The Baby Keeper

There aren’t many women who can understand what the mother of the octuplets, born in California this week, might be thinking right now. Cintya Diaz is one. In early 2008, after a series of fertility treatments, she went in for a 10-week ultrasound, thinking—based on four previous scans—that she was carrying a single fetus. The ultrasound technician said “the baby looked small,” Diaz recalls. Then, the tech turned from the screen, surprised. “Cintya,” she said, “I didn’t know you were expecting four!” (Article continued below…)

Diaz, 29, hadn’t known either—and suddenly, she was “scared to death.” She had good reason to be. Her first pregnancy had been successful; she had a healthy 12-year-old daughter, Daisy. But her second ended in tragedy; she lost twins at 26 weeks. I wasn’t able to carry two babies, she thought. What would make me think I should try to carry four? Diaz’s obstetrician agreed. He said she would need to “selectively reduce” the fetuses, aborting some of them to give the others a better chance.

The risks were clear, yet the idea of abortion made Diaz uneasy. She had the name and number of a reduction specialist in hand when a friend, the mother of triplets, told her there was an alternative: Dr. John Elliott, the director of maternal-fetal medicine at Banner Good Samaritan Medical Center in nearby Phoenix, who specialized in large multiple pregnancies. She went in for a consultation and, four hours later, came out determined to carry all four fetuses to birth. “I don’t trust a lot of doctors,” she says. “But Dr. Elliott empowered me. I came out of that appointment like”—she raises her fist —”yes! I can do this.”

Carrying multiples—or, as they’re called when there are more than two babies, “supertwins”—is a risky proposition, healthwise, for both mother and children. It’s also an increasingly common one. Fertility therapies such as IVF and treatment with Follistim, a drug that prods eggs to mature, have become more advanced, successful and widespread in the past two decades. As viewers of TLC’s “Jon and Kate Plus 8″ know, occasionally—particularly if infertility docs are not careful—the treatments cause many embryos to take hold in the womb instead of one. And that’s where the wrenching decisions come in. (Follow the history of multiple births in our photo gallery.)

Although there are no comprehensive statistics that show how many women are accidentally impregnated with multiple viable embryos—no one collects data on women who abort in those circumstances—it’s clear the number of women carrying multiples has been on the rise. The California octuplets are only the most extreme example (no set of eight has ever been conceived naturally).

Twenty years ago, there were 90,118 sets of twins born in the United States, 2,529 triplets, 229 quadruplets, and 40 sets of five or more babies. By 2005, according to CDC data, those figures had risen to 133,122 twins; 6,208 triplets; 418 quadruplets; and 68 sets of five or more. The numbers peaked in the late 1990s and early 2000s, but did not subside to anywhere near previous levels.

The increase in multiple births doesn’t just reflect a jump in babies being conceived with the help of medical technology; it is also the result of efforts by some obstetricians to help women bring those high-risk multiple pregnancies to term despite the odds. Elliott is one of the most radical practitioners of what might be called “extreme obstetrics.” Medically, Elliott’s strategies seem to work: his patients carry their triplets, quads and quintuplets for longer than the national average. But some doctors criticize his methods as unproven or even dangerous, and they worry that docs like Elliott are inadvertently encouraging more women to try to carry supertwins—and to risk serious medical complications—simply by offering hope. On the other hand, pro-life advocates, among others, would certainly say that controversial doctors like John Elliott are saving lives.

The Baby Keeper

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