A woman with a rare double uterus has given birth to two healthy babies, each growing in a separate uterus. The baby girls were born 10 hours apart, on two different days.
Mom Kelsey Hatcher, 32, gave birth to twins Roxi and Rebel at the University of Alabama at Birmingham Hospital (UAB) on Dec. 19 and Dec. 20 via scheduled induction. It was Mrs. Hatcher’s fourth pregnancy–she and her husband, Caleb Hatcher, already have three children under the age of 7–and her first time expecting a baby in both uteruses simultaneously. This rare pregnancy is considered a one-in-a-million occurrence and is known as dicavitary pregnancy.
Mrs. Hatcher was 17 years old when she was diagnosed with uterus didelphys, a rare congenital anomaly that occurs in 0.3 percent of women. For people with this condition, each of their uteruses has one fallopian tube and one ovary. In Mrs. Hatcher’s case, she has two cervixes too.
A few weeks into her pregnancy, Mrs. Hatcher noticed that she was bleeding and scheduled an ultrasound since she and her husband were aware that with her condition, there was a high risk of miscarriage.
After the ultrasound confirmed the baby was doing well, Mrs. Hatcher asked the technician to check her second uterus.
“As soon as [the ultrasound tech] moved the wand to the other uterus, I gasped,” Mrs. Hatcher said. “Sure enough, there was another baby. We just could not believe it.”
Mrs. Hatcher’s unusual pregnancy proceeded routinely under the care of assistant professor in the UAB Department of Obstetrics and Gynecology, Dr. Shweta Patel, who enlisted the support of colleagues specializing in high-risk cases and unique pregnancies as Mrs. Hatcher approached her due date.
Dr. Patel said: “I had already taken care of Kelsey through her third pregnancy and knew she had a double uterus, but that was only one baby. Two babies in two uteri were a true medical surprise.”
Neither Dr. Patel nor her pregnancy “co-manager,” UAB’s Dr. Richard O. Davis, had delivered dicavitary twins before. Considering three different delivery scenarios–both babies born naturally; one born naturally, the other delivered via cesarean section; or both babies delivered via C-section–they knew that the ideal scenario was for Mrs. Hatcher to go into labor and deliver on her own.
“While C-sections may be a more controlled delivery option for high-risk cases like this one, we did not want to jump to the third plan immediately, knowing Kelsey’s history of successful vaginal births from both uteri,” Dr. Patel said. “We also listened to Kelsey’s wishes: she wanted to aim to have the same birth experience for the girls as her other children, if safe and possible.”
“In a typical twin pregnancy, the twins share one womb, which can limit the amount of space each has, making preterm or early birth a high possibility,” Dr. Davis said. “With Kelsey’s babies, they each had their own womb, sac, placenta, and umbilical cord, allowing them extra space to grow and develop.”
When Mrs. Hatcher didn’t go into labor naturally, she was induced at 39 weeks. She was assigned two labor and delivery nurses to monitor each uterus and each baby and needed twice the normal monitoring and charting.
Her right uterus, which had already supported two pregnancies, progressed faster than the left. Baby A, Roxi, was delivered naturally at 7:49 p.m. on Dec. 19 weighing 7 pounds 7 ounces.
“There was a cheer from everyone in the room when the first baby was delivered, but there was another baby left,” Dr. Patel said. “Kelsey was essentially laboring in the left uterus while simultaneously undergoing the postpartum process in the right. She was having contractions with Baby B while breastfeeding Baby A.”
Since Baby B, Rebel, was not descending as expected, she was delivered via C-section at 6:10 a.m. on Dec. 20 weighing 7 pounds 3.5 ounces. Her sister was already waiting in a bassinet to meet her in the operating room. Seeing both her girls together for the first time, Mrs. Hatcher said it “meant the world.”
While Roxi and Rebel fall outside the dictionary definition of twins, since they were conceived by two separate eggs fertilized during the same ovulation cycle and did not share the same uterus, Dr. Davis believes it’s “safe to call the girls fraternal twins” as they grew together in the same body at the same time. “They just had different apartments,” he said.
In a postpartum interview with UAB, Mrs. Hatcher said that since this was the first time she has had a C-section, this recovery has been different than her past pregnancies, but she is grateful since the babies have grown and are healthy.
“One thing I would say, I‘d be curious ... if they’ll have the weird twin telepathy connection that most twins have,” Mrs. Hatcher said, although she believes they already have a bond.
As to her other kids, they were first able to get a glance at their new twin siblings on FaceTime and were able to see them in person for the first time at Christmas, celebrating their first holiday together as a family of seven.
