In March this year, Galway woman Maria* was overjoyed to discover that her IVF fertility treatment had worked and that she was pregnant with triplets.
However, her joy turned to despair when the consultant explained that pregnancies involving triplets are high risk for both Mum and babies.
“My consultant was frank about my options. Triplets may have meant being on bed rest from 20 weeks and if I was lucky, birth at 30 weeks then hospital tube fed triplets for another few months. I was told there was a possibility they’d not all survive if something happened to even one of them… She told me there could be early labour and triplets with severe cerebral palsy.”
Maria and her husband were concerned that their toddler daughter would have to become a carer for her three siblings for the rest of her life after they died.
Maria’s consultant advised her of other possible outcomes for the triplets. She was told one triplet could die and that might mean Maria needed to deliver the other two who could be born with severe medical complications.
“Or me getting eclampsia, gestational diabetes, severe depression. Pregnancy is not risk-free for the mother. I kept forgetting about the risk to me. My husband couldn’t stop thinking about it.”
The consultant mentioned embryo reduction which is the recommended course in many countries, like the U.K and the US.
“She told me the UK offers them between 11 and 13 weeks, but that a clinic in Barcelona did them between 7-11 weeks. We contacted both hospitals but I only heard back from Barcelona.”
The surgeon told us he considered it medical negligence to not reduce.
“The risks are too high”.
“He kept apologising that I even had to talk to him. It was a horrible Sophie’s Choice but it was about saving lives, not taking them”.
Despite it being considered to be best medical practice in most OECD countries to have an embryo reduction, Maria was unable to access the help she needed here in Ireland.
“I had to travel to get the embryonic reduction, because I was 10 weeks pregnant and there were heartbeats all round, the problem was not an unwanted child, it was a health risk to the fetuses and me. I felt angry that doctors I knew and trusted couldn’t do the embryo reduction at home. I needed access to health care.”
Maria and her husband agonised over the difficult decision they faced. After researching what other first-world countries advise for triplets they ultimately decided to opt for the embryo reduction from triplets to twins so they could give them “the best shot at life”.
They made an appointment with the hospital in Barcelona to travel the following week. This left Maria and her husband under severe financial strain and they had to borrow money and make childcare arrangements for their toddler.
“I felt powerless needing to find money on a week’s notice…I felt like my insides were ripped out having to leave my daughter for five days to take a trip I couldn’t afford.”
Her mother and father-in-law were angry about their decision.
“My in-laws called three times a day telling us we were doing the wrong thing. They said they’d never look at us the same. I already felt absolutely sick at being in this position, but their vitriol made it a million times worse.”
Maria’s parents lent her the money to enable her and her husband to travel to Barcelona for the operation.
“The morning of, I remember being awake in the hotel room from 4 am and getting up to shower at 7 am. I can only imagine it’s how an inmate feels walking to death row…walking towards the hospital that day, every part of me was sick the closer I got.”
Before she had the general anaesthetic, Maria was worried that there wouldn’t be anyone who spoke English available to talk to her when she woke up.
“I was out a few hours. I woke up bawling and feeling utterly alone. And so so sad. The anaesthetist came by to check on me and just stroked my forehead asking in his limited English “pain?” his eyes were so kind and sad. I will always remember his kind gesture.”
After the operation, Maria went to her hotel to rest for two days. She says she spent the weekend lying in bed hoping she wouldn’t start bleeding. Maria then returned to the hospital for a follow-up scan.
“The twins were great, kicking away. I got the go ahead to fly that day. I was so lucky for this privilege that my parents could lend us this money. I’ve no idea what I would have done if I couldn’t have stayed the whole weekend and given myself every chance.”
“We flew home just as Ryanair brought in their new thing of separating people who don’t pay for seats together. So I had to sit alone on that flight. There was a lot of turbulence and the women beside me was hysterical. I was so calm on the outside but so terrified something would happen.”
After a turbulent flight and still recovering from the operation, things got worse for Maria.
“I was tossing and turning in with cramps all night and was bleeding when I woke up. I was 11+4 days, only 3 days away from my booking appointment at the hospital in Ireland. I was worried and went to the EPU. I was told I was OK.”
Maria was told she couldn’t have a scan that day but to come back if the bleeding started again. Two days later Maria returned to the hospital as she had cramps and bleeding.
“I got a scan and was told I’d lost one of the twins. The Dr was very compassionate but I had to relay getting pregnant at the fertility clinic, the procedure notes from Barcelona. I so, so wish I had had a continuity of care so someone at the hospital knew what had gone on…I remember losing it in the hospital corridor and just losing my strength trying to keep it together anymore.”
Maria went home, devastated at the loss of one of her twins but hopeful about the remaining baby.
“The next day my waters broke at home. I didn’t bother calling the hospital because I knew what that meant.”
Maria went straight to the hospital and was given a scan, she was told that her baby had a slow heartbeat.
“We were told to prepare for a miscarriage over the weekend and to come back once the bleeding started. If none did, I was to come in Monday for another scan. They kept telling me they’d have to medically manage the miscarriage and I had no idea what that meant.”
Maria was given a blood test and told to go home. An hour after, she received a call from the hospital.
“My bloods showed dangerous levels of something and I needed to be admitted ASAP. I was told not even to go home and get anything first….Just to come straight in.”
Upon arrival at the hospital, Maria was put on fluids and antibiotics immediately. The next morning, the consultant on call and the managing midwife took Maria and her husband down for a scan.
“The scan showed what we expected, we had lost the last of the triplets. The doctor wanted us to see. At the time it broke my heart but I think it was so that I could prepare for the next step: a D&C later that day. A part of me wanted to deny that a week ago I had triplets and now I had no life inside of me. I don’t know if I could have gotten through the D&C if I hadn’t seen that last baby be still. But it broke my heart.”
Maria says she had to give her medical history to the anaesthetist as she was wheeled into surgery.
“I woke up the next morning convinced the midwives were all talking about me and how terrible I was. I was very mentally fragile.”
Maria suffered a number of complications in the following months but says that the anguish of not being able to receive treatment and care in her own country will take her “years to untangle”. Maria is angry that the Eighth Amendment forced her to seek medical care in another country and that it’s “possible that travelling contributed to losing the twins after having the operation.”
“I felt ashamed of the secrecy of it all and the stigma that I was acutely aware of. I felt terrified of being judged. That anyone would doubt how badly I wanted that pregnancy. I felt frustration knowing I’d never be able to explain myself adequately to someone who judged me and thought I did the wrong thing.”
“I don’t regret my decision because I was adamant it was the right thing for our family. I don’t know if losing the twins is related to the embryo reduction but I’ll never know. I hope it wasn’t. How do I feel now? So sad about everything. That it’s affected my relationship with my family. That I’m not due to give birth any day now.”
Maria says that discussions around the Eighth Amendment have become very personal for her since her own experience of being affected by it, with her very much wanted pregnancy.
“I listen to the discussions on the Eighth as personal attacks against me on one side, and love, support and compassion for me on the other. Whenever I see someone wearing a Repeal jumper or I drive past a car with a free safe legal bumper sticker I just silently am so thankful for that support. It makes me quite emotional actually, that support from strangers.”
“It has given me immense comfort knowing that women and men across the country stand with me in my right to make that choice. And I stand with them to make theirs.”
*Name has been changed to protect Maria’s identity.
