Q&A: Delivering Triplets

Midwife Elizabeth Stein answers the question, What will it be like giving birth to triplets?

Question

I'm pregnant with triplets. What can I expect my delivery to be like?

Answer

The delivery room will be crowded! Most triplet pregnancies are preterm (premature), approximately four to eight weeks early (32-36 weeks of gestation). A planned cesarean section delivery of triplets has probably not even been scheduled yet!

Most triplet pregnancies are the result of fertility-enhancing drugs. Powerful medications that cause many eggs to be released at once are used. The eggs are retrieved, in-vitro fertilization is performed, and three or four embryos (fertilized eggs) are then placed into the uterus to implant. Some or all of these fertilized eggs may successfully adhere to the wall of the uterus and grow. If they do, the results are twins, triplets, or quadruplets!

A triplet pregnancy is very high risk and you should be receiving prenatal care from a perinatalogist (maternal-fetal medicine specialist) with triplet experience. You should deliver in a tertiary-care hospital that can care for several preterm (premature) newborns at the same time without having to transfer your babies to another hospital when they are born.

Triplets should be delivered by cesarean section. If you go into labor or your water breaks, the cesarean section should be done once you arrive at the hospital. Your doctor will be there for you. Ideally, in the operating room there should be one pediatrician and one nurse for each baby. Depending on the individual needs of each newborn, the mom and dad may be able to hold or touch their babies. But some babies are very premature and are immediately attached to many wires, tubes, and machines and taken to the NICU (neonatal intensive care unit) with very little interaction with mom and dad. All newborns should be footprinted and have identification bands attached before leaving the operating room. A cesarean section delivery is major abdominal surgery, done in a sterile operating room. Usually one support person is allowed to be present.

The average weight of a triplet is 1700 grams (3 pounds, 12 ounces), which is half the weight of the average single newborn (3400 grams, 7 pounds, 6ounces). More than a third of triplets weigh less than 1500 grams (3 pounds, 3 ounces) at birth. Less than 1500 grams is called very low birth weight. Being very low birth weight places these tiny babies at much greater risk of long-term disabilities and of death in the first year of life, compared to a single newborn. These deaths are usually the result of prematurity, low birth weight, respiratory distress syndrome (severe breathing problems), birth defects, and SIDS (sudden infant death syndrome).

Although triplets are a triple blessing, carrying three babies where there is usually one will be very difficult for your body. Starting in the second trimester (13-27 weeks), you will spend most of your time eating, drinking, and resting. And no matter how stressful or difficult the triplet pregnancy is, it does not compare to the task ahead: caring for three very needy, fragile newborns at the same time. While you are resting, it might be a good idea to arrange for others to help you after delivery.

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.

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