According to the Centers for Disease Control, spontaneous triplets occur in only 1 out of every 6, 889 pregnancies, and identical newborn triplets are even rarer. Mothers of Supertwins, an organization for parents of higher order multiples, puts the incidence of identical triplets at only one in every 62,500 pregnancies.
How Identical Triplets Happen
Identical triplets occur when one fertilized egg splits into three separate embryos, resulting in three genetically identical babies. This means that the babies not only look alike, they have the same genetic information in each of their cells. At this point, doctors are not sure what causes a fertilized egg to split, but they do know that an incomplete division can result in conjoining of the babies. Identical triplets may have their own amniotic sacs and placentas in their mother's uterus, or two or more babies may share the same amniotic sac and placenta. Babies that share a placenta may be at risk for twin-to-twin transfusions syndrome, which can happen in higher-order multiple pregnancies.
Triplet Pregnancy Risks
Triplet pregnancies are inherently very risky and a variety of problems can occur. Because there are three babies sharing the confined space of their mother's womb, triplets are at higher risk of developing intra-uterine growth restriction (IUGR). Combined with the typically short gestation of only 33.7 weeks in the typical triplet pregnancy, IUGR can result in extremely low birth weight and longer stays in the neonatal intensive care unit (NICU) after birth. Sadly, according to the CDC's birth statistics, the risk of infant mortality in triplet pregnancies is nearly ten times that for singleton pregnancies. This increased rate of loss is why mothers who are pregnant with multiples are often referred to a high-risk specialist during their pregnancy. The high-risk OB/GYN, or perinatologist, will monitor a multiple pregnancy more closely with frequent ultrasounds, more diagnostic testing, and intensive monitoring during both pregnancy and birth.
Medical Teams for Triplet Births
More staff will be present during a multiple birth, especially since the majority of triplet pregnancies are delivered by C-section. A scheduled C-section allows the hospital to have all required staff present for the birth. In general, the medical team for a triplet delivery will include surgeons, neonatologists for each baby, and nurses for each doctor. The team may also include anesthesiologists and respiratory therapists.
Possible Problems for Identical Newborn Triplets
On average, newborn triplets weigh much less than their singleton counterparts. Their small size usually requires a stay in the NICU and puts them at risk for prematurity and serious complications like cerebral palsy, chronic lung disease, and vision and hearing problems. Newborn triplets may stay in the NICU for weeks or even months as they gain weight, learn to suck at the breast or bottle, and are weaned off supplemental oxygen. Sometimes babies are discharged with oxygen and apnea monitors for breathing and a tube system for feeding. Although some babies may qualify for nursing care at home, many parents take over the medical care for their children after the NICU staff trains them on the proper procedures.
Taking Identical Newborn Triplets Home
Most parents will require help when they bring home their newborn triplets. Breastfeeding is possible, but supplementation with either pumped breast milk or additional formula may be needed. The triplets' pediatrician and the NICU staff will be able to recommend specific feeding strategies and schedules, since feeding three newborn babies may take up much of the day. The new parents will also need help with bathing, diapering, clothing, and keeping up with the laundry for their three tiny babies, as well as caring for themselves and their home. Parents may opt for a nanny service or they may choose to enlist the help of family and friends in the first weeks. Parents should choose helpers carefully and take the time to ensure that anyone who is helping with the babies has previous experience or plenty of coaching. Raising identical triplets can be intimidating and exhausting, but it does get easier as the babies grow.