When I think of a multiple pregnancy I think of twins, probably mostly because I couldn’t imagine trying to carry and care for any more than two babies at a time. However, there can be many more than two babies involved. A multiple pregnancy is a pregnancy where there are 2 or more fetuses. Large order multiples are those pregnancies with 3 or more fetuses.

Twins are fairly common, occurring in one out of every 90 births (when fertility treatments are not involved). Large order multiple pregnancies are a little more rare, especially when no fertility treatments are involved. When there is no involvement of fertility treatments triplets occur in one out of every 8100 births, quadruplets occur in one out of every 729,000 births, and quintuplets occur in one out of every 65,610,000 births. As you can see, not all that common. Infertility treatments account for a majority of all large order multiple pregnancies, 60% of triplets, 90% of quadruplets, and 99% of quintuplets.

If you are pregnant with multiples, no matter if it is twins or quintuplets, your pregnancy will be considered high risk, and you will be monitored very closely throughout your pregnancy. The larger the number of babies involved the higher risk your pregnancy is considered. Be sure to discuss what carrying multiples means for your care, what you can expect, and what special measures (if any) you need to take during your pregnancy.

A multiple pregnancy poses many unique challenges including:

  • The everyday symptoms of pregnancy, like morning sickness, breast tenderness, exhaustion, and the pains caused by the added weight as your pregnancy progresses are often more annoying. This is thought to be because of the higher level of hormones produced during a multiple pregnancy.
  • You are at an increased risk of experiencing complications during your pregnancy, such as, gestational diabetes, pre-eclampsia, or high blood pressure, to name a few.
  • Weight gain during a multiple pregnancy is much more significant, particularly with large order multiples. This will increase your discomfort as your pregnancy progresses.
  • There is an increased risk of problems in the womb, including, growth discordance (one baby developing faster or slower than the others), intrauterine growth restriction, and twin to twin transfusion syndrome (when there is an unequal sharing of nutrients and blood flow between identical twins). Your pregnancy will be monitored for indications of any of these problems.
  • Miscarriage of the pregnancy is more common in a multiple pregnancy. A woman carrying triplets for example is 4 to 6 times as likely to miscarry as a woman carrying a single fetus.
  • There is an increased risk of premature labor in multiple pregnancies, this risk increases with the number of babies you are carrying. On average twins are delivered 4 weeks before term, triplets 7 weeks before term, and for quadruplets 10 weeks before term. But each pregnancy is different and some multiples are delivered sooner or later than these averages.
  • You are more likely to deliver the babies by cesarean section because of presentation problems and because the delivery can be too stressful on the babies and you.
  • Multiples are at an increased risk of have low birth weights. The average weight for twins is 5 lbs 5 oz, for triplets and quadruplets it is 3 lbs 12 oz, compared with the average of 7 lbs for a single baby.
  • There is an increased risk of birth defects with multiples.
  • Due to the severe stretching of the uterus during a multiple pregnancy there is an increased risk of post partum hemorrhaging. You will be monitored closely after the birth for any signs of hemorrhaging.

These are just some of the unique challenges a woman carrying multiples faces. It is time of great joy, great fear, and great uncertainty. If you are carrying multiples be sure to talk to your doctor as they will be able to provide you with more specifics about your particular pregnancy and circumstances. Also, there are support groups out there for mothers of multiples that can be of great help during your pregnancy and once your bring you babies home (whole other set of challenges). Your doctor should be able to provide you with information about the support groups in your area.

Are you the mother or father of multiples? Please share your experiences and helpful suggestions.

(source: WebMD, The Mother of All Pregnancy Book)