Published: Wednesday 23 October 2019

Perth mum, Alicia Cant, is expecting twins through a very rare type of twin pregnancy. She has a condition called uterus didelphys, or double uterus, and is pregnant with one twin to each uterus - due in early 2020. Alicia and her partner, Raymond, explain the condition, what it means for their twin pregnancy and how their babies will be born. 

The likelihood of this type of twin pregnancy is one in 50 million. We thank Alicia and Raymond who are sharing their story to raise awareness.

How did you find out about your twin pregnancy?

Alicia: I found out at week 10 during our first ultrasound that we were pregnant with twins. I became very emotional - anxious, bewildered, excited, joyous, state of shock, and worried at the same time. I have always found the concept of twins most fascinating. As a young girl I wanted twins but never ever thought it would happen. I’ve been a general nurse for the past 14 years and always interested in midwifery. I feel very lucky and proud that I soon get to be a twin mum. They will be my first children and they are the two best things that have ever happened to me.

Raymond: I will never forget the moment the radiologist said “here is one baby”. I thought, what does she mean with “here is one baby?” Where was she going with this? Then she finished her sentence with “and here is another baby”. I didn’t know what to say to her or how to act as I was so flabbergasted!

I could barely speak that day. I couldn’t even find my car at the hospital after that (although I parked it right in front of the door). I wasn’t sure how we would go with one baby let alone two. After a few days I think the shock settled in and I started to make room for joy and excitement. In a few weeks, I grew used to the idea of having twins, and now realise this is all I ever wanted out of life. I’m really looking forward to next year and holding the babies in my arms. Maybe we should refer to ‘double delight’ instead of ‘double trouble’.

How did you find out that you had uterus didelphys?

Alicia: I didn’t find out about the condition until I was 29-years-old. I had gone to Perth’s King Edward Memorial Hospital emergency room with unexplained bleeding. They did an ultrasound that located not only a vaginal septum tear but also two horns which are indicative of uterus didelphys. I found out that I’d been born with two uteruses, two cervixes and a vaginal septum separating each (also known as bicornate uterus or uterus didelphys with vaginal septate). The septum had been torn causing profuse bleeding. It was upon this discovery and under recommendation of medical specialists that I had this septum removed as it could become problematic for a future pregnancy and could cause strangulation for a baby during childbirth.

What was your reaction?

Alicia: Why do I have this? This is not normal. I always had Pap smears to one cervix and two horns had never been discovered by medical staff. This was because when I started having my routine Pap smears they would push the unnoticed vaginal septum to reach one cervix but at the same time this would also cover and disguise the other cervix.

The doctor who operated on me to remove the vaginal septum explained that I had one uterus more dominant than the other and indicated that a twin pregnancy (one in each horn) was not very likely. It was explained that the non-dominant uterus would not be big enough, or grow big enough, to accommodate a growing foetus. The midwife at KEMH begged to differ, saying “Don’t rule it out!”

How rare is this?

Raymond: According to science magazine, Scientific American, one in about every 2,000 women worldwide has the condition. Then about one in the 25,000 women who have uterus didelphys gets pregnant with twins, one to each uterus. That means the likelihood of any given woman growing two babies in two separate wombs is about one in 50 million. For me, Alicia was already a special someone, but then to have science prove she is special, that is truly rare.

How is the pregnancy progressing? Is additional care/monitoring needed for such a pregnancy?

Alicia: The doctors and radiologists are very happy with our progress. At this moment we have reached week 24 (as at 22 of October 2019). So far the babies are very similar in size, reaching all their size requirements and measurements, and growing as fast as single babies. We recently found out the genders. We’re having a boy and a girl - our ideal family at the one time.

Because the hospital treats it as a complex case, it is being closely monitored and we’ve had an ultrasound every two weeks since week 10. I guess being pregnant is already very special and unique for every parent out there, but the hospital makes us feel even more special every time they do an ultrasound. The reactions of the radiologists, doctors, midwives (and the occasional student that walks in) are priceless.

When are the babies due? Is there special planning for the delivery/birth of the babies?

Raymond: Although this case is already a miracle for us, it keeps getting more miraculous every time we set foot in the hospital. We heard the experts in the hospital say that the birth of the babies (in case of a natural delivery) doesn’t necessarily need to be on the same day.

Because of a double uterus and a double cervix, one baby might arrive prematurely while the other decides to stay in full term. The babies are due on the 11 February 2020, which is week 40. However, week 37 is considered a full-term pregnancy with twins.

The delivery could be a natural or caesarean birth. I know Alicia prefers to give a natural birth. My respect for her just keeps growing - women are truly the stronger species (I probably would have opted for a caesarean while being kept in a deep sleep!). In case of a caesarean, the babies could both be delivered on the same day and, if this is the safest option for the babies, Alicia is happy to go with that. The doctors are still to confirm which option is safest. To imagine giving birth twice in a few days (or even weeks apart!) that sure is doubly amazing.

How are you preparing for their arrival?

Raymond: Imagine the stories from back in the day when they didn’t have the technology of today and a woman didn’t know herself that she had two uteruses with a baby in each. A few weeks after the first baby, her water would break again and she would go into labour again. She would have been totally unprepared. It may be thought that “another child has been born, without conception, it’s a miracle!” Fortunately, modern technology shows us that there are two babies on the way so we can prepare accordingly.

We’ve recently bought our first house and we’ve been busy buying all our furniture and setting up the babies’ room. We still have to acquire prams, cots, capsules, nappies, clothes, car seats, basically everything. Hopefully we will have enough time to settle in and get everything ready before the babies are (or the first one of them is) here.

Learn more about uterus didelphys in twin pregnancy in this article at Scientific American