How can my wife and I learn to live with our decision to selectively reduce?
January 8, 2010 1:03 PM   Subscribe

How can my wife and I learn to live with our decision to selectively reduce? (warning, long)

After trying for a year and a half to have a baby, (and experiencing a miscarriage,) in early 2007 my wife and I went a fertility doctor to see if something might be wrong. He diagnosed her with PCOS and suggested artificial insemination (IUI). After a couple of cycles, the procedure worked. Too well. Four sacs began to develop, each with its own tiny heartbeat. We were overjoyed, but also horrified. Quadruplets?! We didn’t expect or want four babies! But there they were. My wife told me later that she prayed for a miscarriage, because she would rather they went on their own than through an abortion or reduction.

From the beginning, two sacs were strong and viable but the other two began to show signs of abnormalities. One died out on its own, leaving us with triplets. At this point we were seeing several doctors every week and my wife was being carefully monitored, because carrying quadruplets and triplets can be dangerous. At 11 weeks, we met with them all at once so they could explain our options.

We were told that the third baby was not going to survive. The odds of it making it through the entire pregnancy were slim. If it beat the odds and did make it, it would be deformed and probably wouldn’t live very long. If it died in the womb after developing for 15 weeks or more, it would almost definitely cause a miscarriage, crashing the entire pregnancy. (The body reacts to a fetus dying in utero by trying to flush it out, regardless of whether there are other, healthy developing fetuses still around. One baby had already not survived, which increased the risk of miscarriage.) We were told that it was highly likely that the baby would die before the pregnancy was over. So, faced with the option of saving two babies by killing a third, we decided to selectively reduce at 12 weeks. Both of us are pro-choice. But if you’d asked us then, we probably would have said that while we would die to defend a woman’s right to choose, we would never abort a baby ourselves. But we did.

Our twins survived. They’re happy, healthy and nearly two years old now. The joys of our lives.

But neither of us are finding it easy to move past the reduction, and I don’t know why. Maybe that’s natural? I don’t know. It doesn’t bother us all the time, (we’re busy raising our children now) but every once in a while the mental questions start flooding in (Did we do the right thing? Would it have been a boy or a girl? Wouldn’t it have been better to have given the baby a chance, even with the risks?) and the grief becomes overwhelming for one of us. We’re both going through the same thing, and neither of us knows how to handle that anymore.

We’ve talked about therapy, but neither of us are all that eager to relive the experience by talking about it with someone. Plus, my wife has said she’s afraid that we might be told we’re making a big deal out of nothing and we should just get over it. Would therapy help relieve some of our guilt and grief? Are there other options available to us which might help? We're in lower New York State, near NYC.

Any constructive advice would be appreciated. If anyone needs more information, here's a throw-away email address: askthehivemind@gmail.com
posted by anonymous to Human Relations (36 answers total) 5 users marked this as a favorite
 
I think this is the main point:

If it beat the odds and did make it, it would be deformed and probably wouldn’t live very long.

Maybe it's not an easy question, and there's no straight right or wrong, but I think you saved this potential being from a short existence involving little more than needless, ultimately pointless suffering. Don't feel guilty, and don't let anybody talk you into feeling guilty. What you did was (IMHO) the most humane thing.
posted by moorooka at 3:45 AM on January 9, 2010 [1 favorite]


Yes, it sounds like therapy would give you guys time to really grieve the loss. Even if it was just a fetus, people are definitely creatures of attachment and it makes sense you would have a lot of emotions about it. Especially after trying to get pregnant for so long, having one other miscarriage and then getting pregnant with 4. But don't feel guilty at all, just get support so you can heal. It's quite an amazing story and congrats on your twins!
posted by Rocket26 at 6:51 AM on January 9, 2010


anonymous, I read this question and many of the answers here yesterday and it has been on my mind ever since. I'm really sorry that so many of the answers were deleted in the recent server troubles. I hope you had a chance to read through the comments before they were lost.

I have the deepest sympathy for your situation. While you made the only rational, logical choice available, I know that emotion can not always follow logic. I am currently pregnant, and I find myself able to sympathize with the non-logical, emotional side of things to a new degree. I hope fervently I won't at any point have to make such a choice in my pregnancy, because I have an inkling of how tremendously painful it must be.

