Here's how doctors are preparing to help a patient with a rare double uterus give birth

By Stephanie Srakocic | Fact-checked by Davi Sherman
Published November 27, 2023

Key Takeaways

  • Kelsey Hatcher, 32, has two uteruses and is currently carrying a fetus in both of them. 

  • Doctors at the University of Alabama at Birmingham are preparing for her December 25 due date, but called her delivery unpredictable as her uteruses will act separately.

An Alabama mother of three, Kelsey Hatcher, was born with uterine didelphys. Now 32, Hatcher first learned she had two uteruses when she was 17. During three previous pregnancies, she carried a single baby in one uterus. Her pregnancies were all full-term, and she had no complications.[]

It came as a shock to Hatcher to learn that this pregnancy was different. Her double pregnancy was discovered during her eight-week ultrasound appointment. Uterine didelphys is a rare condition in and of itself, and pregnancy in both uteruses at the same time is extremely rare. Speaking to “Good Morning America,” Hatcher said she had attempted to find others who had experienced a similar pregnancy so that she could reach out to them but only read about two other cases.[]

There isn’t an official term for siblings carried this way. Genetically, however, the babies—both girls—are similar to fraternal twins; Hatcher’s OB/GYN, Shweta Patel, MD, told WVTM 13, “I think medically, this is such a rare thing, that I think we don’t have a better way of describing it besides still calling them twins.”[]

Dr. Patel added that the double pregnancy is likely the result of two separate ovulations followed by separate fertilization in each of Hatcher’s uteruses. Dr. Patel is part of a team of specialists at the University of Alabama at Birmingham’s (UAB) Women & Infants Center, where Hatcher is being treated.[] 

Because Hatcher’s case is so rare, no members of the team had any previous experience caring for someone with two pregnancies in two uteruses; they’re relying on their core knowledge of pregnancy and childbirth and applying this knowledge to Hatcher’s unique scenario.[] 

“‘There’s no true expert out there who knows how to manage a patient with two uteruses and two babies, with one in each uterus,’” Dr. Patel noted. “‘So we really are relying on our baseline teaching and our baseline knowledge and the normal physiology of pregnancy.’”[]

Currently, the plan is to allow Hatcher to carry the pregnancies for as long as she and the babies remain healthy.[] 

There are multiple potential scenarios for delivery. Each uterus can have its own complications, making this delivery difficult to predict. It might be only minutes between each birth, but it could also be days. Hatcher could vaginally birth both babies, have two C-sections, or have one vaginal birth and one C-section. Hatcher, Dr. Patel, and other team members have discussed these possible scenarios. In a November 1, 2023, post on her Instagram account, Hatcher shared that things were currently going well and that she was on track for vaginal deliveries.[] 

Hatcher’s due date is December 25, 2023.

Increased pregnancy and labor risk with twins, triplets, and other multiples

A pregnancy involving multiples is automatically a high-risk pregnancy, although in most cases, twins, triplets, and higher number sets of multiples are born without complications. In 2021, about 3.2% of all births in the United States were multiples. On average, multiple births were about seven times as likely to be preterm in 2021. According to the American Pregnancy Association, around 60% of twins are born preterm, while about 90% of triplets are born preterm.[] []

Additional complications that are more likely to occur in pregnancies involving twins and other multiples include:

  • Low birth weight

  • Intrauterine Growth Restriction (IUGR)

  • Gestational diabetes

  • NICU admission

  • Stillbirth

  • Preeclampsia

  • Placenta abruption

  • Cesarean

“Many of the risks we see with common twin pregnancies are about preterm labor and how the babies are growing. That [growth] has to do with crowding in the uterus. These kinds of twin pregnancies are often followed by a high-risk doctor, or even closely by a low-risk doctor,” explains California-based OBY/GYN and specialist in maternal-fetal medicine, Lary Rand, MD. 

Rare twin types, such as Hatcher’s uterine didelphys twins, can increase risks. For instance, about 20% of identical twins share a placenta. These twins, called monochorionic twins, are at risk of a potentially fatal condition called twin-twin transfusion syndrome. This condition can be diagnosed between weeks 11 and 13 of pregnancy.[]

 “With twins sharing a placenta, some of the things that can happen include twin-to-twin transfusion syndrome. Additionally, that placenta might not be shared equally between the two fetuses, and that can cause a problem in terms of how they grow. One might grow large, but the other might not grow to their potential,” Dr. Rand says. 

As is true of all pregnancies involving multiples, close monitoring, early precautions, and delivery plans can lower risks. Twins can often be delivered vaginally. In fact, there’s some evidence to suggest that vaginal delivery in twin pregnancies has the lowest risk of maternal mortality. However, C-sections for one or both twins are also common, and deliveries of triplets or larger numbers typically require C-sections.[]

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