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The More the Merrier: Rise in Multiple Births as Women Decide to Wait

December 7, 2018

Some people think that having twins, triplets, quadruplets just comes down to the luck of the draw. But there are actually a lot of factors influencing whether a mother has multiple births, including her age. In this article, we’ll be breaking down:

  • A new study showing the rise of multiple births in correlation with a woman’s conceiving age
  • The science behind age and multiple births
  • The risks associated with multiple births and advanced age
  • Some general prenatal care tips if you are carrying multiples

The Numbers

Studies are showing that it’s not just IVF treatment that’s causing multiple births.


New research shows that more American women than ever are having multiple births--and IVF treatments are not the only cause. Since the 1980’s, the number of multiple births has risen from roughly 20 sets per 1000 live births to 35 sets,  a new study shows.

To prove that this wasn’t only due to the advent of IVF treatments, which have certainly been linked to the rising amount of multiple births, the researchers analyzed data from the U.S. Center for Disease Control and Prevention that dates back to 1949--before fertility treatments were widely available.

Researchers found that between 1949 and 1966, by the time that white women reached age 35 they were about 3 times more likely to have fraternal, non-identical twins, and 4.5 times more likely to have triplets and quadruplets. Black women were 4 times more likely to have twins and 6.5 times more likely to have triplets and quadruplets at 35, during this same time period.

The study also showed that the percentage of white mothers in their 30s rose form 16 percent in 1971 to 42 percent in 2015, and the percentage of black mothers in their 30s rose from 14 to 31 percent in this same time frame.

In 2016 alone, 24 percent of multiple births among white women and 38 percent among black women were attributed to the decision to wait to have children. It has been calculated that by 2025 the decision to wait will account for 46 percent of multiple births among white women and 40 percent among black women.

The decision to wait therefore has an obvious impact on the number of multiple births in America. But why--what is it about waiting that makes a woman more likely to have multiple births?

The Science

How does age factor into multiple births?


There are a number of biological factors that contribute the the likelihood of having twins, especially for mothers who have waited before conceiving. Some of these are:

  • A greater fluctuation of hormone levels, especially the levels of follicle stimulating hormones, the hormone responsible for stimulating ovulation and egg production
  • Women in their mid-30s who have a body mass index (BMI) of 30 or higher are more likely to have multiple births; women who fit this description are thought to produce more luteinizing hormone, which causes ovulation; it is also thought that women at this weight may actually release two eggs each monthly cycle

This overstimulation of hormones is thought to push the ovaries into ‘overdrive’, and, according to Dutch researchers, make the likelihood of multiple births, especially non-identical twins, much more likely in older women. It is the body’s way of counteracting the loss of ‘good quality’ eggs with age.

The Risks (and Rewards!)

While having multiple births at any age is difficult, it can be especially so for older mothers. But the benefits are obvious! (image courtesy of Twiniversity)


Carrying multiple children at any age is incredible and presents its own set of challenges, and having them when you are older is even more difficult on a woman. Some of the risks and complications involved with multiple births at a later age include:

  • Premature delivery: more than half of twins and nearly all triplets are born before 37 weeks, which is considered full term
  • Low birth weight: because of premature delivery, most babies that are a result of multiple pregnancies weigh less than 5.5 pounds at birth; premature babies weighing less than 4 pounds are considered very high risk, as their organs may not be prepared for life outside the mother’s uterus and may not function well
  • Pregnancy induced hypertension: high blood pressure is more common among women carrying multiple children because of the added placenta and hormones needed to sustain more than one baby; persistent hypertension can lead to preeclampsia
  • Gestational diabetes: happens when the mother’s elevated hormone levels interfere with her ability to produce insulin; changes to diet can usually control or prevent gestational diabetes
  • Women that are aged 35 or older and carrying children are more likely to have diabetes, fibroids (benign growths) in the uterus, problems during labor, miscarriage and are at a higher risk for birthing children with chromosomal abnormalities

There are obviously many risks associated with carrying children later in life, but many older mothers welcome twins, triplets and even quadruplets into the world. The rewards are obvious--more little babies to love!

Prenatal Care

Prenatal care is important for every soon-to-be mother, but with multiple births comes more that the mother needs to provide for her children, (image courtesy of Smithsonian Magazine)

If you are an older women carrying multiple children, than you’re going to need a lot to sustain them and yourself. This includes:

  • More frequent prenatal visits and ultrasounds to monitor nutrition and weight gain
  • More iron, protein and other nutrients to support multiple fetuses
  • More weight gain; according to the American College of Obstetricians and Gynecologists, women of average weight carrying twins should gain from 37-54 pounds
  • Less high-impact exercise; you may be advised against high-impact exercise such as aerobics or running, and may opt for low-impact exercises such as swimming or prenatal yoga

Your prenatal care doctor will go over the specifics with you, but these are some general guidelines for producing more happy, healthy babies if you happen to be carrying multiple. Carrying multiples seems to be trending these days--especially among mothers who decided to wait!   


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