If you are pregnant with triplets or more, the birth will need careful planning. The main risk with carrying multiples is that they will be born prematurely. Your medical team will help you decide where and when your babies will be born.
Planning for your multiple birth
To plan the birth of triplets or more, your medical team will weigh the risks of premature birth against the risks to both you and your babies of continuing the pregnancy.
Generally, the longer your babies can stay in your uterus, the better. But when you are pregnant with triplets or more, complications often develop that mean it’s better for you and your babies if they are born early.
A normal pregnancy lasts 40 weeks. The average length of a pregnancy for triplets is 32 weeks and for quadruplets 30 weeks.
Continuing a pregnancy with triplets or more for longer than 36 weeks can be risky both for you and the babies, so it’s usually considered best to deliver them early.
When deciding when and how the babies should be born, your medical team will consider:
- the position of each baby
- the weight of each baby
- your health
- the babies’ health
A caesarean section is usually considered safest when there are 3 or more babies. (Giving birth to triplets or more vaginally is very rare and not recommended because of the higher risk of labour complications and infant mortality.)
Since almost all triplets or more will be born prematurely, they will need special care - for example, in a neonatal intensive care unit. It is important that the birth is planned in a hospital that has all the facilities that both you and the babies will need.
Multiple birth and preterm labour
In about 3 out of 4 cases, women who are pregnant with triplets will go into labour naturally before 35 weeks. The signs and symptoms are the same as with normal labour, including:
- sudden breaking of the waters
- a ‘show’ (when the plug of mucus that has sealed the cervix during pregnancy comes away and out of the vagina)
Contact your medical team immediately if you have any signs of preterm labour. It may be possible to slow down or stop the labour. You will most likely be admitted to hospital and may receive injections of corticosteroids to help the babies’ lungs function better and prevent other complications.
A caesarean section is usually the safest option when you are carrying 3 or more babies. This is because of the position of the babies, the position of the placenta (or placentas), the risk that a placenta or umbilical cord can be compressed during a vaginal birth, and the risk that the babies can become entangled during a vaginal birth.
If you are carrying triplets or more, you will usually be offered a planned caesarean. You will be given a course of corticosteroids first. If you go into labour spontaneously, you will likely be given a caesarean after you arrive at hospital.
During the operation, you will be given an anaesthetic so you don’t feel any pain. There will be a full medical team in the room, including a specialist obstetrician and paediatrician who are experienced in the care of triplets or more.
Extra care for multiple babies
Babies born before 34 weeks may need help with breathing, feeding and keeping warm. They are at greater risk of complications than babies born at full term.
The neonatal intensive care unit has specialist medical staff and equipment to care for premature and sick newborn babies. When your babies no longer need this high level of care, they may be transferred to the special care nursery or special care baby unit.
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Last reviewed: December 2019