LGBT Families and Multiple Pregnancies: The Dilemma

by Katharine Swan

Having children is a dream of many gays and lesbians. LGBT singles and couples usually get pregnant via “artificial” means: artificial insemination, surrogacy, and in vitro fertilization (IVF).

What many people don’t realize is that multiple pregnancies are often more common in these cases – and that with each additional baby, the health risks to both mother and babies increase astronomically. Therefore, before undergoing any procedures to become pregnant, lesbian and gay would-be parents need to discuss the risks with their partners, donors, and/or surrogates.

Causes of Multiple Pregnancies

From turkey-baster insemination to test-tube babies, there are a range of options for gays and lesbians who want to start a family. Unfortunately, some of these methods work too well, resulting in a multiple pregnancy – where the mother carries two or more babies. Here is an overview of the factors that make multiple pregnancy more likely.

Mom with Triplets

Fertility Drugs that Work TOO Well

Whether to improve their chances of getting pregnant quickly or to combat a significant fertility problem, it is not uncommon for lesbian women to take fertility drugs when they are trying to become pregnant. Fertility drugs work by stimulating ovulation – sometimes a little too well, as the ovaries may release more than one egg at a time. As a result, multiple pregnancies are more common in women who have been taking fertility drugs.

In Vitro Fertilization (IVF)

Because of the ease of using a sperm or egg donor and/or a surrogate, in vitro fertilization is an important option for many gay and lesbian parents. In IVF, the eggs and sperm are combined in the lab. To increase the procedure’s chances of success, several of the fertilized eggs are implanted in the mother’s or surrogate’s uterus. However, often two or more of the eggs will survive the transfer, leading to a multiple pregnancy.

Delayed Pregnancy

“Delayed pregnancy” is the medical world’s nice way of saying “old mommies.” As women age, so do their reproductive systems; as a result, women over 35 are more likely to have multiple pregnancies than their younger counterparts. However, women are having babies increasingly later due to education and career demands. In addition, the sheer effort and planning that goes into gays and lesbians getting pregnant often results in older mommies – with doctors to be consulted, a donor and/or surrogate to be located, and a range of procedures to be chosen from, getting pregnant is often a lengthy ordeal.

The Risks of Multiple Pregnancies

Many GLBT families, eager to start their families, see multiples as “bonus” children. Unfortunately, these parents often fail to understand that the real “bonus” comes in the form of rapidly multiplying health risks. With each additional baby, the health risks increase exponentially – not only for the babies, but also for the mother or surrogate.

Health Risks Multiples Face

Each additional baby in a multiple birth increases the health risks for all of the babies. A major factor is premature delivery: The earlier a baby is born, the greater its risk of health problems. Unfortunately, almost half of all twins are born premature, and nearly all triplets and other high-order multiples are preemies.

Preemies come with a whole host of health risks, including:

  1. Infection – Preemies’ immune system are not yet equipped to fight infection, leaving them extremely vulnerable
  2. Hyperbilirubinemia – A condition caused by too much bilirubin, which results in jaundice
  3. Apnea – A condition that is common in preemies born at or before 30 weeks, where the baby suddenly stops breathing
  4. Anemia – A shortage of red blood cells, which preemies are unable to make for themselves yet
  5. Low blood pressure – Caused by infection, fluid loss, blood loss, or medications that were in the mother’s system prior to delivery
  6. Respiratory Distress Syndrome (RDS) – A condition where the preemie is unable to breathe very well, caused by its lungs being underdeveloped
  7. Bronchopulmonary Dysplasia – An infection that occurs in preemies that have RDS and are kept on a ventilator for a long period of time

In addition, multiples tend to be smaller, and breech or transverse positions are more common, making Caesarian section a very real possibility. Multiples are also more likely than single babies to have birth defects: Five percent of twins and 10 percent of triplets have birth defects, while the defect rate in quadruplets skyrockets to a whopping 50 percent. Birth defects may affect any of the babies’ systems, including the central nervous system, cardiovascular system, respiratory system, and/or the digestive system.

The Mother or Surrogate is at Risk, Too!

A multiple pregnancy puts the mother’s or surrogate’s health at risk just as much as it does the babies’. Compared with carrying a single baby, multiple pregnancies put women at significantly higher risk for:

  • High blood pressure
  • Anemia
  • Preeclampsia
  • Gestational diabetes
  • Excessive vomiting
  • Digestive problems
  • Heart attack and heart failure
  • Vein thrombosis
  • Placental problems
  • Premature rupture of membranes
  • Preterm labor
  • Postpartum hemorrhage

Solutions to the Multiples Dilemma

By now you are probably thinking that the last thing you want is a multiple pregnancy. But for some lesbian mothers and gay fathers, the best options available are those that increase the chances of having multiples. So how can you protect your babies’ – and your – health?

Fewer Embryos Transferred

In Europe, government regulates in vitro fertilization a little more than American government does. As a result, most IVF cases in Europe result in only one embryo being transferred to the uterus. Even in America, many members of the medical community are beginning to advise transferring fewer embryos in order to cut down on multiple births and protect IVF babies’ health.

Selective Reduction

Even after multiple embryos have taken root in the womb, there is hope – in the form of a process called selective reduction, or fetal reduction. Selective reduction eliminates one or more of the embryos in order to make the others more likely to survive.

Selective reduction is typically performed between 10 and 12 weeks. The doctor and patients may decide to eliminate embryos because they aren’t growing as fast as the others, or because a test of the placenta called a chorionic villus sampling (CVS) displays genetic birth defects. In other words, the weaker embryos are eliminated in order to give the stronger ones a fighting chance.

A Tough Decision for Lesbian and Gay Parents

Multiple pregnancies represent a tough decision for lesbian and gay parents. On one hand, procedures and treatments that make multiple pregnancy more likely may be the only options for a LGBT family to have a bio kid. On the other hand, the health risks – for the mother or surrogate, as well as for the babies – are nothing to sneeze at. If you are considering having a child, be sure to sit down with your partner, donor and/or surrogate, and a specialist to discuss how you can minimize your chances of having a multiple pregnancy without compromising your dreams of being parents.





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