What Every Surrogate Needs to Know About Twin/Triplet Pregnancies

Can I tell you about the worst day of my life? It’s relevant—I promise. The worst day of my life was when I was discharged from the hospital after giving birth and had to leave my newborn babies behind in the NICU. 

I tell you this because I want you to know that twin (and triplet) pregnancies are not just about “awww, twins are so cute” or “twins are a lot more work.” The reality is that a multiples pregnancy is way more risky than a singleton pregnancy. Please, please, please, pretty please, think hard before transferring more than one embryo. I know there are situations where a double embryo transfer is appropriate, but this should be the exception not the rule. Your goal with surrogacy should be a healthy singleton pregnancy. 

That said, here’s what every surrogate needs to know about twin/triplet pregnancies:

Your health: Some of the increased risks include serious harm to your own health, including losing your fertility.

And the health of the babies: Other risks are to the babies—the most serious risk involves delivering the babies too early, resulting in death or long-term disability for the babies.

It's expensive: High risk pregnancies are more expensive than low risk pregnancies. It can actually be cheaper for intended parents to pursue two separate singleton journeys than to have preemie twins.

It's traumatic: Delivering preemies is frightening. Seeing little tiny babies hooked up to all sorts of machines is never an easy experience, even when they are not your own children. (FYI, those two kiddos in the photos are mine, and they are fine now, but it was not an easy journey to get to “fine”).  

It can disqualify you from another journey: Your risks of a premature delivery skyrocket with twins, and a premature delivery will disqualify you from pursuing surrogacy again in the future. You are also at increased risk of requiring a c-section which can limit your future surrogacy opportunities. And the risks of losing your fertility entirely—by losing your uterus—go up with multiple births.

It's not your typical delivery: Two babies means you often have to deliver in an operating room, in case an immediate c-section becomes necessary. And worse, you can end up with both a vaginal delivery and a c-section. At most hospitals, triplets result in an automatic c-section. If you hoped for an easy vaginal delivery, don't count on it.

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