An Unprecedented Case: Alabama Mom Expecting Twins Simultaneously in both Uteruses
An Alabama woman with two uteruses defies odds by becoming pregnant with twins simultaneously, a rare occurrence she never anticipated A remarkable story of double baby bumps and the great unknown of childbirth
Kelsey Hatcher's fourth pregnancy began in the familiar way - with a missed period. After a positive home pregnancy test, she shared the news with her husband Caleb, who has always been a source of great encouragement. Living in Dora, Alabama, the couple had thought they were done with middle-of-the-night feedings after their youngest was born in 2021.
"When I informed him of my second pregnancy, he responded with a casual 'What's one more? It'll be great and fine,' " she recalled.
During her initial ultrasound appointment at about eight weeks into the pregnancy, things unexpectedly changed.
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The ultrasound technician swiftly located the baby and reassured Hatcher that everything appeared to be in perfect condition. The baby was in good health.
Afterwards, Hatcher remembered to inform the technician about her unique anatomy. She was born with two uteruses, a condition known as uterine didelphys.
"Do not dismiss it as random or assume something is wrong if you catch a glimpse of it while scanning. There is a completely separate uterus there," explained Hatcher, 32. The ultrasound technician expressed gratitude for the information and quickly checked the second uterus to ensure everything looked well.
"And as soon as she moved the ultrasound wand over to the other side of my belly, I said, Oh, my gosh! Theres another one. "
Caleb and Kelsey Hatcher are expecting their fourth and fifth children.
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Hatcher didnt even need to be told there was another baby. She could see it herself.
"When I met with the nurse practitioner that day, she was truly amazed. She said, 'I'm not even sure what the statistics of this are,'" Hatcher remembered.
The odds are staggering. Approximately 3.6 million babies were born in the US last year, but only about 114,000 of those births were twins, according to the US Centers for Disease Control and Prevention.
Roughly speaking, for every 200 live births, around three sets of twins are born, with two of these sets being fraternal, meaning they come from two separate fertilized eggs, according to the CDC. Additionally, uterine didelphys is also rare, occurring in about 1 in 2,000 women.
Baby Noah was joined in utero by fraternal twin Rosalie some three weeks after Noah's conception.
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Hatcher needed two eggs to be fertilized, one in each of her uteruses, in order to become pregnant in both at the same time. Like most women, she has two ovaries, the glands that store and release eggs. Each ovary feeds a single uterus. Normally, ovaries take turns releasing eggs, sending one into the uterus each cycle for a chance at fertilization. However, occasionally an ovary may release more than one egg during a cycle, a phenomenon known as hyperovulation.
Hyperovulation has not been extensively studied, but a 2006 study of 500 women revealed that approximately 1 in 5 of them could hyperovulate. However, it does not occur every cycle. When it does, one ovary may release two eggs, and on rare occasions, both ovaries may release a single egg at the same time, as in Hatcher's case.
Case studies suggest that the likelihood of a woman with two uteruses carrying a baby in each one simultaneously is approximately 1 in 2 billion in the general population, although it is impossible to know for certain due to the extreme rarity of the occurrence.
Hatcher was about seven times more likely to win a Powerball jackpot and about 131,000 times more likely to get hit by lightning at some point in her life.
Double baby bumps
Uterine didelphys occurs during the early stages of fetal development, resulting in females being born with two uterine horns that typically merge to create a single larger cavity. However, in cases of didelphys, the uterine walls do not fuse as expected, leading to the individual being born with two separate uteruses.
According to Hatcher, she considers herself fortunate in a way, as some individuals with uterine didelphys have only one functional uterus, rendering the other unable to sustain a pregnancy. However, her medical records indicate that she has successfully carried babies in both of her uteruses, though never simultaneously.
Even her doctors are improvising.
"Even in medical school, we don't really learn about this because it is such a rare thing," stated Dr. Shweta Patel, who serves as Hatcher's obstetrician at the University of Alabama at Birmingham.
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"We didn't have as much guidance for her prenatal care due to the unusual circumstance," Patel explained. "We have been extrapolating the patient care from our knowledge of twin pregnancies involving one uterus for Kelsey."
The babies are both girls and are growing healthily. Hatcher confirms that at 34 weeks gestation, they are developing as expected.
Hatcher notes that one unique aspect of this pregnancy is the presence of not just one baby bump, but two. When she reclines in the evening, she observes that the two separate wombs become clearly visible as her stomach shifts to accommodate the position.
The babies are biologically twins, but without sharing a womb and being unable to physically interact, Hatcher has pondered whether they will develop the same bond as other twins. "I'm intrigued to see their development and whether they'll have a special connection or simply have a sibling relationship," she said.
Her baby is due on Christmas, but Hatcher knows it's unlikely that she will make it that far, as carrying multiples makes preterm birth more probable.
"I've been hoping to at least make it to December," she said.
Kelsey Hatcher's due date is December 25. She's just hoping to stay pregnant until December.
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Birth is the biggest unknown
Hatcher wants to have a vaginal birth, but with two uteruses, its unclear how labor and delivery will play out.
"I think birth is probably the biggest unknown," Patel said.
The medical team is uncertain about whether both uteruses will contract simultaneously, or if the babies will be born separately. There is a possibility that one side will go into labor while the other does not, potentially requiring the induction of labor with hormones. It is also possible that Hatcher will need a c-section. Dr. Patel stated, "We won't know until we see it."
In the interim, Hatcher and her husband have their bags packed, and she is working as much as possible as a massage therapist to maintain their income. To help with unexpected expenses such as home renovations, child care, and lost income after the twins are born, friends have launched a GoFundMe page.
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Hatcher expressed, "Things could happen fast, and I might go into labor tonight. Or it could take some time. We're prepared and ready at any moment. Whenever it happens, it happens."
The only thing they haven't decided on yet are the names for the girls. Their other three children, two girls and a boy, ages 6, 4, and 2, all have names that begin with the letter R. Hatcher mentioned they intend to continue that tradition for the twins, but beyond that, nothing has been finalized.
At first, her son was disappointed to learn that both babies were girls, but now he's eagerly anticipating becoming a big brother. She believes that the rarity of this pregnancy adds even more significance to their family.
The miracle of these babies is undeniable, and it's clear that they are destined for something great. The perfect alignment of events leaves no room for doubt.
