Triplet birth is becoming more and more common. Assisted reproductive technologies are often the cause. Fertility drugs can cause a woman to release more than one egg at ovulation. In vitro fertilization methods often involve placing multiple embryos in a woman's uterus, in hopes that at least one will become a baby. Another reason for increased triplet pregnancies is the large number of pregnant women over the age of 30. Older women are more likely to have multiple births.
Triplet births are always considered high-risk pregnancies. That means a woman pregnant with triplets can expect extra doctors appointments and tests. This attention helps to make sure that both she and her babies are doing well.
Giving Birth to Triplets
Doctors are still studying the best way to deliver triplets. Some doctors believe that a c-section is always the best. Many doctors will consider how far along the pregnancy is, how the babies are positioned, the mother's health, and other issues before deciding whether or not to attempt a vaginal delivery.
Your doctor may recommend a c-section if the babies are in a position that would make birth difficult. Babies are usually born head first. It's sometimes safe for a baby to come buttocks first, too. But, some birth positions are very dangerous. If the baby is lying sideways, it may not be able to come out at all. With multiple babies, it's not uncommon for at least one of them to be in the wrong position.
Vaginal birth of triplets can be much more stressful than a singleton birth. The obstetrician will usually want to monitor each baby individually, so there will be extra equipment in the room for a triplet birth. There will also be more medical personnel on hand, plus one or more pediatricians standing by in case the babies have any trouble after they're born.
An epidural for the mother is strongly recommended, because the birth may be difficult and the obstetrician may need to reach inside the uterus to help position the babies-which can be extremely painful for the mother.
Risks of a Triplet Birth
Triplet pregnancies carry more risks to the mother than singleton pregnancies. One important risk is postpartum hemorrhage, which is extensive bleeding following the delivery. Normally, after a baby is born, the woman's uterus begins to contract to help stop any bleeding. But, when a woman is carrying triplets, her uterus may not react normally after the babies are born. Medications and massage of the woman's abdomen may help. In severe cases, the woman may need surgery or even a hysterectomy (removal of the uterus).
Triplets are often born prematurely. Sometimes they're just a little early, and they don't have any problems at all. Sometimes they arrive very early, before they're really able to survive on their own. In that case, they will need to spend time in the neonatal intensive care unit. The good news is that triplets seem to do about as well as singleton or twin babies born at the same gestational age.
Premature triplets have the same problems as other premature babies. Babies born very early usually have the longest hospital stays and the most difficulties. Breathing problems from underdeveloped lungs are common and sometimes lead to lifelong breathing disorders like asthma. Other less frequent, but still serious, problems include:
- Patent ductus arteriosis. A blood vessel near the heart called the ductus arteriosis, which is supposed to close at birth, may remain open, impairing normal blood flow in the body. Most cases can be corrected with medicine, but sometimes medicine is needed.
- Intraventricular hemorrhage. Bleeding into the ventricles, which are spaces in the brain that are normally filled with fluid, can happen spontaneously in premature babies. It can lead to brain damage.
- Necrotizing enterocolitis. Very premature babies are at risk for inflammation and death of tissue in the gut.
- Retinopathy of prematurity. Premature babies can have abnormal blood vessel growth in their retinas, a part of the eye that is essential for vision. In mild cases, the babies have little or no trouble with vision. Severe cases can result in blindness.
Premature babies are also at higher than normal risk of cerebral palsy. There are many different types of cerebral palsy, but they all involve some kind of difficulty with movement. Cerebral palsy seems to be due to damage to the part of the brain that controls movement.
Bringing the Babies Home
Parenting triplets can be incredibly rewarding-but it's a challenge! New parents of multiple babies should expect a lot of stress and very little sleep. Enlisting the help of family and friends can make a big difference after a triplet birth. Seeking out other parents of triplets can provide emotional support. In addition, there are many web sites run by parents of multiple babies, with lots of personal stories and advice. The Nemours Foundation offers helpful suggestions at the Parenting Multiples page of their KidsHealth web site.