If you feel like there are more twins, triplets, and more around than ever before, you’re not imagining it. Multiple births have increased since 1980, when one in every 53 babies born was a twin; in 2009, that number had risen to one in every 30. That’s a 76% increase in twin births in roughly 30 years.

One (smaller) reason for the spike is older maternal age. Older women are more likely to release more than one egg at a time (with or without fertility drugs), making multiple gestation a possibility more often. Incidentally, this does not pertain to identical twins, who are formed from a single fertilized egg.

Another reason, one which is responsible for a larger share of the increase, is the use of fertility drugs in women trying to become pregnant. Fertility treatments have attracted some attention in recent years following the birth of eight babies by the so-called “Octomom.” In that case, 12 embryos made from an IFV treatment were implanted into the woman’s uterus and the result was eight viable fetuses.

This was a clear case of poor judgment. Most cases of infertility are not treated with IVF, but rather with drugs that stimulate the ovaries to produce eggs. These drugs encourage hormone production, which aids in conception but also increases the chances of multiple gestation.

When women are undergoing treatment via fertility drugs, their doctors routinely monitor, via ultrasound and blood tests, how many eggs are being produced so that the couple can avoid trying to conceive during a month when there are too many. However, in some cases the monitoring is not done, or the couples disregard the advice given to them. Often doctors who have been demonized for “allowing” a woman to become pregnant with more than one or two babies during fertility treatments have actually given the woman advice that would have prevented the multiple pregnancy, had it been followed.   

There are good reasons to avoid having twins (or other multiples) whenever possible. Twin pregnancies are considered higher-risk pregnancies, and are usually more difficult for the mother than singleton pregnancies – especially older mothers, who no longer have the energy they had in their 20s. In addition, caring for more than one newborn baby at a time is exhausting, even when plenty of help is available. The exhaustion and expense factors increase exponentially with each additional newborn. It’s also extremely difficult to maintain social and emotional health during those early years with twins or more.

If you do find yourself pregnant with twins or more, take steps as soon as possible to maximize your odds of a healthy pregnancy and delivery, and learn all you can about ways to make taking care of multiples – not just as newborns, but through the challenging toddler and preschool years as well – as simple as possible.

– Yvonne S. Thornton, M. D., M. P. H.