Social stigma and compounded losses: quality-of-life issues for multiple-birth families

Objective: To determine the quality-of-life domains most impacted by multiple births. Design: Focus groups, qualitative research. Setting: Human volunteers in a medical research environment. Patient(s): Forty-three mothers, 29 raising multiple-birth children, 13 raising singletons, identified from random and convenience samples. Intervention(s): None. Main Outcome Measure(s): Maternal self-reports of the psychosocial sequelae of multiple or singleton births, based on qualitative data analysis of transcribed group discussions. Result(s): The quality-of-life domains that were most impacted by raising multiple birth children were social stigma, pregnancy loss, marital satisfaction, children's health, unmet family needs, parenting stress, maternal depression, and the infertility experience. Conclusion(s): Qualitative methods identified two novel quality-of-life domains in iatrogenic multiple birth families: social stigma and compounded losses. An unexpected finding was the potential for increased marital solidification as parents coped with the inordinate stresses of multiple births. As anticipated, children's health, unmet family needs, maternal depression, and parental stress were key areas of concern. In addition, the infertility experience had a lasting impact. These findings are significant, given that at least 38% of all assisted conceptions result in a multiple birth. This study lays the groundwork for further research on the impact of iatrogenic multiple births. (C) 2003 by American Society for Reproductive Medicine.