. We are angry beyond belief. The woman having sextuplets that they were following on the Today show (let's glamorize it, shall we?), it was her first IUI. Suzanne (I read your blog now too!), your pregnancy was with Clomid. Insurance companies need to pay more attention to what is happening. Fertility clinics need to do a better job of monitoring situations. And people should be told very clearly about the possibilities (granted, my chances of getting preg. AT ALL for this IUI were less than 10%) before they begin treatments. TV and the media need to stop showing these pregnancies as "fun", and pay attention to the real problems. I honor the people who decide to go through with triplets or even more. For us, I have never felt so much sadness in all my life. My reduction is tomorrow. Tonight we say good bye to two of our babies and I will pray that they find another womb that will welcome them and be ready for them. I thank all of you for allowing me to lurk and read your blogs. You provide more comfort than you can ever know.


First, I want to be clear: Any decision that a person makes on reduction IS the RIGHT decision. No one else can tell you what the right decision is. That was the best advice that I received. I got such tremendous pressure to reduce from all sides, except my rabbi who was adamant that if there was a way to carry all three, I should do it. Ultimately, my rabbi determined that halachically (that is, within the requirements of Jewish law), I had sufficient reason to support reduction. But careful review of the medical factors led us to determine that there was not sufficient medical reason to reduce in our case. I was adamant that I would not consider emotional or financial factors in this decision, only medical and halachic factors. But for others, those emotional and financial factors are KEY factors. Everyone needs to determine for themselves where the line is drawn.

Anonymous, you made the right decision, for it was YOUR decision. I wish you much peace with your decision and much health and love with your twins. Please feel free to contact me directly if you ever need to talk more about this, but do remember, you did exactly the right thing for yourself and for your babies. I will be thinking of you, Anonymous. I wish I could do more than that.

9 comments:

Jackie said...

Hey-I too have been following these stories and paying attention to the fallout around the internets. My initial reaction was also-how could the doctors let this happen, until I too went to the Morrison 6 website yesterday and read what was posted about their follicles. It makes me so anxious about continuing to pursue COH/IUI as a treatment option. I feel strongly that I would reduce with high order multiples, but I know that it would break my heart to do so.
Although IVF is not a perfect solution, it makes me think that if health insurance would cover IVF cycles it is possible high order multiple pregnancies could become even more rare by limiting embryo transfer.
I also agree that the media should not be making a happy circus out of these incidents and instead show the cold hard facts about the costs, financial, physical, mental, and emotional that are incurred by these pregnancies.

Chris said...

FANTASTIC post - I was right there with you. How could a doctor be so irresponsible, what are these families thinking, etc. I formed my judgement and never gave it another thought.

Thank you for showing the other side. I'm grieving for that lost baby and hoping that both families are thriving.

Hope you're doing well!

Rachel Inbar said...

Fabulous post! I can only imagine how annoying it is to hear that it's only half the number of babies. I'm sure some of the people mean well, but to me, it seems to imply that a woman with triplets is a failure if she can't do far better than someone who carried sextuplets... As if she has some sort of control over it...

Jody said...

People are going to be saying stupid things for a very long time. I'm sorry to have to say that. But there you go.

Curiously enough, I don't think there are very many examples of people taking crazy risks when they conceive their HOM pregnancies, although that's certainly the spin the issue gets in every book and scholarly article written. Time after time, you see people making careful decisions and being screwed or surprised by the outcome. It seems to me that more needs to be written about that -- that the conception of HOMs often happens against the best intentions and practices of the patients and doctors alike.

Even with single-blastocyst IVF transfer, you can get spontaneous twinning. At higher rates than in "naturally conceived" pregnancies.

The media is never, ever, ever going to get this right. They're just not. I've had to learn to (mostly) tune them out.

Suzanne said...

great post...my heart goes out to both families for the long, hard, road they have ahead of them. hopefully one day, modern medicine will get it right...but the body is truly an amazing and unpredictable thing.

and i hate that people are making such ignorant comments to you, but if there is anything that i've learned with this quad pregnancy (and opening myself up there everyday on my blog), it is that i will get some STUPID @ss comments/advice that i have to just tune out. (and i'm the type of person that would argue til the the sun comes up! so, it's been rough!)

Thalia said...

A very good post, although I still think it's irresponsible to go through treatment knowing you would never do selective reduction, even if there are mitigating circumstances. It's just incredibly unlikely that anyone can deliver 6 babies without them having a really really tough time after birth, and the media SOOO doesn't help.

Anonymous said...

Hi- I've been following your and Suzanne's blogs and therefore the articles with great interest. I'm currently pregnant with twins after stim and IUI (had 3 dominant follicles, 3 sacs but thankfully only 2 developed. Thankfully as my doctor has worries enough about me being able to carry 2).
What really interests me is that my treatment occurred in Germany, our state medical insurance covers 3 IUI as well as 3 IVF treatments, but the doctors must cancel the IUI if more than 3 dominant follicles develop. With IVF they are not allowed to transfer more than 3 blasts. I have not heard of any sextuplets being born here and the only quins were conceived without fertility treatment. Triplets being deemed as the maximum number of foetuses that most woman can carry to a point where the babes will have a good chance to survive without too much risk to their own health.
PS I believe there are another 2 sets of sextuplets due to be born in late summer in the USA.

Erin said...

I have to wonder how in the world she could have ovulated at least 10 eggs while the doctors saw two mature and two immature follicles. That many follicles would have been pretty clearly noticeable on an ultrasound, wouldn't it? Unless it was the most incompetent nurse/doctor in the world.

I'm also in agreement with Thalia that it's irresponsible to say that selective reduction would NEVER be an option before doing fertility treatments. I understand that people have different religious viewpoints and all, but if the mom isn't going to be healthy enough to safely carry the pregnancy (no one's body is designed to carry six babies, no matter how amazing the human body is--and I teach natural childbirth classes, so I truly believe it is amazing), then she's not doing the best thing for her babies. I just can't help but see it as irresponsible parenting right from the beginning. It's probably really narrow-minded of me (hey, the Arizona sextuplets did make it to 30+ weeks), but I'm such a firm believer in the mother's health being the foremost concern.

OK, I'll stop hijacking your comments now. I'm sorry that you're getting ignorant comments on this one. I think Rachel from Uterine Grail had a good point about media glamorization--her singleton isn't going to generate an iota of media attention, but that's more often what happens in fertility treatments. If the media would focus on that as the ideal a little more instead of the "glamour" of sextuplets, perhaps we would get fewer ignorant comments.

Anonymous said...

Great Post!
I've been following both of the sextuplet pregnancies, and am just heartbroken over the Morrison's loss. I can't imagine what they must be going through...
I found your blog randomly, and enjoy your posts! Very witty, and super entertaining!
I'm a mom to BBB-triplets & GG-twins. All of my kiddos are 2 & under! :) I wish you luck and look forward to reading more!