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RESEARCH REPORT #115
SUBJECT:
RESEARCHER:
The Emotional Needs of Mothers of Multiple Birth Children
Emily N. Walker, B.A., M.Ed.
Dissertation for the Degree of Doctor of Philosophy
University of North Texas
DATE:
August 2012
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PURPOSE: The purpose of this study was to assess the emotional support needs of mothers of multiple
birth children, and gain an understanding of the challenges associated with parenting multiples. The
focus of this study was to provide mental health professionals with a more consistent approach to working
with the emotional needs of mothers with multiple birth children.
METHOD: A survey developed by the researcher was given to mothers of multiple birth children. The
survey consisted of 25 demographic items, six 6-point Likert scale items, and three open-ended questions.
The Likert scale items were based on the amount of perceived emotional support mothers received in their
environment at the time the survey was done. Open-ended questions addressed negative and positive
aspects of parenting multiple, and they also addressed the mothers’ emotional support needs.
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STUDY SUBJECTS: The sample consisted of 171 mothers of multiple birth children from 23 states in
the United States. Many of these moms were members of an MOA club, Plano Area Mothers of
Multiples (TX).
Participants ranged in age from 20-50 years of age (however 38% didn’t report their age). Mothers
participating in this study had the following ethnicity: 95.3% Caucasian, 5.8% Hispanic, 1.8% Asian,
1.2% Other, and none were African-American or Native American.
Most participants (94.7%) were married or partnered. Most of the moms (43.9%) did not work outside
the home; 22.2% worked full-time outside the home; 12.9% worked part-time outside the home; and
11.1% worked from their home. Many of the moms (44.4%) had a bachelor’s degree; 28.1% had some
college; 22.2% had a graduate degree; and 4.1% had a high school degree or GED.
A majority of the women (70.2%) used some type of fertility assistance which then resulted in the
conception of multiples.
BACKGROUND INFORMATION: The rate of multiple births has increased significantly in the past
30 years. This rise in multiple births, particularly the higher-order multiple births, is largely due to the
use of assisted reproductive technologies (ART; Bolton, Yamashita, & Farquhar, 2003).
With the introduction of new methods and procedures, women experiencing infertility problems are now
Research Report #115
able to conceive. However, with the expected positive attitude towards pregnancy for those women
seeking fertility treatments, pregnancy also comes with additional risks associated with multiple birth
pregnancies. Parents of multiples are faced with risk factors from the onset of the multiple birth
pregnancy, and the problems don’t subside after the children are born. Multiples are at increased risk for
long-term health problems such as congenital abnormalities, cerebral palsy, delayed growth, learning
disabilities and physical handicaps.
Parents may experience a great deal of emotional turmoil in relationship to having multiple birth babies
and children. According to Bryan (2002), the notion that twins, from the onset of conception, bring
insurmountable enjoyment appears to be a misconception. However, this perceived notion increases
difficulties for parents of multiples to express their internal fears, frustrations, and hardships associated
with their multiple pregnancy. They may be struggling to maintain a positive exterior, while they also
experience internal struggles that they may be unable or unwilling to express to a variety of professionals.
Since little research exists investigating the emotional needs of parents of multiples, gaining knowledge
about this population in how to most effectively interact with them may enable greater communication
between parents of multiples and health care providers. This would allow parents of multiples to
communicate to professionals and obtain the help they need but may struggle to acquire.
RESULTS: Nearly 50% of the mothers of multiples were involved in a local and/or national support
group. The types of support the moms received for themselves and their multiples included: church
(22%); extended family (37%); Pre-K program (17%); mental health professional (4.5%); speech and
language therapy (11.4%); and Other (18.7%). “Other” included friends, nannies, other mothers of
multiples, online communication and early intervention professionals.
When asked about support and emotional status, a large number of respondents (82.5%) reported
moderate to very high support from their partners, whereas 26.3% reported that they received the most
support from their extended family.
A majority of the women (87%) said that they were currently experiencing moderate to very high
amounts of stress related to parenting their multiple birth children, whereas 70.2% stated that they had
moderate to very high levels of anxiety about parenting their multiples.
87.2% of the respondents reported that their satisfaction with their partner was moderate to very high.
Almost 95% of the moms rated their overall life satisfaction in the moderate to very high range.
There was no significant statistical difference found in the mothers’ levels of anxiety or stress when the
researcher compared employment status, income or number of children. However, as anxiety increased,
so did the moms’ stress.
As partner satisfaction increased, so did the moms’ overall life satisfaction. Similarly, as caretaking
responsibilities of fathers increased, the moms reported high life satisfaction.
Increased reports of stress and anxiety and decreased reports of partner satisfaction were correlated with
decreased life satisfaction in the moms.
Many themes emerged when the moms were asked about the negative aspects of having multiple birth
children: “Not enough time for myself;” not enough 1 on 1 attention for each child; financial struggles;
exhaustion from caring for multiples; sibling rivalry; hard to meet all of the children’s needs; getting all
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the children out of the house is difficult; lack of time with spouse/partner; dealing with the public and all
their questions; and mob mentality (the children outnumber mom and gang up on her).
When the moms were asked about the positive aspects of parenting multiples, these themes emerged:
Multiples are instant playmates; strong sibling bond; more love and affection; they are going through
developmental stages (like potty training) at the same time; and fun to watch their interactions and their
unique personalities develop.
The mothers of multiples gave these responses when asked about their emotional needs: “Me time;”
support of friends; support groups (“Having the network of other MOMs – without them you would never
have anyone that understands you or your situation.”); support of spouse/partner; validation that I am
doing a good job of parenting; and support from extended family.
CONCLUSIONS: This study showed that mothers of multiple birth children often experience extreme
amounts of stress and anxiety about providing care for their children. Mental health professionals need to
be aware of this, and mothers of multiples need to monitor their stress and anxiety.
Mothers in this study indicated that they are in need of additional support, both inside and outside of their
home. Health care providers need to be aware of the stress, anxiety and isolation that these mothers
experience and work with them to ease their burden. For example, health care providers may want to
encourage mothers of multiples to join local and national support groups.
The financial burden of having multiples is often a great source of stress and anxiety. If money is an
issue, there are increasingly more social networking forums, such as Facebook, where mothers can obtain
support from others through online interactions, a very cost effective service.
Furthermore, mental health professionals and other professionals working with this population may want
to encourage continued help and support from fathers of multiple birth children to address the isolation
and support needs that the mothers may be experiencing. One of the most striking findings from this
survey is that mothers are negatively affected by poor perceived relationships with their partners or a lack
of involvement by partners in caretaking responsibilities. Mental health professionals might use these
findings to develop services regarding marriage or partnership counseling and programs that focus on
parents of multiples.
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