pam_childbirth_spiritual_fulfillment_reward_effect

pam_childbirth_spiritual_fulfillment_reward_effect = {
	if = {
		limit = {
			has_personal_tenet_flag = spiritual_fulfillment_from_childbirth_personal_active
			has_pam_dlc_trigger = yes
		}
		if = {
			limit = { scope:child = { has_any_negative_bastard_trait_trigger = no } }
			change_spiritual_fulfillment = {
				value = medium_spiritual_fulfillment_value
				if = { limit = { any_child = { is_twin_of = scope:child } } add = medium_spiritual_fulfillment_value }
				if = { limit = { any_child = { count >= 3 is_twin_of = scope:child } } add = medium_spiritual_fulfillment_value }
			}
		}
		else = {
			change_spiritual_fulfillment = {
				value = minor_spiritual_fulfillment_value
				if = { limit = { any_child = { is_twin_of = scope:child } } add = minor_spiritual_fulfillment_value }
				if = { limit = { any_child = { count >= 3 is_twin_of = scope:child } } add = minor_spiritual_fulfillment_value }
			}
		}
	}
	if = {
		limit = {
			has_personal_tenet_flag = stress_loss_from_childbirth_personal_active
			has_pam_dlc_trigger = yes
		}
		if = {
			limit = { scope:child = { has_any_negative_bastard_trait_trigger = no } }
			add_stress = {
				value = medium_stress_loss
				if = { limit = { any_child = { is_twin_of = scope:child } } add = medium_stress_loss }
				if = { limit = { any_child = { count >= 3 is_twin_of = scope:child } } add = medium_stress_loss }
			}
		}
		else = {
			add_stress = {
				value = minor_stress_loss
				if = { limit = { any_child = { is_twin_of = scope:child } } add = minor_stress_loss }
				if = { limit = { any_child = { count >= 3 is_twin_of = scope:child } } add = minor_stress_loss }
			}
		}
	}
}

As written in game/common/scripted_effects/pam_effects.txt.