Many people suggested, and I agree, that no good counsellor is going to tell you to just get over it. Even if the choice you made was the right one, that doesn't negate the feelings that you have.

I wish I could do more justice to the comments that were here, or offer you something more substantial myself. I just wanted you to know that there were lots of comments here, and that people felt overwhelmingly sympathetic to your pain, and also that you made the right choice. I hope that you can find some peace with this soon.
posted by carmen at 8:10 AM on January 9, 2010


Would therapy help relieve some of our guilt and grief?

It's your best bet.
posted by Faint of Butt at 1:06 PM on January 8, 2010


You both had to make a painful decision, and it continues to affect you. This is normal. I personally believe that if your own rationality can't overcome the feelings of guilt, it's a good idea to find a therapist who can help you with the feelings.

You are most assuredly not making a big deal of nothing. The fact that you made what 99.9% of people would say was the right choice doesn't mean it was any less hard to make.
posted by Pragmatica at 1:11 PM on January 8, 2010 [3 favorites]


I'm sorry to hear about your loss. A few years ago my wife and I suffered a miscarriage on Christmas day 24 hours after telling our parents we were pregnant. It was pretty rough.

For the longest time there felt like something was missing, esp. since we weren't getting pregnant again as quickly as we hoped. I read about how in Japan they have a ritual called "Mizuko jizo". While it wasn't quite the same for us, and we aren't particularity religious or spiritual people, we decided to do something similar in memory of our lost baby.

We made a small package of gifts, picked a name and said goodbye after making a small trip to a place in nature.

It really helped.

Good luck.
posted by bottlebrushtree at 1:14 PM on January 8, 2010 [1 favorite]


I will join in the recommendation that you see a therapist. I will also pare down your question to the two operative thoughts. Compare:

If it died in the womb after developing for 15 weeks or more, it would almost definitely cause a miscarriage, crashing the entire pregnancy. ... We were told that it was highly likely that the baby would die before the pregnancy was over.


With:

Our twins survived. They're happy, healthy and nearly two years old now. The joys of our lives.

You saved two lives. Those two lives are your children. You could do nothing else.
posted by monju_bosatsu at 1:17 PM on January 8, 2010 [10 favorites]


No decent therapist is ever going to tell you that you are making a big deal out of nothing. Your feelings are normal and valid. You're still grieving and that's alright. The sadness may last a long time.

I understand your unwillingness to relive the experience through therapy though and your choice not to do so is also valid.

My advice is to try to be as present as possible with the emotional experience of grief. Don't push it away, accept it. Completing a ritual as decribed above by bottlebrushtree may help you accept the process of your grief more fully.

I'm sorry for your loss.
posted by dchrssyr at 1:23 PM on January 8, 2010


I can't even pretend to understand your feelings, but the choice you made was the one that has given you two healthy babies. I agree with Faint of Butt that therapy would be a good idea. Guilt is a horrible thing, and it'll eat at your forever if you don't get some help with it now.

Look at this from the other side of the coin. You might have given the third baby a chance, having already been told that there was a high probability that this choice could result in all three embryos being miscarried. You'd then be wracked with guilt wondering why you'd made that choice, when, if you'd taken the other option you could have had healthy twins.
posted by essexjan at 1:25 PM on January 8, 2010


Plus, my wife has said she's afraid that we might be told we're making a big deal out of nothing and we should just get over it.

I can't image a good therapist saying that. Get a good recommendation for a referral.

And it is a big deal, you made a very difficult decision. Not that it matters much, but I think you did the right thing. Multiple births are correlated with all kinds of issues. I agree with monju bosatsu: you saved two lives.

If you missed this Times article on IUI, you should read it. It tells the story of woman who conceived six children and lost four of them shortly after giving birth. The two surviving children are seriously underweight and may or may not survive.
posted by borges at 1:27 PM on January 8, 2010


You are grieving the loss of the idea of your child. That's a real loss, and it deserves to be mourned. If you're the therapy kind, therapy could really help. If you're religious, you may also want to ask your religious leader if you could have a funeral or other ceremony. I promise you that mental health and other professionals will be sensitive to your grief and will not belittle you for your feelings. Anyone who does is a huge jerk and should not be a part of your life.

