Women with multi-fetal pregnancies "have that much more change in their physiology, and that puts them at significantly higher risk," Day explained.
Babies from multi-fetal pregnancies also face many health risks, primarily being born premature and the complications related to prematurity, including learning disabilities, behavioral problems and cerebral palsy.
"Babies that are born premature, at 23 or 24 weeks in gestation, have about a 50 percent chance of having a major cognitive or motor impairment," said Dr. Marilee Allen, a professor of pediatrics at Johns Hopkins University in Baltimore.
"When we counsel women on multi-fetal pregnancy reduction, we talk about reduction in the likelihood of risk to the babies, and risks to themselves and the likelihood that all of the fetuses would even make it to an age in the pregnancy when they could survive outside the mom," Day said.
Although the ACOG does not give specific advice about what doctors should tell women about multi-fetal pregnancy concerns and the option of pregnancy reduction, it does recommend that women talk with a team including social workers, obstetricians and neonatologists, who specialize in newborn medicine, to get a well-rounded view of their pregnancy.
"My heart goes out to the families facing the question of reduction," Allen said. "Looking at it from before the pregnancy takes place is really the time to be having those conversations with families, because then it's not really so much an ethical consideration as it is a more practical decision."
If a woman decides to reduce her pregnancy, she may also face limited resources and have to travel to an area where she may feel less comfortable and learn whether her insurance company will cover the procedure, Day added.
More information
For more on the risks of fertility treatments, visit the American Society for Reproductive Medicine.
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