Fetal reduction - twins to singleton

[mostlyhappy2010]

Hello,
I know that this may seem offensive to some, and I apologise in advance for this: I am desperate for some advice: I am 7 weeks pregnant with twins (non-identical). After 2 weeks on an emotional rollercoaster, I have decided that I cannot cope with twins due to health, emotional, practical, financial reasons. I am considering fetal reduction.
There seems to be very little information about fetal reduction from twins to a singleton. The doctors seem to default to termination of both. Has anyone got experience with fetal reduction in the UK? Where do I go for more information, either NHS or private?
Any information would be very useful. Thanks a million!

(Please do not post judgement: it has been a difficult decision, and it still is a difficult time).

I have no personal experience in this area but I feel for your dilemma. However, AFAIK performing a fetal reductoin puts the other fetus at a much higher risk of miscarriage.

Help is always available to those in need (emotional, practical and financial!)

Have you spoken to your GP??

i'll be honest and say that it's very hard not to judge... however, i would advise you to chat to the mums on the multiples board on here if you haven't already done so.
they'd be able to give you a very good insight into what life with twins is like, which may help you decide whether or not to go ahead with a reduction.

as catinboots says, a reduction will come with a risk of miscarrying both twins

a friend was offered it with triplets...she declined. There were risks but if placenta was not shared obviosly it IS possible.

I think it is very very early days and you are still in shock - maybe you should take some time out before you start thinking about this and work out how you will really feel? Obviously it is not what you had planned - did you plan the pregnancy?

It might be worth ringing the multiple birth foundation for some advice. When having my scans the sonographer told me that they often advise reduction for triplet/quad pregnancies as the pregnancies are very high risk. I don't know how this works or the risks involved.

I have id twin girls, and to be honest I think it's hard work having a baby full stop, with twins you just get used to it very quickly, I know no different to the mums I meet with singletons.

Financially yes it's more expensive but you can ebay/freecycle/shop around. Also I was offered help from Surestart but didn't feel I needed it.

Sorry you are feeling so down, hope you have some family/friends to talk to in RL

MBF link here

Thanks for the message. The pregnancy was planned as a "last one". We are not young parents, and we have a limited support network. It has been a very difficult decision, and I do feel awful about it, but having 2 more is just not right for us as a family. Somehow the doctors seem to default to termination of both which feel worse for me.

I am a mum of twins. When I found out I was expecting twins (with a 2 year old) I was in such a total total state of shock and was truly horrified. I couldn't understand why I wasn't being offered a reduction.

The first couple of years with three young children were very hard - but of course you do love them so much too. Now my twins are older (now eight) I think I'm the luckiest mum ever with my three.

I really wish you the best, and I don't judge but I hope you can talk this through with someone. It wasn't until I was about four months pregnant that I felt that I had started to accept my twin pregnancy and that was a very lonely place to be. Thinking of you.

@deemented: thanks for the information. I assure you it is not a decision which we have taken lightly.

It's very early in the pregnancy, it can seem overwhelming.
I also spent a large proportion of my twins early life (first 16 weeks)wishing I just had one baby to deal with. It seemed like a nighmare. Eventually penny dropped, which one? They were both indispensable to me. They are both indispensable to me, although I often think what life would have been like if it I had had the easy second singleton baby I first imagined. (It was my second pregnancy) I don't think you will ever regret twins.

I asked about the possibility of fetal reduction when I discovered I was pregnant with twins. This was at the 20 week scan. The consultant said this was possible but carried the risk of losing both. My reasons for asking for it were the same as yours- fear, panic, the feeling that it would be overwhelming and we couldn't cope emotionally, financially, and that it would mean we would be too stretched to look after our other children properly.

In the end I decided against it (my husband supported my decision- he knew it was for me to make, and I am grateful that he did not pressure me in either direction). It has been hard having twins, but they are lovely and I am very glad I didn't do it.

I don't think I could have coped with the guilt and pain of purposely choosing to abort. I think you need to forget about the practicalities and follow what YOU want to do- because you need to be strong for your family either way.

I suppose I'm rambling to say- please consider your mental health if you do choose to abort- I feel it is much harder to abort if you already have children, and you may find that it is devastating to have a healthy twin, but not it's brother/sister. A constant visual reminder, for starters, then the "secret"- do you tell the surviving twin when it's older what you did?

I'm not trying to be judgemental, just telling you some of the scenarios I thought about when going through this.

I wish you well and hope you make the right decision for you.

Well written Barry, you have capture my thoughts too.

OP how many children do you already have?

I personally think the guilt would kill me later on. I would have to go for all and get rid of both, or nothing and keep both. Like others have said, it's very early days, you are only 7 weeks. It may sound callous, but you might well loose one naturally in the next couple of weeks.

I hope you come to a decision you are comfortable with and can live with.

OP Sorry you have so many people being unsupportive here.

I had a fetal reduction in the US from triplets to twins. We were considering going to a singleton but didn't in the end. When I had my reduction many consultants wouldn't reduce to singleton except in special circumstances, we had to ask around to find a consultant who we could talk to about it. Because of our ages the consultant advised having amniocenteses tests first so that any reduction was based on those results. We had amnios on two of the fetuses, the third was the most likely candidate for the reduction based on other factors so they didn't increase risks by doing all three. When the results of amnios came back clear the third fetus became the reduction candidate. If one of the amnios had been less good we would have had a third amnio before making a decision. Because of the amnios the reduction couldn't take place before 12 weeks and the consultant said it wasn't advisable anyway (increased risk of loss of the total pregnancy). There is a possibility of loss of the entire pregnancy (this is also true with amnios), as far as I could ascertain the more experienced the consultant the less the risk.