I have no idea whether this will help, but I think that you did the right thing for all of your children. You protected your two strong, healthy children from being harmed, and you gave them the best possible chance at a healthy life. You also gave your third child a peaceful, painless death. If your third child had survived until birth, its short life would not have been a happy, healthy one. You saved your child from that suffering, and that's a good thing.
posted by decathecting at 1:28 PM on January 8, 2010


I'm so sorry for your loss. I am so glad that your twins are healthy. You had to make a very difficult decision and it is clear that you and your wife did not make this decision lightly. Even though the decision itself was made many months ago, there is no reason to think that that alone will resolve the feelings you have about it. I think you need to acknowledge that you were put in a very difficult situation and made the best decision for your family given all of the information that you had. I know that you're not asking for absolution, but I believe that you and your wife made the right and most humane decision you could under incredibly trying circumstances.
posted by picklebird at 1:29 PM on January 8, 2010


I haven't been in your position in any sense. But first up, I want to say how sorry I am that you've faced so many difficult situations. The depth of your feeling indicates how carefully you've thought this over, from so many angles. Therapy is definitely the right step.

You might think about the situation not in terms of the reduction of the third fetus but the gains you gave your children -- the living, active, healthy children you have now. The chances you were able to give to your twins are so much greater than anything you could have given to three fetuses, some with severe issues. Even assuming that your third fetus was the only one with any abnormalities, it would have taken nutrients and space away from the other two, and -- had it survived until birth -- he or she would take up so much of your time and care.

You would jump in front of a car to save your kids, right? This sacrifice -- still painful, but much smaller in comparison -- prevented the severe difficulties for one tiny being and allows the other two to live their lives, full of possibilities, in ways that might be far beyond what they could have had if you hadn't made this decision.

I think this issue isn't so much about "right" or "wrong" but the fear of the unknown. There's just never an answer for that. So I hope you can learn to make the questions come a little farther apart and the grief not quite so potent.

Best wishes on your journey.
posted by Madamina at 1:29 PM on January 8, 2010


Your feelings are completely normal. My wife and I feel the same way about the right to choose as you are your wife and we also could probably never terminate a pregnancy except in the most dire of circumstances. That is what you faced. You did the right thing but the tough part is to get right with it. Therapy can help and as was said above no good therapist would dismiss your feelings. Best of luck to you.
posted by caddis at 1:30 PM on January 8, 2010


Also, please talk about this with one another and with those close to you. When your children reach an appropriate age, tell them about your experience in a way that they can understand, so that they learn that it's good and healthy to talk about these things, and so that there are no lurking secrets in your family. My mother had two miscarriages and lost a child shortly after birth, and she pushed away anyone who tried to talk with her about it and help her through her grief. I believe that silence hurt our family deeply, and I think that her isolation eventually contributed to her death. Talking about your grief is much healthier than holding it in and feeling guilty for your decision or for the feelings you're having about it now.
posted by decathecting at 1:32 PM on January 8, 2010


A therapist will not tell you that you're making a big deal out of nothing because:

1 - That isn't going to help you, which is what the therapist is trying to do,

and

2 - It's just not true. This is not nothing, it is a giant emotional block, preventing you and your partner from being happy. This is the exact thing that therapy is for, to help people heal emotional wounds and move forward with their lives. I would strongly suggest you talk to a therapist soon, as the sooner you work through this, the sooner you will be happy.

If you don't find a solution for this, know that it will affect your twins and their lives in the future. If you won't do it for yourself, do it for your children so that they can live to be happy individuals, and not be negatively affected by your grief.
posted by markblasco at 1:33 PM on January 8, 2010


neither of us are all that eager to relive the experience by talking about it with someone

I felt the same when I first went to therapy, but it was very cathartic to be able to tell somebody else about it. I left feeling a bit tired from talking about my problems, but all that week I felt rested and at peace, and I actually wanted to keep working on it.

