When High-Risk is Too High

It has been a week now since Michael and I got the big news at our reproductive endocrinologist’s office: there are four embryos growing inside of me.

At first, it was super exciting. We wanted one baby, were planning for two (eventually), but four will work, right?! Four is better than zero!

As we’ve progressed along, we’ve met with doctors who do not agree with that. After listening to their advice, doing a lot of our own research and hearing our options, we’ve decided that I will almost certainly not be carrying four babies to term.

The first advice came from our reproductive endocrinologist, who just wanted us to be aware of the baseline risks. She recommended we see another specialist, so late last week we met with a high-risk obstetrician to discuss our pregnancy. Not just any high-risk obstetrician: this guy is the guy, at least in Kansas City. He’s not just the head of the department at the biggest hospital in town but created the department. He has about six degrees, writes textbooks and peer-reviewed publications, and works with the National Institute of Health. This dude lives, eats, and breathes fetal and maternal health. And he even personally came and got us from the waiting room for our consult. That’s weird, right? I’ve never had a doctor do that before.

Without drowning everyone in statistics, I will sum up what the doctor told us in a 45-minute long conversation: Carrying quadruplets to term is EXTREMELY risky. As Michael has put it several times since our consult, “it carries an unacceptable risk” – to both me and the babies. A good (meaning you avoid labor longer than most) quadruplet pregnancy lasts just longer than 28 weeks. For the non-breeders: a singleton pregnancy lasts anywhere from 38-41 weeks. Quadruplets have about a 50% survival chance before 28 weeks. There just isn’t physically room for that many babies to develop, so they deliver early, and most of the time, with complications.

That addresses their risk. There are complications associated for moms of higher-order multiples too: anemia, hemorrhaging, diabetes, preeclampsia, the list goes on. Whatever risks there are for a mother with a one-baby pregnancy increase with each multiple you carry.

None of this was terribly shocking information to us: we figured it would be risky to carry four. We both went into the appointment with open minds, wanting to learn more about the risks and make a logical decision.

Since we made up our minds, we’ve been pretty open with people in our lives about our plans for the procedure. This openness has been great and terrible at the same time, but that topic is worth a whole separate blog post or five. Most people have been accepting of that fact that it’s our decision for our family. They’ve simply asked questions and offered their support for a tough process and a hard decision. The truth is, though, the numbers the doctor gave us made what could have been a very difficult decision somewhat simple: the risk of carrying four to term is just too high.


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