Caring for Multiple Birth Babies


If you go to your doctor for a prenatal visit, you expect to be treated like almost every other expectant mother, a nice low risk pregnancy. You’ll get lists of things to do and lists of things to avoid, and a routine sonogram. And that’s when your world can be flipped upside down.

 If they find more than one baby in your uterus, you have graduated from low risk to high risk pregnancy. Multiple births, whether it be twins, triplets, quadruplets, or more, are always high risk. And one in every 250 pregnancies will deliver multiple births.

What makes a multiple pregnancy higher risk than normal?

  • Most twin pregnancies and almost all higher number pregnancies go into labor early – before 37 weeks: the more babies, the earlier labor starts.
  • Pre-term labor can be brought on by premature rupture of the membranes or problems with the placenta or multiple placentas. 
  • Pre-eclampsia is common during multiple pregnancies. It is a condition with elevated blood pressure and the leakage of protein in the urine and can be a twin pregnancy symptom. The condition is dangerous to the mother, and doctors will often choose to deliver the babies to protect the mother from stroke or seizures, or other consequences of the disease.
  • Problems can occur within the uterus. Cords can be tangled if there is only one amniotic sac. A condition called intrauterine growth retardation can rob one baby of normal development. 
  • Premature babies are not ready for the world. Their organs and systems have not fully matured. This makes their first few weeks or months a dangerous time for them.
  • There is a higher chance of anemia in both mothers and babies.
  • Congenital birth defects occur more frequently in multiple pregnancies, primarily spina bifida, gastrointestinal problems, and cardiac problems.
  • Miscarriages also occur at a higher rate than in a normal pregnancy.
  • There is an increased risk for a Caesarean section with all the complications of surgery.
  • Hemorrhaging after delivery can also be a complication.
  • Twin-to-twin transfusion syndrome can occur in 15% of the cases when identical twins have only one placenta to share. One twin gets too much blood. The other doesn’t get enough. This is another reason to terminate the pregnancy and get the babies out, even if they are premature.

Maternal Care For Multiple Births Pregnancies

 There are many differences in the care of women with single versus multiple pregnancies.

  • The extra baby(ies) will require extra nutrition. The caloric intake per day will be much higher than in a single birth pregnancy.
  • The amount of protein must be increased to help the babies produce muscles and tissues.
  • Experts recommend increased weight gain. A woman with normal non-pregnant weight should gain between 27 and 54 pounds. Increased weight gain is a symptom of twin pregnancy.
  • You will be seeing the obstetrician more frequently than during a single birth pregnancy.
  • Your doctor may send you to see a perinatologist who will evaluate the pregnancy and do tests, watching for complications.
  • You may be asked to spend more time in bed, resting, during the pregnancy. Sometimes mothers with a high number of pregnancies are even admitted to the hospital for bed rest. This occurs when they are having occasional contractions or when the blood pressure is hard to control.
  • If you go into pre-term labor, your doctor will give you medicine from a class of drugs called tocolytic. This drug, often magnesium sulfate, will slow or stop the contractions.
  • If it looks like you’re going to deliver early, the doctor may give you a dose of steroids to speed up the maturation of the babies’ lungs.
  • In certain high count pregnancies, the doctor may put some stitches in the cervix early on to help keep it closed later and delay a pre-term birth. This is called cervical cerclage.

What happens during the birth of the babies?

  • When you go into labor, you will be connected to a fetal monitor, which will keep track of each baby’s heart rate. 
  • Most births of triplets and up are done by Caesarean section. This is usually the safest route for delivery for the babies.
  • In most cases, you can be awake during the surgery, having been given medications to prevent you from feeling pain.
  • The babies will be taken directly to the NICU after a brief stop for you to say hello to each one.

 Once the babies are born, and many of the dangers of multiple pregnancies are passed, the concerns are not as much about the mother as about the babies. Premature babies have many health problems, which is why they usually go right to a Neonatal ICU (NICU) after birth. The more mature the neonates are, the fewer problems pop up. In other words, if they are around 35 to 36 weeks gestational age at birth, they are much more likely to do well than children born at 30 weeks. 

 While in the NICU, the highly trained professional staff of doctors, nurses, and technicians will be monitoring the babies constantly. They will also encourage the parents to become involved in the babies’ care. It’s hard to bond with a nasogastric tube, but these little miracles do precisely that as long as their parents make an effort to be with their children, to touch and love them, to change diapers and feed them, and to cuddle and hold them.

Post-Birth Expectations

 Breastfeeding multiple babies can be difficult. Breast milk is the food Nature designed for babies. And breastfeeding will be encouraged. 

 Families with multiple births will need help, especially from family and friends. The first few months are the hardest. It will seem like someone of the little ones is always hungry. Feedings will be frequent. Sleep will be minimal. The family, especially the parents, will have very little time to themselves. Everything will revolve around the twins/triplets/etc.

Choose Northside/Northpoint OB-GYN To Deliver Your Multiple Birth Pregnancy 

When you choose your doctor, you will want to choose the best one. Atlanta OBGYN doctors are good, but you’ll find the best at Northside/Northpoint OB-GYN. Our doctors have the greatest expertise in OBGYN in Atlanta. 

Our experts in multiple birth pregnancies will follow you closely, watching for any signs of problems and planning for the big event. They will monitor your weight, blood pressure, urine protein, and all the parameters that a high-risk pregnancy requires.

 The babies will be monitored equally closely. Using the best technology available to an OBGYN in Atlanta, we will help you plan for the day your babies come home. You will be facing several weeks of lack of sleep and very little time to yourself. Northside/Northpoint OB-GYN will help you contact support groups of parents with multiple babies. There is nothing like the voice of experience to guide you through the hectic first weeks and on.

 Your Atlanta OBGYN will refer you to a perinatologist and recommend pediatricians with experience with twins and up. They will provide helpful information and reading material to aid in negotiating the problems that arise. 

 If you suspect that you may be carrying more than one baby, or even if you just need the best OBGYN in Atlanta for a normal pregnancy, contact Northside/Northpoint OB-GYN today and set up an appointment. Your babies will thank you for it. 

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