My problems were very different from yours (family stuff) but I swear I felt improvements from the first session. You could try it for a month, and then decide if it's working for you.
posted by clearlydemon at 1:38 PM on January 8, 2010


Your therapist, should you decide to see one, will most definitely not tell you that you are making a big deal out of nothing. The loss is real, the decisions you had to make were exquisitely difficult. For the sake of all four people in your family, see someone. He or she will not help you "get over it" but will help you to frame your loss in a way that helps you and your wife live a fuller and more joyous life.

Also, I agree with bottlebrushtree. A ritual to recognize that there is a loss can be incredibly helpful. Perhaps discuss this idea with the therapist.

I wish you all the best.
posted by Sophie1 at 1:39 PM on January 8, 2010


No professional should discount your experience or reasons for seeking support.

The rest is beyond my personal experience, but:

If full-blown therapy doesn't seem the right path, have you considered either online or real-life (NYC) support groups? Being around or getting a hug or handshake from someone who has been in your place, or helping others who have just started on this scary journey, may give a new meaning to your experience in helping others. I found some by google, but surely your doctors could give recommendations.

Or, privately, was there any memorial, in remembrance (what may have been) or thanks (for letting the other two grow strong)? Even at a belated date, maybe something like that would be a useful form of closure...
posted by whatzit at 9:41 AM on January 9, 2010


I am sorry for your loss, and for the difficult decisions you had to make.

I am not a doctor, but my girlfriend is a nurse who specialized in pre-natal and neo-natal care. I have heard stories about reductions, and I have heard stories about complications that arose from multiple births. There is a good reason why doctors recommended the reduction. I imagine that you are well aware that your decision increased the chances of survival of your children, and improved their quality of life. I also hope you are not comparing your case against cases of people that decided against reductions and lucked out. These are the stories you hear about because people will talk about good outcomes openly. As you mentioned it yourself, it is hard to talk about the difficult choices you made, and just imagine how tragic it would be if you made a different decision and things had turned out for the worse. Those are the stories you don't hear, but they do occur, and you managed to avoid that potential tragedy.

I don't imagine that me telling you this will alleviate your feeling of loss, which are real and understandable. I just felt like you should know you made a good but difficult decision.

I think therapy might be a good idea. You may be able to get recommendations for a therapist from the grief counselor at the hospital where you had your reduction.

Best wishes to the two of your, and to your two beautiful children.
posted by TheyCallItPeace at 10:54 AM on January 9, 2010


You were in an impossible situation to avoid guilt. Take a look at your two healthy, beautiful children then ask yourself, how would I feel if I had miscarried because I declined the reduction? Is there any choice you could have made without a heavy cost? The hand you were dealt required loss of one sort or another, and you had no choice but to make a terrible choice. Most of us will never have to face the life or death decision you had to make. I deeply emphasize with you and wish you peace.
posted by buzzv at 11:19 AM on January 9, 2010


I'm sorry for your loss. My wife and I have been going through IVF, and this is certainly something we fear as well. We've gone through a little therapy ourselves, and I'd certainly recommend that you and your wife try it as well. I absolutely think your feelings are valid, and likely very normal in this situation. If I were in your shoes, it might help me to remember that I didn't make a decision to end a viable embryo - the decision as to whether your third child would survive was made for you, tragically. What you did decide was to whether to act to save the life of your other two children. It's my understand that when a doctor says that it's highly risky that an embryo won't survive, they tend to mean "almost certainly, but since I'm not omniscient, highly likely is as confident as I can honestly be."
posted by centerweight at 1:54 PM on January 9, 2010


We've talked about therapy, but neither of us are all that eager to relive the
experience by talking about it with someone.


I sought out therapy after my cousin killed himself. Not at all the same situation as yours, but one of the things the therapist recommended was to write a letter to him. It was one of the most emotional experiences of my life, but it did help. A lot.

Plus, my wife has said she's afraid that we might be told we're making a big deal out of nothing and we should just get over it.

This would assuredly never happen.

Would therapy help relieve some of our guilt and grief?

