Multiple pregnancies are considered high-risk because they can lead to many complications for both mother and child, whether those risks appear during pregnancy, during delivery or after delivery. Multiple pregnancies carry an increased risk of high blood pressure, anemia, miscarriage and diabetes, a much higher risk than in regular pregnancies. During delivery, there is also the risk of preterm birth, hemorrhage and placenta previa, and after delivery, there is still a further risk of hemorrhage and infection. Infants born of a multiple pregnancy are at a very high risk of preterm birth and slow fetal growth, which is why doctors consider such pregnancies to be high-risk.
If a multiple pregnancy is conceived using assisted reproductive technology, then unfortunately, it also carries a higher risk than usual that the children will be born with genetic abnormalities. Most mothers who use assisted reproductive technology are already comparatively old, so they are already in an at-risk group when it comes to pregnancy complications. This also means that when such mothers have multiples pregnancies, their children are much more likely to be born with genetic abnormalities.
This will depend on the doctor’s diagnosis. If you have a twin pregnancy and both infants are in a normal position—i.e. both heads are pointing down and there are no other complications—then yes, you can have unassisted vaginal childbirth. However, it will also depend on certain other factors, such as whether your nearest medical center has a specialist team and enough nurses. In cases of unassisted delivery, it is important to prepare for an emergency operation in case something goes wrong. For example, when giving birth to twins, sometimes the first twin is safely delivered but the second twin changes its position and obstructs the birth canal. In such cases, the second twin must be delivered by emergency cesarean section, and if no such preparations have been made beforehand, this can create an extremely dangerous situation.
The first thing you should do is seek out prenatal care. If you have a multiple pregnancy, the doctor will arrange for more frequent antenatal care than if you had a singleton pregnancy, because the chances of complications are much higher. You must attend these regular antenatal care sessions so that the doctor can monitor the growth of your babies during pregnancy. It is not necessary to eat a larger amount of food or take vitamin supplements for a multiple pregnancy: just eat the same amount as you would with any normal pregnancy. Remember to avoid risks such as smoking, alcohol and caffeinated drinks, and most importantly, when you arrange for prenatal care, remember that you must attend all of your appointments and follow the doctor’s recommendations carefully.
M.D., Faculty of Medicine, Chulalongkorn University, 2003. Faculty of Medicine Chulalongkorn University