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Q&A: Having Multiples

Q. My ultrasound shows that I'm pregnant with more than one baby. What now?

A. Don't run out and buy a double stroller just yet, especially if the ultrasound was performed very early in your pregnancy. Here's why:

6-week ultrasound. Even though your ultrasound shows twins, it's still early in your pregnancy, and there is a chance that the pregnancy will "self-reduce." In other words, one fetus (or more) will die, either because of a genetic abnormality or because most of the nutrition is going to another fetus. The fact is that far more multiples are conceived than are actually born.

Because multiples frequently self-reduce during the first couple of months of pregnancy -- before many women have an ultrasound -- women who have conceived multiples and lost one may never know that there was more than one baby to start with. If your first ultrasound is at 20 weeks, you may see one baby and never know there was a second or third.

12-week ultrasound. If an ultrasound shows multiples at 12 weeks, there's a higher chance that all will survive, but you're not out of the woods yet. You really can't count on twins or triplets until you get past 18 weeks. After that benchmark, the chance of both or all of the babies surviving is much greater.

Next steps. Having more than one baby can be a shock, particularly if you have no multiples in your family, did not conceive through assisted reproduction, or are a younger mother. (The older you are, the higher your chance of multiples.) Multiples can add complications to your pregnancy. For example, multiples are more likely to be born early. The thought of having two or three babies can be overwhelming; the reality of caring for all of them at once is two or three times more overwhelming.

Your doctor will advise you on health-related specifics such as how much weight you should gain and how to tailor your nutrition and exercise regimen to accommodate multiples. As for emotional support, most women benefit from talking with mothers who have successfully delivered and are raising multiples. Seek out friends and acquaintances who have had multiples and ask them to share their experiences. You may also want to join a "mother of multiples" club in your community, if there is one.

Originally published in You & Your Baby: Pregnancy.

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