Yes. It might temporarily bring more of it to the surface, but it will help you in the long term.
posted by desjardins at 1:42 PM on January 8, 2010


We've talked about therapy, but neither of us are all that eager to relive the experience by talking about it with someone.

As just a supporting voice to the general advice tone here, it seems to me that the very fact the hard decision is still eating at you means you're already reliving it. You relive it with each surge of guilt, each flash of memory, each wave of second-guessing, every sharply-imagined what-if the mind can get wonderfully adept at torturing itself with. So, there's that: the way you're reliving it right now isn't working. So reliving it in some other way that could probably help is probably worth a shot.
posted by Drastic at 1:45 PM on January 8, 2010


Everyone above has given you excellent advice. I just wanted to add that if you are fearful of what a therapist might say (and a good therapist would never say this is a big deal over nothing!), there are therapists who specialize in grief and loss, especially lost pregnancies. Instead of just picking someone out of the insurance listing, consider calling your OB/GYN office (or whomever did your IUI) and asking for a referral. Since I'm sure they've dealt with many women who've lost pregnancies (in many different ways), they probably know someone that specifically works with that population. Peace to you and your wife on your journey.
posted by MultiFaceted at 1:47 PM on January 8, 2010


Someone close to me told me recently that they had a twin in the womb who did not make it. This twin ended up actually dying unexpectedly inside of their mom. The details that ensued up until their birth severely traumatized their mom. Their mom was depressed after this, permanently. The person who mentioned this to me was very sick as a baby and almost did not live.

You two have overwhelmingly done the right thing.

I don't know about the therapist idea, but you two should both know that, despite the flood of emotions that may make your brain say "oh no we must have made a mistake", you did not. You did the right thing.
posted by lorrer at 2:06 PM on January 8, 2010


If you feel strongly enough about this to post here, you want to talk about it... a therapist will be able to help you deal with this in a constructive manner.
posted by sundri at 2:16 PM on January 8, 2010


i'm going to nth the idea for a ritual or ceremony of some sort. when i was 17 i miscarried a baby i didn't want. i'm pro-choice, but i was going to give the child up for adoption. the guilt of "did i not do everything i could to protect the child inside of me because i didn't want it" was really hard for me to get past. writing a poem, making some some crafts, naming him, and burying it all helped. just taking time to mourn the loss in a structured sort of way allowed me in some ways to let it go. 11 years later i'm still sometimes sad, but i realize that my body just didn't want to carry my baby and my non-excitement for its presence probably didn't have anything to do with it.

as others have said - your emotions on this are normal, spot on, and very real. there's nothing that you need to "get over". what you should strive for is finding a way to settle your own grief and fears so you can enjoy the beautiful lives you saved. listen to what the doctors said and trust that they knew the stakes. your twins are here because you had the courage to make a hard decision at an emotionally charged time.
posted by nadawi at 2:39 PM on January 8, 2010


I wonder, did you name the baby? Do you have images of the ultrasound, or other reminders of the child(ren) you lost?

I ask this, because whenever you lose a child - miscarriage, selective termination, still-birth, or death of a baby or child that lived through birth - its natural and normal to feel this sense of loss. This child was a part of you, a part of your family, a part of your hopes and dreams. Its normal to mourn the loss of this child. Its normal to feel this grief. If she had carried the babies to term and one had died post-birth, you would have many of the same questions (Did we do the right thing?). Somehow our culture has decided that we should be able to move past the loss of a child prior to birth with more swiftness and ease than we would mourn the death of a child we held in our arms, but the heart decides different things.

I have experienced miscarriage and I have terminated a pregnancy, so I know a little about how you feel. Even now, 20+ years after the termination, I wonder about that child - who s/he was, if I did the right thing..... I can promise you that virtually every other parent who has experienced the death of a fetus will tell you they go through the same things.

