In this phenomenological study women's experiences regarding their decisions to undergo or forgo multifetal reduction of their higher-order multiple pregnancies were explored. Seven women who had conceived higher-order multiple pregnancies as the result of in vitro fertilization were interviewed. Four participants accepted reduction, whereas three participants declined. Three themes were discerned: (a) the presence of infertility as a barrier to contemplating hyperfertility; (b) multiple-birth pregnancy as yet another form of loss for infertile women; and (c) the lasting effects of having made the decision.

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With the dramatic increase in the incidence of higher-order multiple pregnancies, more and more women are advised to consider undergoing multifetal reduction. However, little is known about the woman's experience of making the decision to undergo or forgo reduction. This study explored the experiences of seven women in making this decision and to identify any effects of it. Vivid descriptions emerged of multiple levels of bereavement. Several participants lamented that nothing occurred naturally in their pregnancies, from conception right through delivery and life with multiples.

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