Surge in Multiple Births Linked to Fertility Treatment

Mary Beth Stevenson gave birth to triplets — a set of identical girls and a boy — who last spring completed kindergarten where Comeau attended decades earlier. At 34, she turned to IVF and conceived after six tries.

Knowing the Risk

"You know there's an increased risk, but you may never have children on your own," said Stevenson, who had been pregnant before and had a miscarriage. "I just wanted one healthy child."

On the day of her ultrasound, Stevenson feared there would be no heartbeat, but when the doctor heard the second and third beats she thought, "First they tell me I won't have children, and now I have three children."

Their life was a whirlwind of breast-feeding for three, triple cases of formula and — at year's end — a total of 6,600 diapers. Friends showered them with gifts, and every relative and neighbor fought to feed or cuddle the babies.

Today Stevenson, at 41, runs a window treatment business at home and encourages her triplets' independence.

In Massachusetts, as in many other states, parents are legally allowed to make the decision about whether twins are separated or kept together in school.

Her triplets chose to have separate teachers so they could have "their own birthday parties and friends," said Stevenson. "One of my daughters had a set of twins in her class and said, 'Mommy, they don't know how to separate.' My kids went into the classroom the first day and never looked back."

But, said Cole, not all multiple birth stories have a rosy ending. As the number of babies in the womb rises, so does the risk of premature birth -- a danger to both mother and her babies.

Any birth before 37 weeks gestation — three weeks before the due date — is considered premature. And even as advances in neonatology help many survive, they are at greater risk for cerebral palsy, hearing problems, lung and heart complications and learning disabilities, according to Cole.

Mother's Heart Failure

In the recent Arizona case of the Masche sextuplets — all of whom survived — their mother suffered heart failure during the arduous birth.

In some cases, women and their doctors must make the painful decision to abort one or more of the growing fetuses in a multiple pregnancy for the viability of the others.

"Parents struggle with these decisions," said Cole. "It's very important to find those boundaries and not go fishing around in the middle of a pregnancy for impossible answers."

Still, many multiple births go smoothly, and parenting multiples can be both a "big blessing and very challenging," said Pamela Fierro, author of "Everything Twins, Triplets and More," who also writes on the topic for About.com.

Fierro raised twin girls, now 12, who are "very competitive but deeply connected."

"Babies can really put a strain on a marriage, finances and other siblings in a house," she said. "Babies are everything in your life and very consuming."

She urges parents to respect each child as an individual and avoid comparisons. Mothers need to ask for help and keep a sense of perspective.

Teachers, too, need to revere the special bonds that make multiples emotionally inseparable. Comeau needs only to look to her own twin.

"We have the most unique relationship in the world," said Comeau's twin, Jennifer Ward of Melrose, Mass. "I love my husband, but everything is better with her company. We will be together in our high heels and our rockers."

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Metropolitan Autonomous University and Wake Forest Institute for Regenerative Medicine