Questions to ask your doctor if you’ve just found out you’re expecting triplets or more.

Expecting a child is an exciting time but it can also be a physically and emotionally trying one as well. This holds true even more if you are expecting more than one child. In fact, common questions on the minds of expectant mothers often include everything from how to pay for healthcare expenses and how much weight to gain to recommended lifestyle changes to make and details about actual birth and delivery. If you are expecting triplets or more, some questions are more important than others. Below is a list of things to discuss with your doctor as your pregnancy progresses, so read on to learn about what you need to know.

Studies have shown that there is a strong correlation between gaining the right amount of weight and the healthy growth of your babies. These studies go so far as to say that weight gain before Week 20 can help in the proper functioning and development of the placenta. Women who are of normal weight before their pregnancy should gain between 35 and 50 pounds. Women who are somewhat overweight are advised to gain somewhere between 30 and 50 pounds.

Do I need to consult with a perinatologist if I am pregnant with more than one baby?

A perinatologist is a doctor who specializes in the treatment of high-risk pregnancies, including triplet or higher order multiple pregnancies. In case you are wondering, pregnancies with twins and above are classified as high-risk, regardless of other background or health factors you may or may not have. If you are at an advanced age or are in a particularly high risk group as a result of having diabetes, high blood pressure, or other factors, or if you have had pregnancy-related complications in the past, then it is probably better to see a perinatologist. If not, and if your doctor assures you that things are progressing normally with your pregnancy, then you can continue to only see your primary doctor.

Can I have sex during a triplet pregnancy?

what to ask my dr about pregnant with triplets

Some doctors worry that sex during a triplet pregnancy can set off preterm labor. However, research strongly suggests that having sex during a triplet pregnancy is actually quite safe, as long as you have no other health-related red flags or warning to watch out for as advised by your doctor.

Is bed rest really necessary when carrying triplets or more?

Again, many doctors prescribe bed rest for women carrying twins or more to help offset the chances of preterm labor. However, most research does not back up this somewhat antiquated practice. In fact, for some women, bed rest can actually increase their chances for preterm labor. Having said this, getting an adequate amount of rest while you are pregnant with triplets is very important, so try to take more frequent breaks and reduce your overall activity. The fewer calories you burn, the more your babies will have.

Do I need to be induced if I go past Week 35 in a triplet pregnancy?

If everything is going well, you can expect things to go normally until past week 32. Doctors don’t usually recommend that you carry your babies for too much longer than that because of the risk of complications that can arise for expectant mothers carrying triplets as a result of the reduced space in the womb, as well the speed with which the placenta breaks down

Is there any kind of specific exercise that I need to do when carrying multiple babies?

Exercise always helps, but it depends on your personal activity level and the needs of your pregnancy. Someone who frequently works out in the gym will have different needs from someone who is less active. In general, some light exercises are helpful, and your doctor may recommend that you do a few light activities a few times a day. The bottom line, however, is that you should try to be active throughout your pregnancy, but do only low-impact exercises such as prenatal yoga or walking.

What foods or vitamins do I need to take during a multiple pregnancy?

You should try to avoid raw fish and raw eggs, and you might need extra meat in case you suffer from anemia. Also, regularly taking the vitamins your doctor prescribes for you is absolutely necessary; taking adequate amounts of the right vitamins can really lower your chances of facing complications as your pregnancy progresses. The most basic of vitamin regimens include regular doses of vitamin D, iron, calcium, and folic acid (all of these are necessary for the healthy development of your babies).

Are there any specific symptoms I should watch out for during a triplet pregnancy?

Pregnancy symptoms vary from person to person. If your doctor knows you and your family well, or if they at least take your detailed history prior to becoming your consultant (which they will have done), then they will be able to tell you which symptoms are expected for you and which ones might be cause for concern. At the very least, you can expect somewhat more severe morning sickness and breast tenderness, not to mention much quicker weight increases as compared to single pregnancies with triplets.

Sources:
https://sleepingshouldbeeasy.com/2017/05/14/pregnancy-questions-to-ask-your-doctor/
http://blog.southshorehealth.org/five-questions-moms-pregnant-with-multiples-should-ask
https://www.healthline.com/health/pregnancy/pregnant-with-triplets

What are the most common complications during triplet pregnancy?

What do you need to know about triplet pregnancy?

Being pregnant with triplets means both you and your babies are at higher risk of developing health complications as compared to a pregnancy with twins or a single baby.

Common complications of pregnancies with triplets include premature birth and low birth weight.

Extra prenatal care is needed so that your healthcare practitioner can keep a closer eye on you and your babies during your pregnancy.

Remedial actions that should be taken to reduce your exposure to risk and complications include early confirmation of the type of pregnancy you are having, and educating yourself about warning signs to watch out for.

Just found out you’re expecting triplets?

