Risks to the mother

You may have heard of, or know personally, mothers who have successfully carried and given birth to twins or more babies. Newspapers and magazines often carry articles on such families, and the story is usually one of joy, rather than heartache.

Unfortunately, this rosy picture hides the reality for the women who suffer a miscarriage or life-threatening conditions during pregnancy, or who, in extreme cases, die during pregnancy or labour. It also hides the increased risk of mortality and disability for the babies.

Am I at risk?

At present, about one in six in vitro fertilisation (IVF) pregnancies leads to the birth of twins. This means that after IVF/ICSI, you are around 11 times more likely to have a multiple pregnancy than you would be if you'd conceived naturally.

Other fertility treatments, such as Clomiphene citrate (tablets used to induce ovulation) and intrauterine insemination (IUI) can also increase the risk.

Multiple pregnancy and birth carry significant risks to the children. Find out more about the risks to the child.

The expert says...

"Multiple births increase risks for mothers and babies. They should not be seen as inevitable and acceptable outcomes of assisted reproduction."

Prof Siladitya Bhattacharya, University of Aberdeen

What are the main risks to mothers?

The risks to mothers from multiple pregnancy and birth range from the mild to the potentially life-threatening.

Risks during pregnancy

  • Higher risk of early and late miscarriage than singleton pregnancies.
  • 20% of mothers carrying twins suffer from induced high blood pressure (hypertension), compared to only 1–5% of mothers of singletons.
  • The risk of pre-eclampsia is up to 30% for twin pregnancies compared to 2–10% in singleton pregnancies.
  • The likelihood of women who are pregnant with twins developing gestational diabetes is up to 12% compared to only 4% for mothers with singleton pregnancies. Although the risks to the mother are fairly mild, gestational diabetes can increase the risk of death to the unborn child or newborn baby.
  • If the health of the mother or babies is thought to be at serious risk, the clinician may suggest a fetal reduction.

Risks during or after birth

  • Caesarean section (C-section) delivery is more common in twin pregnancies because there’s a higher chance of complications – for example, one or both babies are in a breech position.
  • There’s an increased risk of problems such as haemorrhage and anaemia.
  • The risk of the mother dying is twice as high during twin pregnancy or birth.
  • New mothers may be more vulnerable to mental health problems like stress and depression. See Bringing up twins for more information.

Even the less serious problems may result in the mother spending longer periods in hospital than would normally be necessary. Women expecting twins may have to spend the last weeks of their pregnancy in hospital, and a high proportion have to be induced early.

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Have you had or begun IVF treatment recently?

The HFEA want to hear your views on single embryo transfer.

Your feedback will help them develop their approach to the risk of multiple births from fertility treatment.

  • What did your clinic discuss with you?
  • How did you decide on the number of embryos to transfer?

Let them know in this patient questionnaire