What to expect after delivering triplets

Giving birth to triplets can be a very rewarding experience, but it also comes with its share of complications. After giving birth, you will likely experience a number of physical and emotional changes. Here is what to expect after delivering triplets in the days and weeks that lie ahead:

Long hours of restlessness, immense bleeding, and many more common post-delivery symptoms such as constipation, back pain, and varicose veins. These are all typical symptoms experienced by women who deliver one or more babies. When delivering triplets or more, there are some extra things to consider, which may come as more of a surprise.

You will likely experience fatigue and sleep deprivation and you may have difficulty breastfeeding due to the added stress of feeding three infants at once.

Many women experience swelling in their feet and ankles. These are all common side effects of pregnancy and childbirth. Talk to your doctor about how to best treat these conditions. With time, you will adjust to your new role as a mother of triplets.

Emergency Or Preterm Delivery Of Multiples:

Multiple pregnancies often cause a cachetic effect on the mother’s health, that is, a loss of weight and muscle wastage, similar to what might be seen in someone who is very unwell. This is generally found in women who experienced extreme nausea during pregnancy (much more common in multiple pregnancies). A negative health effect on the mother during pregnancy plus the inability to carry multiple babies to full term can increase the risk of those babies being born with health complications.

It’s common for triplets to be born preterm (often between 28-32 weeks) and this is usually by c-section. Emergency c-section or sudden deliveries can equally effect the health of mother and potentially compromise her ability to carry more pregnancies in the future. The good news is that medical technology is constantly advancing and multiple pregnancies born early have better odds at thriving now than ever before.

A preterm delivery most commonly means babies are born underweight and may need to stay in a humidicrib for warmth. Premature babies may lack the strength to suck properly so feeding via a gastronasal tube is a common way to get them nourishment until they are strong enough. Underdeveloped lungs can often mean that preterm babies have breathing difficulties, but in the case of triplets or more, doctors will often give the mother steroid shot in weeks leading up to delivery. The steroids are aimed at helping the unborn babies lungs get stronger and since most multiple pregnancies result in preterm birth, it’s a smart strategy!

I guess the aim of this information is to make you aware of some common things to expect after delivering triplets. There are some factors that are unique to having higher order multiples and emergency or preterm delivery is not unusual.

Common Birth Complications With Triplets Or More:

As I explained before, birth complications with triplets or more are more common than with a single baby. This is largely due to the increased chance of preterm delivery and so most complications are associated with premature birth than the fact that it’s a multiple birth. There are certain risk factors linked to the fact that you have three or more babies growing at once, but even these risk factors have many variables such as the types of triplets you are carrying. Many, many triplets are born early with minimal complications every year, so this information isn’t designed to cause alarm. Hopefully you have an excellent medical professional taking care of you who can answer any questions you can and give you they best reassurance when preparing for the birth of your babies.

Potential health problems for your babies can include anemia, infections or neonatal sepsis, heart complications (eg; patent ductus arteriosus), respiratory distress syndrome, neonatal jaundice and hemolytic anemia. It’s best to discuss these conditions with your doctor as chances are some of them have already been screened for and potentially ruled out.

With a triplet pregnancy, the mother is at increased risk of high blood pressure. This can lead to many other precarious factors, including placental abruption (early detachment of the placenta), pre-eclampsia, hormonal imbalance and grave loss of fluids or blood during the birth process. Again, your doctor should be all over this, but if you are keen to discuss potential complications further, this list might give you some points of discussion.

Leaving hospital before your babies can:

Ok, this is definitely something i didn’t prepare for well enough. I your babies are born preterm or having other complications they will likely be staying in the NICU (neonatal intensive care unit). The strict timings and sophisticated nature of NICU can be emotionally crippling for parents. God NICU staff (and most of them are amazing) will be as sensitive as possible, but there will be times you can’t visit or hold your babies. If you’re discharged before your babies are (which happens a lot) you will be going home to a quiet house with a decked out nursery, yet your babies aren’t in your belly any more. It’s pretty rough emotionally, but your little ones are in the best of care. This bit could have a bit to do with increased risk of postpartum depression which is so common now a days.

what to expect after delivering triplets
delivering triplets or more

Recovering from C-Section after triplets:

Undergoing caesarean section means a woman can face significant long-term health risks later in life. The incision itself can take 6 to 10 weeks for recovery. The main thing to remember after c-section is that your abdominal wall has been sliced open, so your trunk stability and core strength will be greatly compromised while the healing process takes place. It’s important to attend any follow up appointments to ensure infection isn’t occurring and to allow your body to recover fully. The cut is close to the lining of uterus so there is risk of infection from surgery leading to endometritis (an infection of the uterine lining).

Physical movement should be limited, especially lifting things and driving is usually not recommended until a 6 weeks follow up have taken place with your doctor. This might mean having someone pass you your babies rather than lifting them initially (although multiples are often quite a bit smaller than full term, single babies, so you may find you can lift them sooner. Discuss pain management with your medical professional. Some women experience a great deal of pain and discomfort following c- section, while others seem to bounce back robustly. Regular follow-up should be maintained with the respective doctor to negate any other disease factor such as formation of blood clots or hemorrhages. For more information specific to recovering from c- section, there’s a separate article here.

