The Baby Keeper

This is where the medical controversy around Elliott comes in. It is not so much a matter of pro-choice versus pro-life values as one of data interpretation. Elliott and Grimes essentially look at the same literature and come to vastly different conclusions: one says he can use mag to prolong pregnancy, the other says no one can. Each says the other has cherry-picked data to support his point of view. Grimes says Elliott makes "dogmatic statements based on no data" and has published the results of his work in Phoenix-only substandard formats or "minor league journals." Other detractors knock Elliott for not publishing all of his work.

Meanwhile, Elliott has been fuming for two years over Grimes's article and recently finished a response, which he has submitted for publication in a major journal. "Anybody who has used the drug knows that it works,"  says Elliott. "When it doesn't, that's because people use it for only 48 hours and then they stop. I mean, come on: Well-meaning people have basically underdosed mag and then found that, gee, it doesn't seem to work as well as we hoped."

Dr. Mark Evans, an obstetrician and geneticist and a specialist in "selective reduction," is another of Elliott's critics. Evans more or less invented selective reduction in the late 1980s and continues to be its most vocal, and most radical, practitioner. He is even willing to reduce twin embryos to a singleton if he thinks the procedure is medically warranted. The point of reduction, he says, is "maximize the chance of having a healthy family" by avoiding the complications of large multiple births, which can include brain damage and death for babies.

And for the mother, the health risks can be life-threatening too. One of Elliott's patients, —Jenny Masche, who gave birth to sextuplets on July 11, 2007, had pre-eclampsia (common in high-risk pregnancies) and went into heart failure in the delivery room. With her children in the neonatal intensive care, Masche found herself fighting for her own life in the ICU. She remembers praying to survive so she could be with the six babies that she had miraculously carried for 30 weeks. (You can find our video of the Masche sextuplets at their home in Arizona and footage of the babies' delivery here.)

Evans worries that doctors like Elliott are "putting patients at huge risk" and "leading them down a path of over-optimism." Even when a full set of supertwins is carried to birth with no fatalities, he notes, the babies have higher risks than singletons of "lifelong calamities" such as cerebral palsy, and the mothers may suffer long-term health consequences as well. He questions how many of Elliott's babies end up with cerebral palsy and suspects that the number is high.

Elliott counters that he believes the number to be low. He can name many sets of supertwins he has delivered who have grown up completely healthy. But the disease is usually diagnosed long after delivery and Elliott says he's "too busy taking care of patients" to track down and write up the data. Besides, he adds, he is a clinician first—i.e., he is not in the business of running large, randomized clinical trials. "If I publish it," he says, "it'll just be, 'where's your control group?' "

In any case, Elliott is adamant that he does not want to encourage women to carry many babies at once. He's all too aware of the risks. But, he adds, if women are set on a big multiple pregnancy, someone has to get them through it. He is willing to be that person. So he's sticking to his protocols. "I think we're right. Everybody else thinks we're wrong,"he says. "I'm OK with that. But it gets a little frustrating fighting uphill."

Elliott may never win the support of much of the medical establishment, but he does have advocates—particularly in the heartland, where fertility treatment is now fairly common and pro-choice attitudes are not. "There is," explains Mark Evans, "a big blue-state, red-state divide in how patients and doctors look at this." And of course Elliott can always point to happy patients—including Cintya Diaz. On June 25 of last year, "five feet around" after several months of bed rest and so heavy a normal hospital bed would no longer support her, she delivered David, Diesel, Damien and Dayami. They were small but apparently healthy, and only David required oxygen after birth. Less than three weeks after they were delivered, the babies were out of the hospital and sleeping at home, all four of them sideways in a single crib. Afraid of losing them, Diaz had refused to prepare the nursery, buy onesies, or even pick names in advance. Now, she acquiesced to a baby shower. Elliott, she said, had given her a miracle. Elliott himself didn't see it that way. "It's your job to save those babies' lives," he says. "You've gotta do what you gotta do."