As suggested up-thread, it may be valuable for you to create a ritual for those babies - the siblings of your living children. Name both those babies. Plant a tree in their honor, water it and watch it grow. Make a donation in their honor. Decide on a day (perhaps they day they were conceived?) when you and your wife can privately remember those children. The rituals of mourning do not have to be so much different from those you would do if you had a grave to visit. When they're old enough, you can tell your living children the story of their birth, if you wish. You don't have to say that you decided to reduce, if you don't want to (I wouldn't). But I would not hide the fact that they had siblings at conception, nor the fact that you miss those babies just as you love and embrace the children that are here with you.

I read something once about grief that I'm going to paraphrase badly, but the essence is that if you try to ignore the pain, it will linger. But if you hold that grief close to you, embrace it, refuse to fight it and instead let it wash over you, that in the end you will be the stronger for it. Your sadness for the babies you lost (and the hard decision you had to make) is normal, normal, normal. Don't let anyone tell you otherwise.

I wish peace for you and your family.
posted by anastasiav at 3:00 PM on January 8, 2010


We've talked about therapy, but neither of us are all that eager to relive the experience by talking about it with someone.

But you are reliving it , and its aftermath, by not talking about it. Not dealing with it is causing you to look at your current parenting through a tainted lens. Go talk to someone about it. Life will feel better.
posted by DarlingBri at 3:21 PM on January 8, 2010


I'm sorry. I don't know what to do but tell you that you did the right, honorable thing -- you protected a healthy mom and your healthy children, and you did what you had to do. Multiple births under the best of circumstances are incredibly challenging; they're pretty much guaranteed to be premature, and they have to fight for every bit of sustenance they can get. We aren't designed to carry that many children, our bodies just aren't.

I think maybe you should have a funeral, just the two of you, some private ritual of letting go. The baby was loved, but too weak to survive, and would have compromised the others and the mother. You had no choice and as painful as it was, you did the right thing.

You did the right thing.
posted by A Terrible Llama at 3:47 PM on January 8, 2010


Another person here to commend you on making a tough decision.

What I would suggest is what others have said; don't try to force yourself to be happy about the decision or to gloss over how painful it was to make. I would even suggest that you not try to think of it as protecting your twins or as some kind of transactional "needs of the many outweigh the needs of the few" kind of thing. I don't think that will help, but I really haven't been in that situation.

If it was me, I would probably try to look at as an act of mercy. It was the right thing to do, but that doesn't mean it is going to be easy. Allow yourself to feel the loss and don't try to stifle those feelings with any rationality.
posted by gjc at 4:58 PM on January 8, 2010


I'm not in any position to comment on your situation other than to say: what a difficult experience you have been through, I wish you the very best. I wanted to comment in this thread to say that there are therapists who specialize in infertility, pregnancy, miscarriage, and post-partum issues. The practice where you underwent the IVF treatments may be able to refer you to one of those specialists.
posted by Meg_Murry at 5:44 PM on January 8, 2010


No mention of your religious backgrounds. Perhaps there are conflicts with early-ingrained beliefs, notwithstanding your profession of "pro-choice" beliefs.

Counseling would help, as many others have said. The decision to reduce in this instance was a "pro-life" decision, but it is hard to go against the early training.
posted by megatherium at 8:22 PM on January 8, 2010


Therapy is the correct option. I think you both need to grieve, but feel you shouldn't because you elected for the reduction. I know you don't want to relive things, but right now all you are doing is not dealing with it at all. You need to face the grief and the bad feelings in order to be able to move on. The longer you put that off the worse it will be.
posted by Catbunny at 9:38 PM on January 8, 2010


One more thought, expressed by others as well, but you will have to relive it to give it up. Grief just works that way. That one you can't fight or ignore. Face it, acknowledge it, acknowledge the pain, then put it away. It's harder than that, but those are the steps. I even think you might want to consider giving this child a name. I would talk that one through with the therapist first though. It could cut both ways. It might help to acknowledge the loss, but that name might keep it there in your catalog of loss for longer. Whatever happens, don't be surprised if this is not something that causes some sense of loss even decades from now - you just sitting there on your couch and then remembering it and sensing the loss. That's normal.
posted by caddis at 10:19 PM on January 8, 2010


« Older like a record, baby   |   Midlife fish, teeny tiny pond. Newer »
This thread is closed to new comments.