UW News

November 20, 1997

Coping with twins, triplets — and more: UW Medical Center offers special classes for expectant parents

The impact of multiple births on a family is not additive, it’s exponential. Few parents are prepared for the enormous emotional, physical and financial demands that accompany this phenomenon.
To help couples deal with this huge change in their lives, University of Washington Medical Center hosts “Expecting Multiples,” a series of classes for families expecting twins or more.

“All of the health concerns of pregnancy, labor and delivery are magnified by the incidence of multiples,” said Christine Adams, coordinator of UWMC’s Prematurity Prevention Program. “The mother’s nutritional requirements soar, especially in the last trimester. The need for sleep and adequate rest is also increased.

“Women expecting multiples, especially triplets or more, should probably plan to spend the latter part of their pregnancies in severely restricted activity or even confined to bed,” continued Adams. “They only have a few months to plan their maternity leave, arrange child care if they have other children, and enlist help with ongoing domestic chores.”

Labor and delivery are also far different for parents of multiples. Up to 40 percent of twins, most triplets and all quadruplets are born prematurely.

The high incidence of prematurity in multiple births was what prompted the development of a class just for multiples. It evolved from UW Medical Center’s innovative Prematurity Prevention Program, developed by Dr. Thomas Benedetti, professor of obstetrics and gynecology.

After labor and delivery, the hard part begins. The television sit-com versions of life with twins and triplets are a far cry from the truth. The effect of one baby on a household is monumental; two, three, four or more is earth-shaking. Couples may experience frightening strains on their relationship due to physical and emotional exhaustion. The heightened attention, in public and in private, given to multiples may cause “singleton” siblings to feel neglected.

Couples are encouraged to engage outside assistance, whether from family, friends or hired help, before the babies are born. As part of the classes, families receive a resource list of organizations and other contacts, including Internet addresses, so they can extend their support network.

Most parents of multiples agree that one of the hardest things to deal with is the lack of normal privacy and even common courtesy extended to them in public places. “We try to forewarn parents that they are about to become a public conversation piece,” Adams said. “People will ask about their sex life, medical history and finances. The public can be incredibly — if unintentionally — rude.”

For more information on the classes, call the Prematurity Prevention Program, 206/548-4070 and/or the Perinatal Education office, 206/548-4003.

Why so many multiples? In the past 20 years, the number of multiple births has nearly doubled. In 1973, there were 56,777 multiple births recorded; in 1980 there were 68,339; and in 1993, there were more than 100,000.

Much of the dramatic increase in the incidence of multiples has happened in the last decade. In the early 1980s, twins occurred in every 80 to 90 births; now they occur in every 40 to 45 births. The incidence of triplet births in 1980 was once in every 6,400 births: now it’s once in every 1,300.

There are several reasons proposed for this dramatic increase in what was formerly an uncommon event. For one, a significant number of women are having children at an older age.

After 35, a woman’s ovaries tend to release more than one egg per month, perhaps as a way of compensating for the natural decrease in fertility that comes with age. Secondly, the use of fertility drugs and other assisted reproductive technologies has become more widespread, in part to overcome age-related decreased fertility. These methods have long been associated with multiple births, especially in cases of quadruplets or more.