What to Expect When You're Pregnant With Quadruplets

Updated June 2, 2019
Extremely pregnant woman

Being pregnant with quadruplets is extremely stressful, both physically and mentally. The challenges of carrying four babies long enough to have a safe delivery is among the most difficult tasks. Organizing for the arrival and making financial plans are considerable burdens as well.

Becoming Pregnant With Quadruplets

Some women are more prone to having multiple births than others. The relatively rare occurrence of pregnancies with three, four, or more babies appears to be increasing, and there are reasons for this slight surge of multiples. Factors that may contribute to carrying more than one baby at a time include genetic, biological, and environmental conditions.


Natural conception of quadruplets is very rare, and heredity is a factor that is inconsistent. Some women are genetically inclined to have multiples, in most cases, twins. Families that have many sets of twins have a higher potential of having triplets or quadruplets. This is especially significant for families who have twins on the maternal ancestral lines.


Hormones play a significant role in the chance of becoming pregnant with quadruplets. The hormone gonadotropin causes the eggs to ripen and to be released from the ovaries. Women who have increased levels of this hormone may have a higher risk of having multiples. The gonadotropin hormones that can affect the number of eggs released include:

Some hormone-stimulating drugs can increase the risk of getting pregnant with multiples, and infertility drugs are among the most prevalent environmental contributors to the increased chance of having two, three, or more babies in a single pregnancy.

Environmental Factors

Infertility treatments, including fertility drugs and in vitro fertilization, increase the risk of multiple births. However, other environmental factors can have an effect on the number of eggs released and fertilized as well. Some environmental factors include:

  • Stress
  • Nutrition
  • Climate
  • Resuming sexual activity after abstinence

Each of these environmental factors can affect hormone levels, possibly leading to the release of more than one egg.


Age can play a factor in multiples as well. Women who are over 30 years of age have an increased chance of having multiples.

What to Expect

Quadruplet births are rare occurrences that may cause considerable stress. Knowing what to expect when carrying quadruplets can help relieve some of the anxiety. Factors to consider include, health, development, delivery, and bringing the babies home.

Health and Development

Women carrying quadruplets can expect to visit their doctors more frequently. It is also likely that a specialist, called a perinatologist, will help manage the pregnancy until delivery. When carrying more than one baby, there is always an increased chance of having pregnancy complications; therefore, prenatal health is monitored very closely. Another potential, yet common complication is that the babies will likely be born premature, which is prior to 37 weeks gestational age.

Food and Water Intake

Pregnancy diets typically include foods rich in folic acid. Water intake is critical during this time because fluids help keep the babies safe and nourished in the womb. Morning sickness and food aversions may make eating difficult at times and, with four babies close by, the stomach may feel full very quickly.

Weight Gain

Weight gain is a considerable concern for multiple births. Women expecting quads should gain quite a bit of weight in order to ensure proper development of the babies. The gain can be upwards of 45 pounds, but at this time it is important to listen and follow the advice of the obstetrician and the perinatologist since each case is different.

Gestational Diabetes

Women who are pregnant with multiples have a higher risk of developing gestational diabetes. It is important to have testing done to determine if this condition is developing.


Preeclampsia is a pregnancy complication. This is defined as high blood pressure and signs of possible damage to certain maternal organs such as the liver and kidneys. This is more common in women who are carrying multiples. If preeclampsia is not treated, it can be life threatening for mom and baby.

Low Birth Weight

Low birth weight is directly associated with preterm labor. Quadruplets tend to be delivered at around 30 weeks gestation. Babies born before 32 weeks gestation weigh around three pounds and in general, acquire a greater risk of having complications.

Labor and Delivery

It isn't likely that the quads will make it to full term before delivery is necessary. Women expecting quads can expect to have four preterm babies in nearly all cases. It is also likely that the pregnant woman will require bed rest toward the end of the pregnancy. While some may have vaginal births, most have Cesarean sections. Many women create birth plans in collaboration with their obstetricians. This can include a scheduled date of Cesarean delivery.

Bringing Babies Home

Women pregnant with quadruplets may look forward to bringing their babies home and there can be some apprehension mixed in with all the excitement. Preparing for the arrival with the support of friends and family can make the transition a little smoother.

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What to Expect When You're Pregnant With Quadruplets