In fact prospects for Mandy or her babies couldn't be bleaker. Kypros Nicolaides, a professor of fetal medicine at London's Kings College Hospital and Allwood's consulting physician, fears that her overtaxed womb will stretch to its limit and then contract, causing a "complete miscarriage." (There is no confirmed report of the birth of healthy octuplets.) Nicolaides offered a standard option for women carrying supertwins (a term denoting triplets and above): "selective reduction"—that is, aborting some fetuses by lethal injection so that others might survive. Allwood declined. Consequently she is far more likely than most pregnant women to hemorrhage or to develop blood clots or hypertension. She is, says Nicolaides, "in danger for her own life."
Though it has become one of the year's more perverse media sideshows, Allwood's story casts light on heated controversies surrounding the too rarely discussed downside of fertility drugs and in vitro technology. In the U.S. fertility treatments remain largely unregulated, and the rate of supertwins has increased by 50 percent over the past 25 years, presenting more and more couples—some 50,000 families each year are now having multiple-birth babies—with agonizing dilemmas. Those who opt to see the pregnancies through must grapple with the physical, emotional and financial stress of a large instant family and the very real possibility of raising one or more handicapped children. (Multiples are six times more likely to have cerebral palsy and twice as likely to have birth defects, including blindness and brain damage.) On the other hand, selective reduction can be a wrenching choice, forcing people who desperately want children to play Solomon, aborting what might be healthy babies. "It is not a mere medical issue anymore," says Nicolaides. "It is a major philosophical issue."
PEOPLE has talked extensively with two couples who have had to navigate those issues: Scot, 36, and Patty Shier, 35, of Westchester, Calif., and Ron and Roz Helms, both 37, of Peoria, 111., each of them parents of quintuplets. The Shiers, who used in vitro fertilization and on religious grounds spurned their doctor's advice to selectively reduce, went home early this year with perhaps the healthiest set of quints ever. By contrast, the 9-year-old Helms quints, conceived with the help of a fertility drug, have battled multiple disabilities—at one point running up $2.75 million in medical bills. When they were born 11 weeks prematurely on March 2, 1987—ranging from just over a pound to 2 lbs., 3 ozs.—they were the nation's smallest surviving fivesome. Their parents had spent most of their five-year marriage trying to bring them into the world.
Ron Helms met Roz McGinnis in 1980 at the University of Iowa, and they married in September 1981, when she was a radio station program director and he was looking for work. Roz, who had an irregular menstrual cycle, took the fertility drug Clomid for three years with no results. Then her physician Dr. George O'Neil placed her on the more potent Pergonal, warning that the drug dramatically increased the risk of multiple births. The pregnancy was harrowing. "I threw up constantly," says Roz, who never considered selective reduction. "The only thing I could eat was Jif peanut butter sandwiches." The day the children were born, Roz recalls, "I could not lie on my back because I could not breathe and would start to suffocate. As soon as I would start to shift a little, the babies would go 'plop.' " Heavily sedated at the time, she remembers little of the 11:30 p.m. birth of daughter Shannon, followed by son Ben, then daughters Samantha, Bevin and Meredith—except the aftermath, when a succession of people came into her room announcing she had borne quints. The last was her husband. "I know," she snapped at him. "I'm going to sleep."
Gradually each of the quints came home, but not until Samantha was discharged on the eve of their first birthday were they all together in the family's four-bedroom house. Meredith had seizures and was put on phenobarbital and Valium, which so slowed her heart rate that she twice needed CPR. Ben was diagnosed with mild cerebral palsy, which has impaired his speech and motor skills. All suffered from respiratory stress syndrome, and their immature lungs kept collapsing, so ventilator tubes, carrying the danger of infection, were required until they matured.
For several months three of the quints had to have home nursing care, which the Helmses' insurance covered at a cost of $228 daily per child. "We had 32 people on the payroll," says Roz. "We needed two nurses every 8-hour shift." In 1989 their group insurance was canceled. "Our [accumulated] claim was the largest they had ever processed," Roz says. State-sponsored insurance tided them over until they recently reacquired group insurance through the company for which Ron manages five Illinois restaurants.
Because all five quints are several inches smaller and about 10 pounds lighter than their peers, their parents have held them back a year in school, but despite their disabilities, they have surpassed all expectations. Shannon, the first home from the hospital, was also the first to ride a bike and learn to swim. Poised and confident, she wants to be a supermodel. "She is pretty happy most of the time," says her mother.
Little Ben at first resented having cerebral palsy—"I think it is time to give this disease to somebody else," Roz recalls his saying. He now moves more fluidly and is an avid Cub Scout. He is also an incorrigible flirt. His grades are solid, but, Roz adds, "he can't always express himself the way he wants to." Because of his condition, he speaks in such a whisper that his school hooked up a microphone to an amplifier at his desk. "When he first read out loud this spring, the children in his second-grade class were stunned," says Roz. "I think a lot of kids didn't know he was intelligent."
Roz calls Meredith "the warmest child." She is also the most hyperactive. "She doesn't have an attention span," Ron says. "She is constantly bouncing around like a pinball." Brown-haired Bevin—her sisters are all blondes—is a voracious reader. Even as a preliterate toddler, she would slide books under her blanket at bedtime, then examine them by the light of a street lamp that shone through her window. Of all the quints, Samantha has been the frailest, her cognitive and motor skills lagging behind her siblings. Still, she is the most gregarious and maybe the most ambitious. "I want to be a singer," she announces. "I also want to help make laws."
