As soon as the ultrasound probe touched my belly, two dark sacs, each containing a fuzzy white speck, popped up on the screen. “Nooooo!” was my initial reaction. Twins. OMG. Instead of feeling the warm, fuzzy feelings of impending motherhood that I expected, I was hit with a wave of anxiety—how was I going to manage two babies at once? Would everyone assume we used IVF? As an only child, the thought of instantly becoming a mother to siblings felt overwhelming. Yes, I recognized how fortunate I was compared to couples who have to endure lengthy struggles to conceive, and yes, I adore my fuzzy white dots (who are about to turn 3), but at just seven weeks pregnant, the reality of carrying twins felt daunting.
Would both of them make it? Would they arrive too early? How would I take care of two little ones and myself? Growing up, I knew only one set of twins, but now I’m familiar with dozens. It seems every class my girls join has another pair of twins, and at the playground or bookstore, it’s the same story. Statistically, twin births skyrocketed by 76 percent from 1980 to 2009, with 33 out of every 1,000 births now resulting in twins. The surge is largely attributable to advancements in fertility treatments like Clomid, which boosts ovulation, and assisted reproductive technologies (ART) such as IUI and IVF.
“Multiple pregnancies have flourished thanks to successful fertility treatments,” noted Dr. Laura E. Riley, president of the Society for Maternal-Fetal Medicine and medical director of Labor and Delivery at Massachusetts General Hospital. “It’s common to see one or two sets of triplets on the labor floor nowadays.”
This dramatic increase in multiple births has profound implications for the mothers, the babies, and the medical professionals involved. Twin pregnancies pose higher risks for both mothers and babies. Mothers carrying multiples are more susceptible to gestational diabetes, pre-eclampsia, and other complications, leading to increased monitoring and more frequent prenatal visits and ultrasounds compared to those expecting singletons.
Since I was expecting twins and nearing 40, I was classified as high-risk and referred to a maternal-fetal medicine group. This led to monthly appointments, then weekly check-ups as my pregnancy progressed. My commute transformed from a breezy 10-minute walk to a 30-minute trek, and navigating subway stairs felt like an Olympic event. Thankfully, I transitioned to remote work around 7.5 months, but I ended up needing a walker just to get to my front door.
Mothers of twins are also more likely to have a C-section, often due to complications or when one or both babies are breech. Many obstetricians today are less trained in vaginal breech deliveries and prefer C-sections instead. “The skill for breech delivery is becoming rarer,” Dr. Riley pointed out. A C-section generally costs around $50,000 compared to $30,000 for a vaginal delivery, and in twin births, each baby requires its own medical team. Alarmingly, mothers of multiples face a staggering 13 times higher risk of giving birth before 32 weeks and six times more likely to deliver before 37 weeks, with a significant portion born prematurely at low birth weights.
At 37 weeks, I was hospitalized due to pre-eclampsia but decided to wait for my own OB to be on call since one of the twins was breech. After a grueling 27 hours of labor that included failed inductions and epidurals, I ended up in the operating room for a C-section. Fortunately, we were blessed—one twin weighed nearly 7 lbs., and the other topped 6 lbs., both without complications. Despite meticulous planning to ensure our medical team was in-network and our insurance covering 90% of the costs, the bills still piled up.
Twin pregnancies will always incur more costs than singleton pregnancies. “We’re all under pressure to manage expenses, but when it comes to twins and triplets, some costs are unavoidable,” Dr. Riley remarked. The good news is that practitioners are becoming more adept at caring for mothers and babies in these situations, leading to enhanced training for residents and better care practices in neonatal units. However, the reality remains that there are no guaranteed medical solutions to the inherent risks of carrying multiples. “We don’t have treatments; we just monitor and respond,” Dr. Riley stated. “To improve outcomes for mothers and children, single births are preferable.”
The American Society for Reproductive Medicine (ASRM) echoes this sentiment. Their 2012 guidelines recommend single embryo transfers for women under 35 undergoing initial IVF rounds, promoting “healthier singleton births.” Despite advancements in fertility science, the rate of twins has plateaued, with a minor decrease noted in 2011.
“It’s crucial to lower the rate of multiple pregnancies,” stressed Dr. Riley. “Ultimately, the goal is to ensure healthy births, which is best achieved with one baby at a time.” However, implementing single embryo transfers has proven challenging, as the costs of IVF can be prohibitive. Many women battling infertility are willing to risk multiples for a chance at parenthood. As for me, I certainly heard the warnings about twin risks, but I never thought it would apply to my situation.
As fertility science evolves, perhaps attitudes will shift. For now, the phenomenon of twins is prevalent and likely here to stay. Watching my girls embrace each other or comfort one another brings joy, even if they occasionally engage in hair-pulling contests. Their bond is special—and more love in the world is always a good thing.
For more on the challenges and joys of navigating pregnancy, check out our post on this site. For insights on fertility boosters, visit Make a Mom. And for a deeper understanding of IVF, check out this resource.
Summary
The rise in twin births, driven largely by advancements in fertility treatments, has significant implications for mothers and healthcare providers. Twin pregnancies come with increased risks and challenges, leading to heightened medical monitoring and costs. While the medical community is more skilled at managing these pregnancies, the reality is that carrying multiples can be fraught with complications. It’s crucial to prioritize healthy births, often achieved through single pregnancies.