Q: Can multiples births have different delivery dates?

A: Yes, different delivery dates are possible. One family actually has a set of triplets who were born in different centuries! Two babies were born on Dec. 31, 1999 and the third was born on Jan. 1, 2000. Aside from babies born around midnight, some mothers experience what is known as a delayed interval delivery (also called an asynchronous delivery) where a woman pregnant with more than one baby goes into preterm labor resulting in the birth of one or more babies, but if labor stops progressing on its own or due to medical intervention, the remaining baby(ies) are born at a later gestation.

In general, a delayed interval delivery (DID) is an option when the first baby is born very early at 23-25 weeks gestation or sometimes even earlier. Although the chances of survival are less than 30%, even when delivery is delayed, interventions used to lengthen the pregnancy’s gestation for the remaining babies may increase their chances of survival and decrease their complications due to extreme prematurity. Doctors will discuss their reasons to attempt DID with families in this situation, and families should discuss with the physician the possibility of success and any risks involved.

Often, the delay allows the pregnancy to reach only a gestational age at which the remaining babies are at risk of serious long-term medical complications or disabilities as a result of an extremely preterm birth. Although the risks are great, Raising Multiples has members who had great success with DID: delivering the remaining babies at much higher gestations and with fewer complications than if they had all been delivered when the first infant was born.

Whether the remaining infants in a pregnancy at 26 weeks gestation or later  are delivered following the spontaneous delivery of one or more other infants may depend on each baby’s presentation (head-down versus breech), the mother’s risk of infection, and other factors specific to the mother and her babies. If a DID is attempted, hospitalization, medications to prevent contractions, placement of a cerclage, and other interventions may be used to delay the delivery of the remaining babies.

Medical details provided by John P. Elliott, MD – Perinatologist, Partner Phoenix Perinatal Associates, Director of Maternal-Fetal Medicine, Good Samaritan Regional Medical Center, AZ 

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