With each additional baby that a woman carries during her pregnancy, there is an increase in the chances and likelihood of developing a pregnancy complication. When it comes to having more than one baby at a time, twins, therefore, have the lowest chance of complication as compared to other types of multiple pregnancies, and the chances go up for triplets, quadruplets, and beyond.

Common Complications with Triplet Pregnancies:
multiple pregnancy complications

Here are brief explanations of some of the more common complications of birth with triplets. The same complications are common with higher order multiples such as quadruplets and the risk often increase as the number of babies goes up.

Preterm Delivery
Preterm or premature delivery can be defined as a pregnancy that lasts less than 37 weeks. The actual length of gestation usually falls with each additional baby that the mother carries, and most pregnancies last, on average, 39 weeks for single pregnancies. Pregnancies with twins typically last 36 weeks, and about half of them are delivered preterm. Pregnancies with triplets, on the other hand, usually last about 32 weeks, but 9 out of 10 of them are preterm, with higher order pregnancies almost always being preterm.

Low Birth Weight
Babies born under 5.5lbs are classified as low birthweight babies. Babies that weigh less than 3.3lbs and who are born before 32 weeks are more likely to develop complications and may suffer long-term health issues such as slow mental development, cerebral palsy, and loss of vision or hearing.

Intrauterine Growth Restriction (IUGR)
This phenomenon occurs because babies sharing the same womb, and in many cases, the same placenta, compete for nutrients and space. With multiple pregnancies, while the fetuses grow at approximately the same rate in the beginning, the rate then slows, and it slows earlier and earlier the more fetuses there are in the womb.

Anemia
Anemia is a shortage of red blood cells and hemoglobin. Symptoms of anemia include tiredness, paleness, shortness of breath, and passing out. An iron-rich diet can help fight off anemia by keeping hemoglobin levels up, and good foods to have include lentils, dark and leafy green vegetables, and anything fortified with iron. You can even take supplements to bring your iron levels back up to the recommended or required level.

Preeclampsia
Preeclampsia is another name for pregnancy-related high blood pressure. Twin pregnancies are two times as likely to develop preeclampsia as single-baby pregnancies, and 50% of triplet pregnancies develop preeclampsia.

Fetal Death
Intrauterine fetal death, while uncommon, is still a risk for multiple births. You may have to induce labor or have a caesarian to avoid the risk of losing the other fetuses, but ultimately your healthcare practitioner will determine for you what plan of action is best if you are faced with a fetus that has died while still in the womb.

Common questions from those expecting triplets:

The following questions and answers provide useful information on having triplets or higher order multiple pregnancies and the risks associated therewith.

Is it true that multiple pregnancies are riskier than single pregnancies?

In terms of simple risk, the answer is yes. While it is true that the vast majority of births in the US result in healthy babies, any pregnancy that involves two or more babies can be labeled high risk. Furthermore, the more babies there are, the higher and higher the risks are.

What is the incidence rate of premature delivery?
Roughly 6 in 10 twins and 9 in 10 triplets are born prematurely. Premature delivery does not necessarily mean you can definitely expect health complications, but the two things are correlated and the incidence rate of complications – including premature delivery – is higher with higher multiple births.

Will I necessarily have a cesarean while having triplets?
Being pregnant with multiples does not necessarily mean that you will have a cesarean birth. Twins are often delivered vaginally, and such delivery depends on the position of the babies in the womb, but with triplets and higher order multiples, a cesarean is usually recommended.

What risks are associated with premature deliveries?
The entire aura and even the science behind gestation and birth are magical for a reason. Because the undelivered baby goes through specific cues before being born, it gets ready, in a way, in a step by step manner for the outside world. Premature babies do not go through all of these steps (the same is true to a certain extent for caesarian babies that are not delivered vaginally) and as such, vital organs including the lungs and brain of preemies may be underdeveloped. Their immune systems may not be ready either, meaning they will have a harder time fighting infections, and they may not even be able to suck or swallow.

Will I need bed rest during my pregnancy?
Your doctor may put you on bedrest because reducing your overall physical activity and taking breaks can be good for you, but it really depends on you, the growth of your babies, and the recommendations of your doctor.

How can I reduce my exposure to health risks?
Many complications arise over time and don’t have as much to do with specific lifestyles or behaviors as many people think, so getting an early confirmation of the type of pregnancy you are having is the best way to give your doctor the time they need to handle any issues that may come along. You should also educate yourself about common risks and complications, learn what common warning signs of different risks and illnesses are, and keep yourself healthy and hydrated.

Sources:
https://www.marchofdimes.org/complications/being-pregnant-with-twins-triplets-and-other-multiples.aspx
https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P08021
https://patient.info/health/multiple-pregnancy-twins-and-triplets
https://www.tamba.org.uk/pregnancy/complications
http://americanpregnancy.org/multiples/complications/
https://www.babycenter.com/0_pregnant-with-multiples-potential-complications_3584.bc
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