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Higher Order Multiples – Triplets, Quadruplets and More
Introduction
Canada has always been fascinated with higher order multiple births, perhaps best exemplified by the intense curiosity and fascination with the Dionne Quintuplets. These five monozygotic girls, born in 1934, became a sideshow to most Canadians — removed from their family, made wards of the Ontario government and forced to live on display. They became the image of higher order multiples to generations of Canadians. Fortunately, we have come a long way since then. The increasing number of triplets and more mean our families are being viewed less as curiosities and more as very busy families with hearts, lives and hands very full.
Statistics
It is difficult to know how many higher order multiple birth children were born before 1974, due to inaccurate or inconsistent record keeping. Since 1974, there are still inconsistencies in record keeping, but the numbers closer reflect reality. In its report on Births by Plurality, Statistics Canada records over 220,000 multiple births children born between 1974 and 2000. The vast majority of those, 98.5%, were twins; 1.4% were triplets; and 0.1% were quadruplets or quintuplets. In Canada today, one child in 36 is a twin, triplet, quadruplet or quintuplet. Although the majority are twin births, the most dramatic growth has been in higher order multiples; the number of triplets has increased by 300% in 30 years. Statistics Canada 's annual births' database plots the dramatic increase: in 1981, 130 triplets were born; in 1999, that number grew to 375. In 1981, there were 12 quadruplet or quintuplet births; in 1999, that doubled to 25. (There are still some concerns with the validity of these statistics, since some quadruplet and quintuplet births are occasionally rolled into triplet statistics. Another caution is that the true incidence of conception of higher order multiples is difficult to gauge because there is no way of knowing how many of these pregnancies are spontaneously or medically reduced so they result in twin or even singleton births.)
Because there is a lag between overall population trends and statistics, the anecdotal insights of those who work with higher order multiples can fill in where the numbers leave off. The gradual rise in the number of births over two decades suddenly took off in the 1990s and some experts say it may not yet have hit its peak.
The most significant cause for the rise in higher order multiple births is increasing developments in fertility treatment and the growth of assisted reproductive technologies. The majority of multiples in Canada are born in provinces with a large number of fertility clinics. Although the risk of becoming pregnant with higher order multiples is still small, the use of these technologies does lead to a documented rise in higher rates of multiples. Although only 15-17% of all multiple births result from fertility treatments, the proportion is much higher among higher order multiple births: an estimated 60% of triplets, 90% of quadruplets, and 99% of quintuplets result from these treatments.
Another factor contributing to the growing number of higher order multiples is the increasing age of mothers. Not only does a woman's chance of having multiples increase with age, the decision to delay childbearing itself increases the likelihood of medical interventions to boost fertility, so the two factors act in concert to increase the number of multiple births.
What it all means
The arrival of multiples brings a wide range of emotions, expectations, demands and changes to the lives of the families they inhabit and the world we live in. It is critical that multiple birth families get the support and care they need from the outset from professionals and from other parents who share this unique experience.
The rapid growth in the number of multiple births has been called an epidemic by some medical professionals, who worry that the social and health systems have been too slow to catch up to the speed of this recent multiple baby boom. There are many medical complications and lifestyle alterations associated with higher order multiple births:
- these pregnancies are high risk and often require bed rest at home or hospital stays, early departure from work, or increased medical intervention;
- these births are almost always (90% of the time) early, and premature and low-birth weight babies require extensive and expensive medical intervention;
- premature and low-birth weight children are also at greater risk of long-term developmental and physical challenges and even death.
Surveys have also shown that the stress that often accompanies multiple birth children can lead their families to experience social challenges such as marital break-ups, abuse, and drug and alcohol use.
Fortunately, many of these problems can be relieved quite easily with early intervention and guidance from those who have been there before. Over the years, the volunteer network known as the Triplets, Quads and Quints Association found that families who connected with a support group were more likely to reduce the risk factors and tended not to follow the general gloomy picture. That network of knowledgeable parents, children and experts is now available through the Higher Order Multiples (HOM) Support Network of Multiple Births Canada, which provides the connections that higher order multiple birth families require to get the most out of this challenging, exhilarating and unique experience. This rich store of parental expertise has been collected in Finding Our Way, a book which pulls together anecdotes from Canadian families dealing with multiples on the front lines.
If you are expecting higher order multiples, are already a multiple birth parent, or are yourself a triplet, quadruplet or quintuplet, the HOM Support Network can provide a wide range of emotional support and information regarding this special multiple birth journey. New families are provided with a New Parent Package and are connected with a Parent Contact in their area. The Higher Order Multiples Support Network is here for you – please contact us if you have any questions or concerns, or would just like to chat.
Web Sites:
The Triplet Connection - www.tripletconnection.org
Mothers of Supertwins (MOST) - www.mostonline.org
To contact the Chairperson of the Higher Order Multiples Support Network, e-mail homnetwork@multiplebirthscanada.org. If you are interested in becoming a HOM parent contact, please contact the Chairperson.
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