Multiple Pregnancy: What Are the Odds and Other Useful Information

Pregnancy and childbirth are major events that will change your life forever. When you're dealing with multiples — hang on to your hats! — the life-changing effects are spectacular. I am the mother of twins, and this subject is dear to my heart.

Multiple pregnancies occur when more than one egg is released and fertilized, and more than one embryo implants and grows in utero. Fraternal twins, or triplets — or more — are conceived this way.

Multiple pregnancies also happen when one egg is fertilized, splits and creates multiple identical embryos. This is where identical twins, triplets, etc., come from. It's less common than fraternal conception.

Who Can Have a Multiple Pregnancy?

1) Those on fertility drugs to induce ovulation, sometimes can have their ovaries release more than one egg.

2) Women who've had a transfer of more than one embryo for in vitro fertilization may have a multiple pregnancy.

3) Women more than 35 years old have a greater chance of releasing more than one egg at a time.

4) If you've recently quit taking contraceptive pills, you're more likely to have multiples.

5) If multiples run in the maternal side of your family, you're more likely to have them too. If you've had fraternal multiples in the past, you're more likely than most to do it in the future.

The tendency toward fraternal multiples could be genetic. If you release more than one egg per cycle, you're more likely to have multiples, according to Nick Martin and Grant Montgomery, senior research fellows at the Queensland Institute of Medical Research in Brisbane, Australia.³

I hit two items out of five on the high-risk list. I hadn't taken fertility drugs or done in vitro. I was under age 35. But I'd just stopped taking the Pill, and as I found out after my twins were born, there'd been twins a couple of generations earlier on my mother's side.

My three daughters are more likely than average to have multiples, though none of them have — yet. My two sons would only be more likely to have multiples if they married women who have them in the family already.

I didn't know I was carrying twins. I just knew I was more exhausted than I thought possible, and I got really, really big. I figured I was going to have one really large baby. Instead I had two small ones.

Ultrasounds will often reveal a multiple pregnancy. I didn't opt for an ultrasound because they were a fairly new thing 30 years ago, and we were uncertain as to their safety.

The fetal heart monitor only ever showed one heart beat so our twins were a double-surprise package when they were born.

I recommend having an ultrasound.

Possible Complications

If you're carrying more than one baby, you'll have prenatal visits more often in case of complications.

Preeclampsia, gestational diabetes, miscarriage, C-sections and certain genetic disorders happen more often in multiple pregnancies.

Premature delivery happens in more than half of twin pregnancies. Triplets or more are almost always preterm births. Premature births can lead to breathing or eating problems. Later, behavioral and learning disabilities can occur according to Medline.

Not knowing I was carrying twins, I was unaware of these greater risks. We made it to 38 weeks, which is a bit like being overdue, with twins.

My greatest complications were soul-draining exhaustion, and trying (unsuccessfully) to find clothes to fit in the last couple of months.

Breastfeeding

Breastfeeding multiples is certainly an option, if this is important to you. Don't let anyone tell you different. I chose to breastfeed my twins and was astonished at the negative reactions from friends and even the medical community.

This was 30 years ago, but I'm amazed at how much remains unchanged all these years later.

A health nurse who was sure my babies would starve told me horror stories. I had to change family doctors to find one who was supportive.

Fortunately a friend put me in contact with the local La Leche League, and a mom who successfully nursed her twins years before.

You'll need to drink a lot — I drank 15 glasses of water a day and things worked swimmingly. If you nurse past six months or so, you may find the baby weight — yours, not your babies' — starts to drop like crazy. I ate like a horse and lost weight.

It is possible to breastfeed twins successfully without supplementing. Triplets and more are different territory. But if it matters to you, you don't have to discount breastfeeding, even if the breast milk is a supplement.

Of course, if the whole idea of breastfeeding a platoon of babies fills you with dread, you certainly don't have to. Don't let the usual Catch-22 many mothers fall into on the feeding question ensnare you. Your hands are more than full with plenty of babies, and whatever you decide is fine.

Mothering multiples is an overwhelming proposition. But the rewards are just as enormous as the challenges.

Reviewed October 11, 2016
by Michele Blacksberg RN

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