Information About Higher Order Multiples


Higher Order Multiple (HOM) pregnancies are generally very high risk situations. According to the March of Dimes, the following are the average gestations seen in HOM pregnancies:


Triplets - 32 weeks

Quadruplets - 30 weeks

Quintuplets and higher - 29 weeks


Most preterm HOMs are generally under 2,500 grams (5.5 pounds) which is considered low birthweight.


The medical community continues to make great advances in managing care of both mother and babies, but there can be variations in level of experience and care, especially in areas that do not see many HOM births.  Expectant parents need to educate themselves about the HOM pregnancy and learn about:

  • seeking out a medical team (physician, hospital, nutritionist, etc.) with experience in managing triplet, quad or higher pregnancies
  • using protocols such as electronic fetal monitoring, special medications to halt or slow down contractions, strict bedrest, etc.
  • knowing the signs of preterm labor or other complications
  • preparing for caesarean birth (almost all HOM births are by C-section)
  • preparing for breastfeeding triplets or more by consulting a lactation expert and newborn nurses


In some instances, the medical team may discuss selective reduction as an option to a higher order multiple pregnancy. The procedure eliminates one or more of the fetuses to reduce the pregnancy, generally to a twin or singleton pregnancy. This is a very difficult and complex decision that will have different considerations for each individual situation. Families facing this issue will want to seek out medical information and counseling from several different resources; contact NOMOTC's This e-mail address is being protected from spam bots, you need JavaScript enabled to view it  for more information about this issue and any of the items above.