Complications with breastfeeding preterm babies:

Breast milk is considered one of the most valuable ingredients in baby’s growth and development. In the case of preterm babies, colostrum will be rich in proteins in order for full growth that is yet to complete. For some mothers, breastfeeding isn’t an option for a multitude of physiological or psychological reasons. Fortunately, in our modern world, baby formula has been developed to a point where it can provide a newborn with a solid start to life, regardless. For women who do intend to breastfeed, having three or more babies who arrive early can make for a rough road ahead. The main complication in breastfeeding a preterm is their size. If the baby is born after 34th week the baby is often (though not always) able to feed directly from his or her mother. For infants born earlier than that (or who are still undersized as if common with multiples even in later gestation), being able to feed from a breast or even a bottle may be troublesome. Nasal-gastric tubes (a tiny tube inserted through the nose and feeding directly into the baby’s stomach) allow expressed breast milk or formula to be delivered to your little ones to help them grow and thrive.

The flip side to this is the actual breast milk production at the mother’s end. Premature deliver and c-sections mean that the usual hormones which flood the body as labor and vaginal birth occur don’t get released as the optimal time. These hormones tell the body to start producing breast milk for the newborn, but when a preterm birth catches the body by surprise, the message doesn’t always get through! Once bubs are born, your body will realize and the breast milk production begins, but it’s not uncommon for there to be a delay. Other factors that impact breast milk production include poor health during pregnancy, extreme loss of blood / fluid during delivery and serious conditions such as pre-eclampsia. If you’re interested in hearing from other women and their experience breastfeeding triplets, check out articles here and here.

Body changes after having triplets

Of course everyone is different and no two women will experience that same changes to their bodies. Since you’re reading this article, I’m assuming you’re curious, so I’ll list off some of the more common bodily changes you could expect after delivering triplets:

Belly: Your abdominal skin is really stretched out and you will probably look as though you’re pregnant with a single baby at first. I remember being shocked when someone held an elevator door for me and commented that I was pregnant 4 days after delivering my triplets! Your belly will go down, but give it time. Wearing a maternity belt is recommended in this part for added support, but you might want to wait until your c-section stitches are healed. Just see what feels more comfortable for you.

Breasts: Enlargement of breast and leakage is the main physical change. Engorged breasts can feel pretty sore.

Vaginal bleeding: Increased stretching of vaginal walls during birth may lacerate the internal lining of vagina that leads to more blood loss than normal. Even for a c-section delivery, you will probably have heavier than ‘usual’ bleeding. The site where each placenta attached to the uterine wall needs to heal.

Perineal pain: Excessive pushing can leave the muscles extended beyond their normal lengths that damages the nerve supply of the perineum and hence resulting in pain. If you have your triplets via a vaginal birth, the good thing is that they are generally smaller than single babies so hopefully your body will undergo less trauma getting them out into the world! (Having said that, there are three…*winces*)

Back pain: The hormones that helped your body stretch and shift to accommodate your babies has been super helpful during pregnancy. The downside of these stretchy ligaments and muscles is that they are more prone to injury. Also, the sudden change in your center of gravity (ie; having three or more babies no longer hanging off the front of you) can cause pain and problems too. I highly recommend swimming and pilates (if your doctor approves) during your pregnancy and as soon as possible following delivery. Treat it as medicine and make it a priority, because the better you take care of yourself, the better you can care for your babies.

Some women do need corrective surgery after carrying multiple babies to reconnect the two sides of their abdominal muscles that have had to separate in order for your pregnant belly to grow. It usually knits back together on it’s own, but if it doesn’t, surgery can help with returning core strength and reducing back pain.

Postpartum acne and itchy skin: The rise of estrogen and other hormonal imbalance can have a significant effect on the skin of a new mother. Drink plenty of water and try to eat good food, but also know that the hormone fluctuations are temporary.

Postpartum Hair Loss and Stretch marks: It’s not uncommon to experience hair loss or thinning of hair after having a baby and it’s just a hormonal thing. You should see your hair start returning to normal soon enough. Stretch marks are a common worry for women who find out they are pregnant. There are some things you can do to reduce your likelihood of stretch marks, but a lot of it hinges on your individual skin type. I wrote another article specifically on stretch marks a while back, which you can check out here. Honestly, once your beautiful babies are born, you’re not going to be thinking about stretch marks!

In summary: What to expect after delivering triplets

Most triplet pregnancies are delivered by cesarean section to avoid complications. There is an increased risk of preterm labor, which carries potential complications for your babies and your body. After delivery, there is a likelihood of neonatal intensive care unit admission for one or more of your babies. Get your midwife or medical professional to give you a tour of the NICU mid way through your pregnancy, so you have a better idea of what to expect.

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