Psychological adjustment to twins after infertility

Susan C. Klock*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations


The birth of twins and other multiples is physically and emotionally stressful. The increase in the use of the assisted reproductive technologies has lead to an exponential increase in the rates of twins and triplets in the US. Whereas the medical complications of twins and other multiples has been well studied, the psychological and social implications of these events has not. Very little empirical research has been conducted to assess the differential impact of twins, as compared to singletons, on maternal adjustment, postpartum depression and marital functioning. In addition, assessment of infant health, disposition and behavior and its relation to maternal adjustment is lacking. The birth of twins after a period of infertility complicates the clinical picture and the impact of infertility on subsequent parental adjustment is only beginning to be understood. Although research suggests that infertile couples often desire multiples, the experience of parenting multiples after infertility has not been studied. Research on fertile couples indicate that: (i) approximately 10% of women develop postpartum depression and; (ii) marital adjustment declines after the birth of the first child. Because of the unique demands of parenting multiples, it is hypothesized that mothers of twins who have a history of infertility would be at increased risk for depression and marital decline. Descriptive studies of these families support this view, although additional studies are needed to determine the degree and extent of the problem. Additionally, variables such as, prepregnancy adjustment, equitable division of child-care tasks and perceived social support should be studied to determine if they buffer against the expected effects.

Original languageEnglish (US)
Pages (from-to)645-656
Number of pages12
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
Issue number4
StatePublished - Aug 2004


  • Infertility
  • Marital adjustment
  • Multiple pregnancy
  • Postpartum depression
  • Twins

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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