I don't know if reduction from twins to singleton is supported on the NHS in your circumstances. I would suggest you start by talking to your GP if s/he's pro-choice. Otherwise somewhere like Marie Stopes or BPAS may at least be able to put you in touch with the right people.

I'm very glad I went ahead with the reduction. I had been having increasing difficulty coping with the pregnancy and was very worried about how I would make it through. The day after I felt so much better I could hardly believe it - very much confirmed to me the fact that we aren't designed to carry more than one at a time. I was also concerned about the risks of a multiple pregnancy on the fetuses and the impact on family life of having three when we had only really planned for one. I now have a fantastic family that I love and am not overwhelmed by. I can see how this applies to a twins/singleton choice as well, and I encourage you to keep thinking about your life and trying to do all you can to make it work the best you can for you and your family.

YourChoice - i don't think anybody is being unsupportive

Op - How are you feeling today?

I think phrases like "I personally think the guilt would kill me later on." and "I'll be honest and say that it's very hard not to judge" and "please consider your mental health if you decide to abort" are very unsupportive. Posts telling the OP that she basically just doesn't know her own mind and she should talk to lots of people who haven't chosen the route she has rather than trying to answering the questions she actually asked are not really supportive either.

Gosh, OP- I do feel/have felt your pain

I don't think anyone's being particularly unsupportive to the OP, YourChoice-just honest

thing is, with posting in multiples, most people on the boards will be parents of multiples- ie those who might have had doubts and fears about having multiples, but who went through with it anyway, so will mostly be from one angle- by definition

I would try to redirect you to another part of the site, OP- but I can't think where! Anyone else?

and do contact Tamba www.tamba.org.uk/ here

Hello. I am the Mum of twins and while I don@t jusdge you, I would just urge you to talk to some other multiple Mums about the uniquely wonderful things about having multiples. It is easy to get bogged down in the scary thoughts. Whatever you decide though I wish you well.

I don't think anyone here is qualified to answer your questions since it is very rare. I think the only people you can talk to are the doctors. I think also they insist on counselling before any decisions are taken. It is a very very tough thing to decide. the can best consider the health implications too ( I presume that is to you while pregnant).

As a parent of twins I think maybe you might be overestimating the impact of 2 compared to 1 more. It is tough in the early days - but once past the toddler stage it is not a problem. And financially - again you cope - just as you do with whatever combination of children you have.

Good luck - whatever you do.

Oh my gosh,
I have fraternal twins. They are such individuals, just brothers who happened to be born at the same time, not 'two halves' or 'two the same'.
I agree with Londonlottie and Yousankmybattleship. Really, twins are OK (fantastic after the first year).
I don't know your situation, don't want to judge but really cannot see how you can choose one to live over the other.

Awful decision to make. Hope you are Ok

I would suggest you have some form of counselling before you 100% make your decision. The thought of multiples is massively overwhelming: as a triplet mum, I know this only too well. Talk, talk and talk some more and if you decide to go ahead, choose the very best consultant you can, as has been stated, the risk of miscarrying the other twin will be fairly high.

The very best of luck to you.

Mostly, I have a singleton son who is 2.10 and ID twin DDs who are 7 months, I am also due again in September.

I can honestly say, for me, the twins were/are less work than DS, he was a clingy, colicy baby, he was sick a lot and just a bit grumpy! DDs were got into a routine ASAP and as such I don't think I've found them anywhere near as hard work as their brother! they keep each other company and now if they're both awake sometimes they'll sort of play with each other!

DH and I briefyl considered a termination with this pregnancy as we both have A LOT of student debt, don't know how we'll afford it or where we'll put her when she arrives! But I thought I think I'll always regret not having the baby more than having her, once she's here I don't think any of us will be able to picture life without her!

youchoice you may have a point there... if you believe that being supportive means just agreeing with an OP and telling her how wonderful her choice is

I think it would be incredibly hard for her in a few years time when she is watching her child grow up.. and thinking of the other one which should/could have been there beside it.

I am sure she has thought of that, but as others have said, it's very easy to get bogged down in the negative side of things, ie how much extra work/money/time it would be. Hence my suggestion of talking to the multiples mums on here.... any specific worries the OP may be having about twins may well be answered on there and she may find that actually it's a lot easier than she imagines it would be

Of course, it may be the case that she already has twins and knows it all already. But i'd rather say something and be wrong than just say "there there, it'll be ok, you just do whatever you want"
she wouldn't have come here for information/advise if she had made up her mind 100% would she?

When we talk about the problems of multiples we generally talk about things like complete lack of sleep in the first few months, the difficulties of childcare, the problems of managing a house with multiples, buying two of everything, whether or not to put them in the same class at school, how others make annoying comments etc. These things sound overwhelming but you end up coping with for the most part.

But here's another angle that multiple parents don't talk about much but is also the reality (not all of which is mitigated by a fetal reduction). Compared to parents of singletons:

We are more likely to have a miscarriage or still birth
We are more likely to get divorced
We are more likely to bring our children up in poverty
Our children are more likely to have physical or mental handicaps
Our children are less likely to do well academically
Our children are more likely to die in the first year of life

Those are also valid things to think about when considering your decision. It's pretty hard not to love your children once you have them, but that doesn't mean that controlling your fertility is a bad idea.