Launching a journey they'd never imagined
Sissy, Jay and the kids returned to Texas. She had confirmed the results with two more home pregnancy tests, so there wasn't much suspense when she called Chad and David after the blood test.

"Helloooo," she said. "It was positive!"

They talked about her beta number, a measure of hormone levels that can provide the first indication of multiple fetuses. It was 191. That suggested a singleton but it didn't rule out more.

They wouldn't know for sure until her first sonogram on Feb. 13. But her next blood test, taken on Jan. 31, provided a clear indication.

"Are you sitting down?" she asked Chad and David before telling them that the numbers had soared off the charts. The doctors and nurses said there was little doubt she was carrying more than one. The real question was how many.

"There's probably three of them in there," Sissy fretted.

"No, no, no, there's not," Chad told her.

The two-week wait for the sonogram was excruciating. The risk of multiples, which they had all willingly accepted while trying to get pregnant, was now a looming reality. Even twins would elevate the likelihood of prenatal complications, premature delivery and low birth weight.

"I'm worried about being on bed rest and my kids and how it would affect them," Sissy said. For legal reasons, the plan had been for her to deliver in Atlanta. Multiples would require her and the children to travel there sooner.

Sissy was already suffering terrible morning sickness. She was always hungry — with cravings for popcorn shrimp — but had trouble keeping anything down.

"Your babies are sucking the life out of me," she needled Chad.

Chad spent the weeks trying to fathom what life would be like with three newborns. David spent the weeks trying not to. Given all they'd been through, Chad told David, three would still be better than none.

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'Nothing natural'

Chad and David flew to Dallas the day before the ultrasound. They wouldn't have dreamed of missing this glimpse of their child, or children. It also would be their introduction to the obstetrician who would handle Sissy's pregnancy.

The doctor had delivered both Matthew and Anabelle, and Sissy adored him. But she had shocked him a year earlier by announcing that she hoped to be a surrogate for her gay brother. He told her he had never handled a case like that and would have to think it over.

The doctor, who asked not to be named in this account, is socially conservative, the medical director of a clinic that steers pregnant women away from abortion. He holds firmly to the belief that children should have mothers, and he found the moral footing of this arrangement slippery.

"Without great use of technology," he said, "this pregnancy doesn't even come about. There's nothing natural about it. There's nothing spontaneous about it. And the circumstance is different when the parents are going to be two men. You can say it's not different, but it's like saying men and women aren't different."

On the other hand, the doctor didn't want to abandon his patient. Sissy's devotion to her brother impressed him. And she wasn't asking him to engineer this pregnancy, only to give a baby the best possible start. "The child is an innocent bystander in all this," he said.

Sissy wondered if she should go elsewhere. She didn't want checkups to be awkward for Chad and David. "I just don't want any negativity around any of it," she said.