Quick Answer
When a woman gives birth to four babies from a single pregnancy, it is called quadruplets. This occurs naturally in about 1 in every 700,000 pregnancies. Having quadruplets is very rare and high-risk.
What Are Quadruplets?
Quadruplets refers to four babies born from one pregnancy. This occurs when a woman’s ovum splits into four embryos instead of just one. Each embryo then develops into a separate fetus with its own placenta and amniotic sac.
Quads can be:
- Fraternal (multizygotic) – from four different eggs fertilized by four different sperm. Each baby will have unique DNA and can be different sexes.
- Identical (monozygotic) – when one fertilized egg splits into four identical embryos. The babies will have the same DNA and sex.
Having four babies from a single pregnancy is very rare, occurring in around 1 in 700,000 pregnancies. For comparison, the odds of having naturally-conceived triplets is about 1 in 10,000.
Other Key Facts About Quadruplets
Here are some other important things to know about quadruplets:
- Quadruplets can be conceived naturally, but most quadruplets today are born with assistance from fertility treatments like IVF.
- Carrying and delivering four babies is high-risk and requires close medical monitoring.
- Over 50% of quadruplet pregnancies result in premature delivery before 32 weeks.
- The average quadruplet pregnancy lasts around 30 weeks.
- Babies born prematurely often have more health problems like cerebral palsy, blindness, and respiratory issues.
- Around 75% of quads have low birth weights under 3.5 pounds.
- Less than half of quadruplet pregnancies make it to 28 weeks.
- Stillbirth is unfortunately common in quadruplet pregnancies.
Due to these risks, doctors today recommend selective reduction for women carrying 4 or more fetuses. This involves terminating 1 or more fetuses to increase the chances of survival for the remaining babies.
Issues and Risks With Quadruplet Pregnancies
Carrying four babies is extremely taxing on a woman’s body. Some key risks and issues include:
Preterm Labor and Early Delivery
Around 60% of quadruplet pregnancies end before 30 weeks, with the average length being 29 weeks. Babies born this premature are at high risk for lung problems, infections, vision loss, and developmental issues.
Preeclampsia
Up to 30% of quadruplet moms can develop preeclampsia. This serious condition involves high blood pressure and damage to the liver and kidneys. It can be fatal if not managed.
Gestational Diabetes
The placentas of quadruplets produce hormones that make insulin resistance and gestational diabetes more common. This requires careful blood sugar management.
Placental Problems
Having four placentas strains the uterus. Issues like placenta previa and placental abruption are more likely.
Fetal Growth Restriction
Nutrients and space get divided four ways, often resulting in poor growth of the fetuses. Babies that are very small for gestational age may have impairments.
Stillbirth
Stillbirth of one or more fetuses occurs in around 20% of quadruplet pregnancies. This can be devastating emotionally and risky physically.
Miscarriage
Unfortunately, the risk of miscarriage with 4+ fetuses is extremely high. Vanishing twin syndrome is common as embryos struggle to implant and develop.
Caesarean Delivery
Vaginal delivery of quadruplets is nearly impossible and extremely unsafe. C-sections are scheduled around 30 weeks and require a surgical team.
Postpartum Hemorrhage
Having a uterus stretched to the max makes bleeding too much after delivery more likely. Transfusions may be needed.
Postpartum Depression
Quad moms have a high chance of postpartum depression and anxiety due to hormonal shifts, stress, and trauma. Support is critical.
Selective Reduction
Because of the risks, pregnancy reduction is usually recommended with quadruplets and other higher order multiples. This involves terminating one or more fetuses to give the remaining babies a better chance.
Selective reduction:
- Lowers risks like preterm labor and stillbirth
- Increases the odds of taking home one or more healthy babies
- Is safest when done in first trimester
- Reduces strain on the mother’s body
- Is emotionally complex and often involves grief
With quads, one or two fetuses may be reduced. The ones with less optimal positioning or development are often chosen. After reduction, the pregnancy has risks closer to twins or triplets.
History of Quadruplets
Quadruplets have always been exceptionally rare. Some key historical examples include:
The Chukwu Octuplets
In 1998, Nkem Chukwu became the first recorded mother of octuplets – 8 babies! Tragically the smallest babies did not survive. The remaining 5 girls and 2 boys were able to go home.
The Eman Ali Quadruplets
One of the first heavily publicized cases was the Eman Ali quadruplets born in Egypt in 1953. Their birth was a result of fertility medication. Two of the girls survived.
The Dilley Quads
In 1993, the Dilley sextuplets were born in Virginia, with quadruplets surviving. Their birth was all over talk shows and tabloids at the time.
The Brown Quadruplets
A set of identical African-American quads, the Brown girls were born in 1997. They received significant media attention. All four girls survived and thrived.
The McCaughey Septuplets
In 1997 Bobbi and Kenny McCaughey gave birth to (septuplets) – 4 boys and 3 girls. It was a sensational story at the time. However, serious health issues impacted the babies’ development.
