Triplets can be what are known as Higher Order Multiples (HOM), which signifies more than two babies are being carried at one time. 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. The current estimate is that around 80-90 sets of HOM babies are born in Australia each year. So if you’re pregnant with triplets, be reassured that you are not alone.
Triplets can be either monozygotic – meaning they are formed after one fertilised egg has split into three identical embryos, or they are dizygotic – meaning they are formed from separate eggs. Polyzygotic triplets can also occur when there is a set of identical (or monozygotic) twins conceived + another egg is released which is then fertilised by another sperm. One very cute term which is used to describe the most common form of spontaneously conceived triplets – identical twins + a fraternal sibling is “A pair and a spare”. This means that the identical twins are always the same gender and exactly the same DNA but the “spare” could potentially be of the opposite sex and share no more characteristics than any other sibling.
One explanation for why multiples are more common in older women is because as the eggs get older, their quality diminishes and the chances of them splitting increases.
Ovarian production also tends to peak as women age; there is generally a spike in fertility before women enter their peri-menopausal years. Perhaps this is nature’s way of maximising the chances of a woman having another baby or two before she becomes infertile.
There are also theories about how the brain influences hormone levels and that hormonal imbalance in some women becomes more common. This then affects ovarian stimulation and how many eggs are supported to maturation each month.
Currently in Australia, the odds of naturally conceiving with triplets are around 1 in every 9000 births. Via fertility assistance, the likelihood increases to around 1 in every 40. By far the most likely way to conceive with triplets is to have fertility assistance and/or take medication which increases ovulation.
If you come from a family where hyper ovulation occurs, e.g. when the ovaries release more than one egg each month, then you are more likely to conceive with multiples, including triplets.
There is nothing which you can consciously do to increase your chances. Other than having lots of sex when you are most fertile. Overall, this will increase your chances of conceiving with even one baby.
There does not seem to be any scientific evidence to support the theory that having identical multiples is influenced by heredity. It seems that the splitting of a fertilised egg happens at random. But hyper ovulation is certainly influenced by genetics, so women who come from families where non-identical multiples are common do have more chances of having their own multiple births.
By far the majority of triplets are born premature. This means that they do not reach full term and come before the normal gestational period for human babies which is 38-42 weeks. 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.
Most triplets are born between 32-34 weeks of gestation and 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.
Shock, denial, terror 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 and having this confirmed are very different realities.
Many couples emerge from the ultrasound office feeling numb and in shock. Others may laugh hysterically and feel over the moon. Other couples may feel excited and terrified at the same time. There is no one right way to feel when being told that you’re having triplets.
Disbelief, coupled with denial that there must be some sort of mistake also helps to insulate parents from the reality. At least until there has been some time to let the magnitude of this news filter into their consciousness.
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 worried and anxious. 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 you’re bound to have.
It goes without saying that as well as the emotional processes involved in having triplets, there are a lot of financial and practical factors to consider as well.