General Health & Wellness • Jun 06, 2011

Twins, Triplets, Quadruplets, Oh My!

I’m having what?!
Parents look with great anticipation to the first ultrasoundsof their baby. But the words to Justin Bieber’s song “Baby, baby, baby, Oh” take on new meaning when that first look shows two, three or more fetuses. Regardless of how multiple birth pregnancies occur – through IVF or spontaneously – , we’re all hoping to see the same thing on that first ultrasound: a single healthy baby.

I found myself in that exact place almost 11 years ago. After years of fertility treatment, there I was watching the ultrasonographer and counting baby one, baby two and baby three. On the screen were three tiny circles, and on subsequent ultrasounds, three tiny beating hearts. Due to excellent care, prayers and a little luck, I am blessed today with three healthy children. But, twins and higher order pregnancies are high risk pregnancies requiring much more specialized care. The chances of losing the pregnancy, delivering prematurely or complications to the mother’s health are much greater. Still, for all of us who start off wanting a baby and end up with two or three smiling, laughing babies, the journey is worth it.

 Here are a few facts about multiples:

 In 1980, 68,339 twins, 1,337 triplets were born in the US.  By 2005, the numbers had grown: 139,816 twins, 6,208 triplets, 418 quadruplets, 68 quintuplets or more.

 Not all multiple births are the result of fertility treatment. 67% of twins are spontaneous, and so are 18% of triplets. For women pregnant in their twenties, 30 per 1000 babies born are multiples, 47 per 1000 for women in their 30s, and 59 per 1000 for women over 40.

 Multiples are more likely to be born prematurely. While a normal, healthy pregnancy averages 40 weeks, the average gestational age for twins is 35 weeks, 32 weeks for triplets and 30 weeks for quadruptlets.

 Multiples resulting from a single fertilized egg dividing are called monozygotic or identical. Monozygotic multiples are rare: 1 in 250 twins, 1 in 62,500 triplets and 1 in 15,625,000 quadruplets. Monozygotic multiples are at higher risk of developing many complications, including getting entangled in their umbilical cords and twin-twin transfusion syndrome.  

Where do you get care when you are pregnant with triplets? What is twin-twin transfusion syndrome? How do you plan for help after the babies come home? Can you really breastfeed triplets? We’ve assembled a panel of experts to answer these questions next week, during a live, online chat dedicated to multiple births. Please join us Wednesday, June 8 at Noon by visiting the St. Louis Children’s Hospital website at and bring your questions.

 Dr. Ross is mother to ten-year-old triplets, a pediatrician at St. Louis Children’s Hospital and Co-Editor of the book: Expecting Multiples: A Comprehensive Guide for Expectant Parents of Triplets, Quadruplets, Quintuplets or More


  1. I have 4 1/2 year old identical boys. They are twin to twin transufsion syndrome survivors. We were very lucky to have early diagnosis & intervention to save them. We did serial amniocentesis at Barnes under the care of the Wash U peri-natal group. They did amazing & continued to pass every pregnancy milestone that we had hoped for. What started out as a very grim prognosis, turned out to be a lifesaving miracle. My boys were born at 35 weeks. One stayed at the SCN at Barnes & one (the recipient twin) went to the NICU at Children’s. Our compliacations were far less than most after birth. Other than RDS, jaundice, blood sugar issues, etc. our boys did amazing.
    When we were diagnosed with TTTS, our donor was “stuck”. The only reason that we ever found out about them having TTTS was because a routine anatomy survey done by my regular OB was reviewed by a radiologist & he thought we might have banding syndrome. Obviously we did not, and were told at Missouri Baptist by Dr. Paul that my “boy/girl” fraternal twins were actually identical boys with TTTS. We were shocked. We started treatment the very next day.

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