Tuesday, 06 March 2012

• The A's and B's of Multiple Pregnancies

  

  Why are multiple babies labeled with letters? Don't they have normal names like their singleton counterparts? How is Baby "A" always born first? What gives?

  When a multiple pregnancy is identified by ultrasound, the only "real" way to do so, the occupants are given a "name" in order to track them. It starts with Baby "A", or whomever is closest to the "exit," and going clockwise with the appropriate quantity of letters. Babies may switch places during their gestation, and also their identities. However, if gender differences or anomalies are identified, the babies may retain their former identities solely for medical tracking purposes.

  I observed a birth difference on Baby "B" of my fraternal twin girls at an early ultrasound. Although my babies switched position by my next ultrasound, for medical purposes (records consistency) we identified her as she had been previously. This made for a lot of fun later on when I had pregnancy complications and had to explain to each care provider that I was well aware of how the system worked, but her Baby "A" was really my Baby "B." It was a case of "Who's on first?" as I ensured that each baby was properly identified in every image in order to accurately monitor her health and safety.

  You ask, "But how do you know that Baby 'A' will be born first?" The tricky answer is, no one does, yet it always happens. It's neither science nor magic, though. Whomever is born first, regardless of placement during gestation, is always Baby "A", second is Baby "B", and so forth. When a multiple pregnancy is reduced for whatever reason, the reverse occurs. For example, a mom may experience a triplet pregnancy in which one baby (always referred to as Baby "C") miscarries at some point, leaving two living fetuses, Babies "A", and "B." Other moms may experience a twin pregnancy, Babies "A" and "B", that reduces to a singleton who no longer needs to be differentiated.

  Although this was somewhat entertaining while I was pregnant, I was surprised when this carried on for months as my girls were NICU patients. Their alphabetical name status remained their names- for billing purposes! Despite having legal, normal, "people" names and their own personalities, my girls were still "A" and "B" until the day of their discharge.

  Now, see if you can follow this: Baby "B" has the birth difference, but moved to become Baby "A." However, she was still Baby "B." At birth, she was born first, thus becoming Baby "A". However, I still referred to her as Baby "B" when discussing her with my prenatal care providers, and Baby "A" with my postnatal people. Fast forward months to seeing pediatric specialists who were baffled by who was whom. And billing- yikes! I had to track six names between two babies. It's true, moms of multiples have our hands full, and that's just keeping our babies' names straight!

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