Triplets can lead to despair for infertile couples

Infertile couples who spend years and thousands of pounds trying to have a baby and end up with triplets are at risk of physical and emotional breakdown because they feel too guilty and ashamed to admit that they are having problems coping.

Research published in the latest issue of the journal Human Fertility, looks at parents who have multiple births following infertility treatment. It finds that after the euphoria of being pregnant with a ready-made family, some parents are at risk of despair, ill-health and divorce as they struggle to cope with the enormous work-load of twins or triplets.

Since the early Eighties, the incidence of twins has nearly doubled and that of triplets nearly quadrupled largely as a result of infertility treatment. The latest figures from the Office of National Statistics show that in 1998, 297 sets of triplets and 8,776 sets of twins were born.

Fertility specialists are so concerned that the social and financial cost of multiple births is too great that the Royal College of Obstetricians and Gynaecologists recently recommended only two embryos be put into the mother to reduce the number of multiple births. Dr Alexina McWhinnie, a senior research fellow at the University of Dundee and author of the study, said that it was important to understand that parenting triplets is not just about being a good parent but being able to deal with a multitude of practical and repetitive tasks.

Her own study of 54 families who had children after assisted reproductive technology, and a review of the literature,show that mothers of multiple births experience a higher level of depression and anxiety than those who have a single baby, and divorce is more common when parents receive poor support in the first year. The report shows that mothers become socially isolated, have problems getting babies ready to leave the house and find it too daunting to take public transport.

"When parents aren't coping they cannot bring themselves to tell the clinic that, after all the years of longing for children, when they got them they were not coping with them. They feel guilty and ashamed," said Dr McWhinnie.

"If more than two embryos are transferred, then clinics could consider targeting those families most at risk in relation to social factors, and to be proactive in ensuring these families have adequate and immediate help with the care of babies once they leave hospital and continuing support over a considerable period," she said.

Currently social workers only help multiple-birth parents with four or more babies. The Twins and Multiple Birth Association has called for greater financial and social support for families of twins and triplets.

Tracy Clifton, 31, a former civil servant from Newbury, Berkshire, gave up work more than four years ago when her triplets, Jack, Tom and Harry were born.

"We were having problems conceiving and ended up having fertility treatment. Eighteen months later we were told... that we had triplets. We were absolutely thrilled, and I burst into tears with happiness. It was such a shock."

Mrs Clifton had a mainly problem-free pregnancy but nothing had prepared her for the next few years. "It was like perpetual motion, just feeding them took all my time and energy. There were 24 feeds a day. I was always feeding, or preparing to feed them. After a week my husband went back to work and I just felt I couldn't cope."

"I used to sit on the bed in the morning crying... The whole time I felt I had no right to cry, and this voice in my head kept saying you wanted children now cope with it.

"It hasn't got any easier, as they've grown up," she said. Her sons are now four years old. "I still need military precision to leave the house."