Having Twins (or more!) in Hong Kong

Finally, a positive pregnancy test… soon after, your doctor confirms it with a blood test. But, during your first ultrasound, there are two heartbeats (no, it is not yours and the baby’s)! Finding out you are pregnant is amazing news. Finding out you carry twins is just that, but with many questions.
Fertility treatments
Let’s be clear: you are not alone. Twins’ birth rate in Hong Kong has doubled in the past 20 years: twins represented 1.6% of HK births in 1996 (last year, it was over 3%.) The trend has been similar in the US, as more and more couples undergo assisted reproductive treatments. In IVF treatments, chances of multiple births are higher because multiple embryos are implanted. In Hong Kong, the number of women with fertility treatments doubled from 2009 to 2016, going from 5,000 to over 11,000.
Other factors
- Heredity: ok, you will likely know about this one.
- Age: the older you are, the higher your chances of multiple pregnancies (note: the median age at first childbirth in HK went from 26.5 years in 1986 to 31.4 years last year).
- History of twins: if you already have twins (and assuming you’d want more!), you’re twice as likely to have twins in future pregnancies.
- Number of pregnancies: the more pregnancies you’ve had, the more likely you are to have twins.
- Ethnicity: twins are most common with African women and least common with Asian women.
- Body type: twins are more common in larger, taller women than in small women.
Unique features
While two embryos have been detected in early pregnancy, only one may continue to develop within 12 weeks. It’s called the vanishing twin syndrome, and it’s more common than people think: it affects about 20% of multifetal pregnancies. Generally, multiple births also result in shorter pregnancies. For twins, 37 weeks is full-term but around 1 in 3 births occurs before term. For triplets, full-term decreases to 34 weeks and again, 1 in 3 are born prematurely. Lastly, multiple pregnancies increase the risk of delivery problems as the position of the babies can make natural birth difficult, if not impossible. Speak with your doctor about any questions you have, including on your birthing options!
Extra-costs
Discovering you carry twins (or triplets!) will likely make you think right away about logistics (two cribs, two car seats, two feeding chairs..). There are extra costs in having twins anywhere but in private Hong Kong hospitals, a twin birth costs more because of the increased risk of complications (see table below). Note that in public hospitals there is no extra charge.