Famous Parents of Quadruplets
A few celebrity parents who’ve had quads:
- Tori Spelling and Dean McDermott – Stella Doreen, Hattie Margaret, Finn Davey and Beau Dean
- Celine Dion – Eddy, Nelson, Nelson and Cesar via IVF
- Michael Chang (tennis) – daughters Vanessa, Daniella, Tabitha and Jasmine
- Bob Gosse (director) – sons Jack, Luke, Ryan and Jesse
- Marlon Wayans (comedian) – daughters Amai, Shawn, Kiera and Keisha
Unique Quadruplet Stories
Here are some of the most fascinating real-life stories of quadruplets:
The almost quintuplets
The Asfaw quads were originally quintuplets but sadly lost one baby a month before birth. The 4 remaining girls were born at 30 weeks in Australia.
Born on Leap Day
The Zywlak quads were a rare set born on February 29th, 2000 in Poland. They instantly became local celebrities.
Double trouble
In 2008 the Berrington family had two separate quadruplet births, with 3 girls + 1 boy in each set! A crazy coincidence.
Quadruplets split at birth
The bizarre Greenberg quads case involved 2 boys being adopted separately without knowing they had 4 other siblings. They didn’t find out until age 25!
Born across 2 days
Spanning midnight, the Byrne quads hold the record for being born on two separate calendar days: February 28th and March 1st.
Conjoined twins
An extremely rare case in Germany in 2016 resulted in 3 babies and 1 set of conjoined twins, connected at the chest and abdomen.
Reaching adulthood
Most historical cases didn’t survive infancy. But times have changed and many modern quads are reaching adulthood like the O’Brien quads of New York.
Fertility Treatments and Quadruplets
Before modern fertility interventions, naturally conceived quadruplets were almost unheard of. But today most quads are the result of:
Ovulation induction medications
Drugs like Clomid and gonadotropins can cause a woman to release multiple eggs. If more than one gets fertilized, multiples occur.
IVF
In vitro fertilization involves incubating embryos outside the body before transfer. Doctors often implant more than one embryo to increase success rates, which can result in quads.
Artificial insemination
Intrauterine insemination puts concentrated sperm directly into the uterus. Sometimes this fertilizes more than one released egg.
Here are the approximate odds of quadruplets with fertility treatments:
- With artificial insemination – 1 in 8000
- With IVF – 1 in 500 to 1 in 700
- With ovulation induction meds – 1 in 600,000
Due to these increased risks, reputable fertility clinics today limit the number of embryos transferred during IVF to 1 or 2. Some countries also restrict higher-order multiple embryo transfers by law.
Survival Rates and Long Term Outcomes
Survival rates have gone up in recent decades as neonatal intensive care has improved:
- 70 to 85% of quads will make it to birth alive
- 85 to 95% will survive the first month
- 75 to 85% will live to one year
- 70 to 75% will reach age 5
Fraternal quadruplets generally have better outlooks than identicals sharing placentas. Girls also tend to fare better than boys.
Unfortunately, long term disabilities are common even among surviving quads. Issues like:
- Cerebral palsy – in 25% to 65%
- Vision impairment – in 15 to 30%
- Hearing problems – in up to 20%
- Cognitive/learning disabilities – in 20 to 30%
- Speech delays – in 25 to 40%
- Physical impairments – in 10 to 15%
Early intervention services can help counteract these deficits. But full term births result in much lower rates of impairment versus extreme prematurity.
Unique Challenges of Raising Quadruplets
Being a parent of quadruplets comes with many unique challenges including:
Practical Considerations
Simply having room for 4 cribs is a puzzle. Then there’s feeding, changing, bathing and transporting 4 babies at once. Help is essential.
Staying Organized
With 4, it’s extra important to stay on top of schedules, routines, who got fed, who got medicine, who got a bath and who needs a diaper change! Chaos comes quick.
Sleep Deprivation
There is pretty much zero sleep those early months. Feeding and caring for 4 infants through the night and day is utterly exhausting.
Preemie Challenges
Many quads are born premature. This can mean months in the NICU, health issues, and developmental disabilities.
Division of Attention
One of the toughest balancing acts is giving each child sufficient time and attention as individuals. Parents strive to make each one feel special.
Financial Strain
Even with help, the expenses of food, clothing, health care and childcare for four adds up fast. Many families struggle financially.
Maintaining Sanity
All parents are sleep deprived at times. But it’s especially tough for quad parents working round the clock. Mental health help is a good idea.
Finding Childcare
Finding one good babysitter is hard enough. Finding someone up for handling 4 infants or rambunctious toddlers is essentially impossible.
Social Isolation
Getting out simply takes too much time and effort for many new parents of quads. Loneliness and depression are unfortunately common.
Conclusion
In summary, quadruplets refers to four babies born from one pregnancy. This rare occurrence comes with risks including extreme prematurity, stillbirth and lasting disabilities. However, survival rates have greatly improved in recent decades.
Carrying and birthing four babies is extremely difficult and often requires reduction. But with medical care and family support, many quadruplet babies are now reaching childhood and beyond. These unique families simply take things one day at a time.
