title: Social stigma and compounded losses: quality-of-life issues for multiple-birth families.
abstract: OBJECTIVE
  To determine the quality-of-life domains most impacted by multiple births.
  
  
  METHODS
  Focus groups, qualitative research.
  
  
  METHODS
  Human volunteers in a medical research environment.Forty-three mothers, 29 raising multiple-birth children, 13 raising singletons, identified from random and convenience samples.
  
  
  METHODS
  None.
  
  
  METHODS
  Maternal self-reports of the psychosocial sequelae of multiple or singleton births, based on qualitative data analysis of transcribed group discussions.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114-2696, USA. marcia_ellison@msn.com
authors.forename: Marcia A
authors.initials: MA
authors.lastname: Ellison
authors.forename: Janet E
authors.initials: JE
authors.lastname: Hall
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D003365:Costs and Cost Analysis; D019052:Depression, Postpartum / Q000523:psychology; D005190:Family; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007224:Infant Care / Q000191:economics; D007226:Infant Mortality; D007229:Infant Welfare; D007231:Infant, Newborn; D007246:Infertility / Q000628:therapy; D008393:Marriage; D009099:Multiple Birth Offspring / Q000523:psychology*; D016487:Parenting / Q000523:psychology; D011247:Pregnancy; D011788:Quality of Life; D012922:Social Change; D013315:Stress, Psychological / Q000209:etiology