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Bridgewater, NJ
OCTOBER 2005
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By Judith Newman
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Photographs by Nina Berman
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Central New Jersey produces more than its share of twins and triplets—far more. What's going on here?
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Get a taste of what awaits you in print from this compelling excerpt.
Here's a list of things you don't plan for:
1) Being unable to get pregnant.
2) Going for fertility treatments.
3) Having those treatments be unsuccessful.
4) Having those treatments be a bit too successful.
And there, in a nutshell, is the story of most women who've had triplets. Women like Kathy Rusiecki, who weighed 125 pounds (56 kilograms) before she got pregnant and gained 100 more before giving birth to her three daughters. By the end of her pregnancy she was gaining six pounds (two kilograms) a day. "I had no knees," she says. "My legs looked like tree trunks." Or Lisa Catrambone, who cheerfully endured three months of bed rest while awaiting the birth of her three sons. "We know we did something with our time before these guys came along, but we've forgotten what it was," jokes Catrambone. Watching her energetic 18-month-old sons, Michael, Matthew, and Daniel, gum the furniture and toddle around the living room of her Bridgewater, New Jersey, home, it's hard to imagine that not one of them weighed more than three pounds (one kilogram) at birth.
But here's the thing too: If, like Catrambone and Rusiecki, you happen to live in the New Jersey suburbs, you'll have lots of company. Because New Jersey has the highest ratio of triplet births in the United States. Between the years 1998 and 2002 the state recorded 358 sets of triplets (and higher-order births) per 100,000 live births. This might not seem like many, except when you consider that the national average is 186 per 100,000. Meaning that a New Jersey resident has twice the chance of having triplets as the average American.
So what's special about New Jersey? Two words: Fertility clinics—specifically, the fact that New Jersey has a lot of them, more per capita than almost anywhere else in the country. Of some 400 clinics nationwide, 5 percent are in New Jersey, a state with only 3 percent of the total population.
The goal of a fertility clinic is to give a woman one healthy child at a time. Twins are not considered a significant health risk, but triplets are—frequently resulting in low birth-weight babies and maternal health problems. But here's the little secret of the fertility clinic game: If a woman is going to get pregnant at all, her chance of having twins or triplets increases exponentially. The probability of having triplets naturally is about 1 in 8,000, or about one-hundredth of one percent. In 2002—the last time statistics were compiled—the chance of a woman under 35 having triplets after undergoing treatment at, say, the East Coast Infertility Clinic in Little Silver, New Jersey, was 21 percent.
That's because a number of embryos are created through in vitro fertilization, then deposited into a woman's uterus. The number transferred depends partly on the woman's age; younger women generally receive fewer embryos than older patients. But some clinics have been a little more Wild West about their methods, transferring three or more embryos into even a young woman's uterus to increase her chance of getting pregnant. "A couple of clinics in New Jersey have been very aggressive to try and get the highest pregnancy rates by transferring lots of embryos," says Jamie Grifo, director of New York University's fertility clinic. Such practices, though frowned on by the medical establishment, may suit a woman anxious to get pregnant just fine.
Why are so many New Jersey women showing up at these clinics in the first place? One popular explanation, whispered among infertile couples, is that pollution might be lowering fertility in the state. But scientists say such worries are unproven. The more likely culprit is the state's high concentration of women starting families later in life. It becomes increasingly hard to get pregnant after 35.
"This is the land of the working woman," says Serena Chen, director of the division of reproductive medicine at Saint Barnabas Medical Center, where most of the babies conceived at local clinics are delivered. "There are so many high-powered females here who've delayed childbearing," Chen says, "and unfortunately nature planned to have us barefoot with babies in the kitchen by age 25. That's just not the norm here."
Get the whole story in the pages of National Geographic magazine.
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