Currently in Australia triplets occur in 1 in every 9000 naturally conceived births. Via fertility assistance the likelihood increases to around 1 in every 40.
All good things come in threes! Although rare, it is entirely possible for women to conceive naturally with three babies, however fertility assistance is the strongest influential factor when it comes to having triplets.
Triplets can be either monozygotic (formed after one fertilised egg has split into three identical embryos) or dizygotic (formed from separate eggs). Polyzygotic triplets can also occur when there is a set of identical (or monozygotic) twins conceived and another egg is released which is then fertilised by another sperm.
Common parent reactions when triplets are confirmed
Shock, denial and anxiety are the most common responses. Most parents find out they are expecting triplets when an ultrasound is done and three tiny embryos are seen on the screen. Multiples may be suspected beforehand due to exaggerated pregnancy symptoms, the use of fertility drugs or assistance, or alternately, a family history of multiple births. But suspecting triplets may perhaps be in your future and having this confirmed are very different realities.
Many couples emerge from the ultrasound office feeling numb and in shock. They know what they’ve been told and even what they’ve seen, but the reality of this can be too much to take in. There is no one right way to feel when being told that you’re having triplets.
It is also common for couples to respond very differently to each other; one may be utterly delighted from the start and the other partner almost horrified. It can pay to just aim for a quiet few days to let the news settle into your brain and for rational thought to replace surging emotions. Don’t worry about the embryos “knowing” you’re less than delighted. This is impossible and their brains too immature to be capable of interpreting their parent’s reactions.
Be prepared for some interesting responses from your family and friends and even total strangers when you tell them you’re expecting triplets. Their responses are often so much more about how they would react given the same situation, rather than their feelings about your reality. Just be prepared to smile and try to ignore any negative comments.
Support from close family and friends, as well as multiple birth agencies will help you to process any nagging doubts and/or anxieties.
What increases the likelihood of having triplets?
- Women over 30 years old have a greater chance of conceiving multiples. As the eggs get older their quality diminishes and the chances of them splitting increases. Production also tends to peak as women age; there is generally a spike in fertility before women enter their peri-menopausal years.
- A diet high in milk, yams and dairy foods.
- Women of African descent are more likely to have triplets.
- Around 85% of triplets are conceived through fertility assistance.
- Women who have previously had fertility assistance have a higher than average chance of conceiving naturally with triplets with their consecutive pregnancies.
- Conceiving with multiples is more common in women who have had babies previously.
- Women who come from a family where there is a history of multiple births.
- Those who are very, very lucky!
Will my triplets be born early?
The majority of triplets do not reach full term and are born premature. The normal gestational period for babies is 38-42 weeks, however most triplets are born between 32-34 weeks of gestation. There are many reasons for this but generally it is because of a lack of room to grow any further in the mother’s uterus.
Caesarean section delivery is common. Smaller hospitals tend to refer mothers who are pregnant with triplets to larger, metropolitan or tertiary maternity hospitals. This is because of the availability of specialist staff and resources for both obstetric and premature baby care.
Complications of having triplets
- Greater risk and range of pregnancy complications generally.
- Premature delivery.
- Delayed fetal growth otherwise known as Iugr – Intra Uterine Growth Restriction, or Sga – Small for Gestational Age.
- Maternal Pre Eclampsia.
- Gestational Diabetes.
- Placenta Praevia.
- Increased risks to the babies include a higher likelihood of cerebral palsy, prematurity complications including breathing and feeding difficulties and issues with maintaining normal temperature and blood sugar levels.
Preparing for triplets
It is important to prepare your mind as well as your body for the triplets’ arrival.
- Once you know you are having triplets it is a good idea to start thinking about them as separate individuals so you can get to know them.
- You can start building your relationship with your babies by getting to know their movements and their position in the womb. You can also use ultrasound pictures to share your experiences with the babies' father.
- You might feel emotionally and physically drained by the changes happening to your body. It is important to share these feelings with your loved ones. This helps them to start sharing the care.
- You are doing the best thing you can by reading as much as you can about triplets and how to care for them.
- Looking after even one baby can make you feel very tired, and caring for two babies can be even harder if they are unsettled. The most common cause of depression for new mothers is fatigue. If you are experiencing stress, anxiety or depression seek help immediately.
- In addition to the emotional processes involved in having triplets, there are a lot of financial and practical factors to consider as well:
- The size of your house, where the babies will sleep and how you’ll fit three bassinettes/cots in.
- Your car – fitting three car seats into a standard family vehicle may be a challenge.
- A pram to fit three babies, as well as a toddler and older children if you have them.
- Three lots of everything including clothing, bed linen, nappies, changing areas and feeding requirements. Many mothers of triplets do breastfeed or express breast milk for their triplets, at least in the early months. A breast pump will make this job so much easier. Do some research early on in your pregnancy and decide how you want to feed your baby and what will work for you.
- Avoid thinking you need to buy everything new. Borrow, lend, rent or buy second hand. You’ll be amazed by the offers you’ll get of clothing, nursery furniture and general baby goods. Don’t be too proud; you will need to get used to accepting all reasonable offers of support and this includes gear which will make life so much easier (and cheaper) for you and your family.
- Freeze some meals in advance for times when you need them after the birth.
- Plan what you are going to do about nappies. A nappy service or disposable nappies may be helpful.
- Because multiples often come early, plan to go to your antenatal classes a bit earlier than usual to make sure you can complete them. Your midwife or doctor will be able to help you with this planning.
- If you have other children at home, particularly very young children, think about how you are going to prepare them for the new babies.
- If you get offers of help – accept! You may feel uncomfortable about this at first. Every bit of help you get will help you to build a better relationship with your babies. People like to be helpful. You could, for example, accept help with cleaning, ironing, shopping or with preparing food.
Because breast milk supply increases with extra demands, most women can breastfeed triplets well. This can mean much less work compared to preparing and giving formula. However, because of the extra challenges of feeding three babies, you may wish to get some support from your nurse or midwife, local breastfeeding association or a lactation consultant.
You can feed your babies together or separately. Feeding your babies at once can give you more time to get some rest in between feeds, however you may want to feed separately some of the time so you get more chance to get to know each baby.
If you are bottle feeding your babies, it is often recommended to feed each baby separately, as this separate closeness and touching helps encourage bonding with the baby. If you try to feed them together you will find you are holding the bottles, not the babies!