A: Dear Tom and Shari,

Congratulations on your triple surprise! With growing popularity of fertility treatments, your situation is becoming increasingly common.

Having triplets presents special risks and challenges, and you deserve special medical attention. Triplet pregnancies are at higher risk than singleton or twin pregnancies; 98% of triplet pregnancies develop some kind of complication. If you are in the first weeks of pregnancy, be aware: it is not uncommon for one or more of the triplets to stop developing in early pregnancy, resulting in a twin or singleton pregnancy. Your doctor will monitor for this with frequent ultrasounds.

If your pregnancy proceeds uneventfully, your body will need to accommodate the needs of three growing babies. This means extra nutrition and rest for you, and extra prenatal care. Your doctor will likely place you on bedrest during the pregnancy and request that you restrict your activities early on. You should get specific nutritional advice to help you plan your diet and choose appropriate supplements. Many women with triplets choose to have a perinatologist monitor their pregnancy. This is an obstetrician who has additional training in high-risk pregnancies. Ideally, you should deliver in a hospital that has a newborn intensive care nursery. 90% of triplets deliver early (the average delivery age is 33 weeks gestation) and benefit from specialized medical care in the first weeks of life.

The only way for your doctor to accurately monitor the growth and development of your babies is with regular ultrasound exams. Because the risks of preterm labor, gestational diabetes and hypertension are increased with triplets, you will need to be monitored closely. Your babies’ development will be charted with repeated ultrasound exams. And your cervix should be checked (ideally using ultrasound measurements) at least every two weeks. If your cervix begins to shorten, you may be at risk for preterm delivery. Learn the signs of preterm labor (see my article on this web site titled, Warning Signs of Preterm Labor) and contact your physician if you notice any changes of this sort.

Carrying triplets presents additional physical and emotional demands on both of you. In addition to your pregnancy concerns, you will need to prepare for life with three babies. You may find support from twin groups in your area or internet sites with a focus on “supertwins.” Some helpful resources include:

• Mothers of Supertwins, (M.O.S.T.) PO Box 951, Brentwood, NY 11717 , tel.516-434-MOST or www.mostonline.org
• The Triplet Connection PO Box 99571, Stockton, CA 95209, tel. 209-474-0885 , or www.tripletconnection.org
• Sidelines at 800-876-3151 or www.sidelines.org – for full listings of Resources for High-Risk Parents