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July 2007

Baby, baby!

Are you seeing double? Or perhaps even triple or more? Don't run to your eye doctor just yet. The number of multiple births in the U.S. has risen significantly in the past several decades. Between 1990 and 2000, twins births increased by 74% and higher-order births increased by almost 500%. In 2005, almost 3% of all babies born in the U.S. were twins, triplets or higher-order multiples. North Carolina mirrors this national trend. Almost 3.5% of North Carolina babies were born in sets of two, three or more in 2005.

The increase in the number of twins, triplets or higher-order multiples has been attributed to several factors. Increased maternal age alone accounts for about a third of the rise. The rest of the increase is credited to the use of assisted reproductive technology such as in vitro fertilization and fertility drugs such as Clomid.

The risk of pregnancy-related complications is significantly higher for women carrying multiples. And the more babies, the more potential complications. Premature birth and low birthweight are two dangerous complications that multiples face at rates higher than single babies. Babies who are born too early - before 37 weeks or pregnancy - or babies born low birthweight - weighing less than 2,500 grams (5.5 pounds) - are at risk for serious health problems such as respiratory distress, learning and developmental disabilities, cerebral palsy and blindness. More than half of twins, almost 90% of triplets and most quadruplets and higher-order multiples are born premature and weigh less than 2,500 grams at birth.

Signs of Preterm Labor

A woman pregnant with multiples is at greater risk for preterm birth. Still, all pregnant women should learn the warning signs of preterm labor.
The warning signs of preterm labor include:

  • Contractions of the uterus, which may be painless or feel like the baby is "balling up", that occurs 6 or more times in 1 hour
  • Cramps, similar to menstrual cramps
  • Low, dull backache
  • Pressure as though the baby is pushing down
  • Increase or change in discharge from the vagina, may be watery or with mucous blood

If a pregnant woman experiences these symptoms before her 37th week of pregnancy, she should immediately call her doctor, clinic, midwife or nurse.
When she calls, she should be prepared to:

  • Give her name and address
  • State when the baby is due
  • Name the signs of preterm labor she is experiencing
  • Tell how often she is having contractions

North Carolina Healthy Start Foundation's catalog offers free Prevent Preterm Labor Cards that women can keep in their purses as a guide in case they think they are experiencing preterm labor. By sharing preterm labor information with an expectant mom and her family, you're helping promote healthy outcomes for mom and baby, or babies as the case may be.

Free Materials

Prevent Preterm Labor Card (also in Spanish)

Radio spot about African Americans and prematurity and low birthweight


NC State Center for Health Statistics
National Center for Health Statistics
Meyer R, Beuscher P, Surles. Multiple Deliveries in North Carolina: Effects on Birth Outcomes, Maternal and Child Health Journal 1999 3:4 233-9.
March of Dimes PeriStats

Click here to order free educational materials.

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Last updated: July 2007


At a glance

NC Stats











13.5% (2004)*

NC State Center for Health Statistics
*March of Dimes PeriStats

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