A recent wave of research suggests twin births across Asia are set to rise in the coming years, a trend driven by the growing use of fertility treatments and women increasingly delaying motherhood. The finding, highlighted by a leading global analysis, warns that higher twin rates could complicate pregnancy and childbirth for mothers and babies alike. For Thailand, where birth rates have plunged and the population is aging, the potential uptick in twins could reshape how perinatal care is organized, funded, and delivered.
Twin births have long been a marker of fertility technology’s reach. As IVF and related procedures became more common, multiple pregnancies rose, particularly when clinics transferred more than one embryo or used techniques that increased the odds of twin conceptions. In many Asian contexts, the pace of demographic change—fewer births, older mothers, and expanding access to assisted reproduction—means even modest increases in twin pregnancies could translate into sharper demand for specialized care. The news calls to mind the somewhat famous Kodinhi village in southern India, known for its unusually high twin birth rate; while Kodinhi is an outlier, policymakers now worry that similar patterns may emerge more broadly across South Asia and beyond if current fertility practices persist.
Experts say the implications go well beyond obstetric supply chains. Twin pregnancies carry higher risks of preterm delivery, low birth weight, and maternal complications, all of which can strain neonatal intensive care units and maternity services. A growing body of research emphasizes these hazards, especially when multiple embryos are involved or when pregnancies occur at an older maternal age. The concern is not merely medical; it intersects with family economics, social planning, and the broader public health budget. In practical terms, clinics might see more complex pregnancies requiring longer hospital stays, more frequent monitoring, and extended parental support after birth. That means hospitals need more NICU beds, more specialized staff, and better referral networks to manage the higher-risk cases that twins often represent.
The Thai context amplifies the relevance. Thailand has entered a period of demographic transition marked by a record-low number of births in recent years and a lasting push toward population aging. In 2024, the country recorded one of its lowest annual birth counts in decades, underscoring ongoing fertility decline even as life expectancy improves. Health officials and researchers warn that the combination of fewer births and more assisted conceptions could shift the country’s perinatal landscape in unexpected ways. If twin births rise, there will be a sharper need for early prenatal screening, maternal-fetal medicine expertise, and robust newborn care capacity, especially in urban centers where access to advanced care already concentrates.
Thai medical professionals emphasize that preparation must be proactive, not reactive. A senior obstetrician at a major Bangkok hospital stresses that rising twin rates would magnify existing inequalities in access to quality care. He notes that women who travel longer distances for treatment or who begin fertility treatments later in life are more likely to face pregnancies with higher risk profiles. He and others advocate for clear clinical guidelines that encourage safer ART practices, including the broad adoption of single embryo transfer when appropriate and well-timed embryo quality assessments. By reducing the likelihood of multiple births without compromising overall success rates, such policies could blunt some of the downsides that come with twins while preserving the benefits of modern reproductive medicine.
From a public health perspective, the potential shift toward more twin pregnancies intersects with broader trends in the region. The rise in older motherhood, evolving family planning choices, and expanding access to fertility services all feed into this dynamic. In Southeast Asia, fertility policy often has to balance cultural expectations around family size with economic realities, childcare costs, and workforce participation. For Thai families, the choices around pregnancy and parenting are embedded in a network of elders, relatives, and religious and cultural norms. Decisions about fertility treatments and timing often involve consultation with doctors, family elders, and, in many cases, temple-based or community support systems. The social fabric thus shapes how health systems respond, including how providers communicate risk, how resources are allocated, and how families navigate the journey from pregnancy to early childhood.
The research behind the forecast does not imply inevitability. Several factors could slow or modify the trajectory of rising twin births. Advances in ART that favor single-embryo transfers, tighter clinical guidelines on embryo numbers, and improved patient education about the risks of multiple pregnancies could dampen the growth in twin rates. Public health campaigns that emphasize prenatal care, near-maternity access, and postnatal support can also mitigate some of the hazards associated with twins. In addition, improving data collection and surveillance—so policymakers can detect shifts early and respond with targeted services—will be essential. Thailand, with its expanding network of regional hospitals and a growing cadre of perinatal specialists, has the capacity to adapt, but it will require deliberate planning and sustained investment.
The potential consequences for Thai communities extend beyond hospitals. For families, twins bring unique joy and shared milestones, but they also bring higher costs, more intensive caregiving needs, and a greater burden on parents who must balance work with round-the-clock care in the early years. Culturally, Thai families tend to place a strong emphasis on filial piety, shared decision-making, and collective responsibility for child-rearing. In this context, a rise in twin births could intensify the responsibility many families feel to ensure both children receive equal care, education, and opportunities. Policymakers can respond by expanding affordable prenatal testing and neonatal services, subsidizing essential maternity care for high-risk pregnancies, and supporting community-based programs that help families navigate the medical and logistical challenges of raising twins.
Looking ahead, the question for Thailand and its neighbors is how to translate global insights into practical, locally appropriate actions. One clear step is to strengthen the perinatal care continuum—from early pregnancy monitoring and risk assessment to delivery planning and postnatal support. Telemedicine, mobile health clinics, and targeted outreach in rural and underserved areas could help reduce delays in care and ensure high-risk pregnancies are identified early. In parallel, the health system can work with fertility clinics to promote safer ART practices, including transparent reporting on multiple birth rates and adherence to evidence-based transfer guidelines. Educational campaigns aimed at prospective parents—emphasizing the realities of twin pregnancies and the resources required to care for multiples—would empower informed decision-making in households across Bangkok and the provinces.
Thailand’s broader demographic challenge adds urgency to these efforts. With a shrinking birth pool, every pregnancy takes on greater significance for the country’s future. By investing in high-quality maternal and child health infrastructure now, Thailand can improve outcomes for all babies, while preparing for a potential uptick in twins that may accompany future fertility trends. The task is not only to protect health but also to preserve families’ hope and resilience, grounded in Thai values of care, community, and respect for medical expertise. As with many health and education policy questions, success will hinge on timely information, proactive planning, and the humility to adapt as the data evolve.
In sum, the latest research points to a future in which twin births become a more visible feature of Asian fertility landscapes. For Thailand, this is a call to action: bolster perinatal services, encourage safer fertility practices, and support families as they navigate the dual joys and challenges of raising twins. If the region can align clinical standards with culturally sensitive communication and solid social support, it can turn an emerging trend into a shared opportunity—a healthier start for more Thai children and a more resilient health system that can meet evolving needs with confidence and compassion.