Parents-to-be of twins, triplets or higher-order multiples have plenty to think about, from arranging for maternity leave to paying for college. Their first priority is for mother and babies to get through the pregnancy and delivery safely. After that, life will become a whirlwind of bottles, diapers and sleep deprivation for a while. Multiples can provide extra love and joy, but they also require plenty of extra effort at every stage.
Types
Multiples can be identical or fraternal. Identical, or monozygotic, twins develop when a single fertilized egg splits in two, with each half developing into a separate baby. If one of the identical halves splits again immediately after the first split, identical triplets develop. Fraternal twins develop from two separate eggs fertilized by two separate sperm, according to KidsHealth.org. Triplets and other higher-order births are sometimes termed "supertwins." Such pregnancies can involve identical or fraternal babies, or a combination of both.
Statistics
Twin births made up about 32 of every 1,000 total live births in 2006 in the United States, according to data from the federal Centers for Disease Control and Prevention released in 2009. Triplets or higher-order multiples occurred about 1.5 of every 1,000 total live births. In 2006, 143,625 live multiple-birth babies were born. That number included 137,085 twins. The numbers have been on the rise. From 1980 and 2004, according to KidsHealth.org, the number of twin births rose 70 percent. And the number of triplet and higher-order births quadrupled.
Causes
Recent increases in multiple births have two main reasons, according to KidsHealth.org. One is the growing number of women giving birth in their mid-30s and beyond: The rate of multiple births increases with age because women become more likely to release more than one egg in a given menstrual cycle. The other is a rise in the use of infertility treatments, including medications that stimulate the release of more than one egg and in vitro fertilization, in which more than one embryo is often placed in a woman's uterus. Other factors that can play a role are race, with African American women being more likely than women of other races to have fraternal multiples, and heredity, since the tendency to have fraternal multiples can run in families.
Risks
The big risk of multiples is that they will be born too early. Depending on how early the birth is, prematurity can lead to a host of health challenges for the babies. Among them are, in the short term, brain problems, breathing problems, digestive problems and death and, in the long term, delayed development and learning problems, according to the March of Dimes. A normal pregnancy lasts 40 weeks, but nearly 50 percent of twins are born before 37 weeks, according to KidsHealth.org. The risks increase with the degree of prematurity. Being pregnant with multiples also increases health risks for the mother. Among the potential problems are gestational diabetes and preeclampsia, where hypertension develops along with significant levels of protein in the urine.
Preparation
Women pregnant with multiples generally must see her obstetrician/gynecologist, according to KidsHealth.org. Visits may be every week or 2 near the end of the pregnancy. It is vital to get prenatal care from providers experienced with multiple births, according to KidsHealth.org, and that, when it is time to deliver, you have access to a specialized neonatal intensive care unit in case one of the babies experiences problems. A general guideline for nutrition is 300 additional calories per day per fetus, but you should discuss nutrition and expected weight gain with your doctor.