Which raises the specter of how the Helms will pay for five college educations at once. "We can afford to have me as the single earner," Ron says, "but we are in the hole." Orthodontics is one concern—"Everyone has a massive overbite," says Roz—but a local orthodontist has offered a 5-for-1 deal.
Despite the medical and financial pressures, the Helms marriage remains sturdy. "The big threat we have is, whoever quits first gets the kids," jokes Ron. Says Roz of her spouse: "I can't imagine going through this with anyone else." Yet if she had to do it all over again, she says, she wouldn't hesitate to take Pergonal, and she calls the quints' birth a blessing. This fall, Roz is enrolled in a literature course at Bradley University in Peoria. For her, the first title on the syllabus, an essay by Virginía Woolf, must resound with irony: A Room of One's Own.
Patty and Scot Shier also don't have much privacy these days. More than 30 volunteers, mainly from their fundamentalist Four Square Church, help out in daily shifts and, once a week, babysit so the Shiers can have a night out. Patty, a Stanford graduate, manages the lives of her infant quints with the same rigor she brought to her work as a systems analyst for Hewlett-Packard. "Babies don't really know what's good for them. They have to be trained," she says. It took her just three months to condition the quints to sleep and wake on a predetermined schedule. For each child she keeps a small notebook—green for girls, black for boys—to record the amount of formula, in cubic centimeters, consumed in each of five daily feedings.
Patty Payton married stockbroker Scot Shier in 1988 and plotted her reproductive agenda with characteristic discipline. After an agreed upon waiting period of two years, the Shiers tried to start a family. That year, Patty's gynecologist surgically removed two ovarian cysts, assuring the couple that conception was now more likely. Finally, 18 months later, her doctor referred them to the Pacific Fertility Center in Torrance, where a doctor found that Patty had two deformed fallopian tubes.
The only option was in vitro fertilization, in which eggs removed from the ovaries are fertilized in a petri dish, then implanted in the uterus. The Shiers signed up for a package deal that included the transfer of one set of fresh fertilized eggs and two sets of frozen ones for a discounted rate of roughly $12,000. "We trusted that the Lord had a plan for our lives," says Patty, who believes the fertility technology was in part divinely inspired. God seemed to leave a strong hint in June 1994, when their first harvest yielded a phenomenal 28 eggs. But none proved viable. "You get a phone call from the nurse," Patty says, "and you just know from the sound of her voice you aren't pregnant." A second cycle, a year later, yielded seven eggs—five of excellent quality. Now came the dilemma: How many to implant?
That's a thorny question in the medical community. As Dr. Louis Keith, president of Chicago's Center for the Study of Multiple Births, puts it: "The uterus is not designed to carry a litter." In Great Britain, where the national health program often pays for infertility treatment, doctors may implant no more than three embryos. But so far, the American Society of Reproductive Medicine has failed to agree on U.S. guidelines, though its medical director, Dr. J. Benjamin Younger, has said the number should be limited "to anticipate that no quadruplet pregnancies will occur."
As for the Shiers, "We decided going in, if we had a lot of eggs, we'd go with the standard four," says Scot. "But since we hadn't succeeded before, the doctor recommended five. I cringed, because what if all five took?"
On July 4 their fertility specialist Dr. Rifaat Salem called to announce that Patty was pregnant at last. "He was not very happy," she remembers. "He's like, 'I think it's higher multiples.' " A sixth-week ultrasound confirmed Salem's suspicions. "He starts counting heartbeats," Patty says, "and by the time he gets to three, he says, 'You can't do this. You have to reduce.' " The Shiers refused.
Dr. Salem remembers things somewhat differently. "When I saw [Patty's] feeling and how strong it was, I respected her decision," he says. In fact the equally devout Scot did consider reducing. "The thought of Patty carrying so many babies scared me," he says. "But she had phenomenal resolve."
It would take that and more, however. At week 18, Patty, who had gone on leave from work when she began the in vitro procedure, was all but confined to her bed to avoid problems with high blood pressure and stress on her uterus. At week 27 she was admitted to Long Beach Memorial Hospital. The goal was for her to carry the babies for 32 weeks, since waiting too long could result in stillbirth. On Jan. 26—at 33 weeks—Dr. Craig Towers performed a cesarean. The quints were all given biblical names: First came Sarah, then Joshua, Rachel, Hannah and Jonathan—all five more than 3.5 lbs. and breathing on their own.
So far the children have developed normally, crawling, sucking their thumbs, holding their own bottles and using pacifiers. "Sarah and Hannah like to suck their toes," Patty notes. "Sometimes I feel overwhelmed," she adds. "But I don't think you would find any mother of 8-month-olds who wouldn't say that."
RICHARD JEROME
GIOVANNA BREU in Peoria, DANELLE MORTON in Westchester and BRYAN ALEXANDER in London
- Contributors:
- Giovanna Breu,
- Danelle Morton,
- Bryan Alexander.
Saved by the Bell Reunion
The hookups, the meltdowns, the memoires
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