Marci Breazeal Pruit was five months pregnant and having a routine ultrasound when the technician turned and asked if she knew she was having twins.
"I went white," said Pruit. "I would have passed out if I hadn't been lying down."
Though Pruit had just two, she and her husband -- like most parents of multiples -- were in for a life change as they moved from their one-bedroom apartment and Pruit quit her job to care for their boys, now 4.
Whether anticipated or a surprise, news of multiple babies is becoming increasingly common. Nationwide, the twin birthrate has jumped 53 percent since 1980, with an astonishing 423 percent spike in triplets and higher-order multiples, according to the National Center for Health Statistics. The most current figures available are from 1999.
Moms of twins and triplets say their multiples introduced them to the world of mandatory minivans, double strollers and comments from strangers.
They watch their twins they crawl in bed together to cuddle, feed each other and brush each other's teeth. Still, most moms said they were surprised that each child's personality is so different.
From pregnancy on, multiples bring a unique set of challenges and rewards.
Mothers carrying two or more babies face a higher risk of complications before and after labor; infants are more likely to be born premature or be considerably smaller than a single baby.
Triplets, for example, average just 3 pounds, 12 ounces, with 80 percent of deliveries at least a month early, according to the book "When You're Expecting Twins, Triplets or Quads."
The logistics of feeding and caring for multiples also challenge new parents.
"Unless you have them, you don't understand," said Vonalaine Crowe, the mother of twin girls, 5.
The rise in multiple births is credited to fertility treatments and the increasing age of mothers (women age 35 to 40 are three times more likely than younger women to have fraternal twins even without fertility therapies). A recent study estimated that a fifth of triplet births in 1997 were spontaneously conceived, with the rest linked to reproductive techniques and medicines.
The rate of triplet and higher multiple births dropped slightly from 1989 to '99, a trend expected to continue as physicians refine fertility treatments and follow new recommendations to prevent multiple births.
Experienced moms of multiples say the first year is the most challenging, and Cindy Muszynski is still living it. It was two months before she gathered the courage to take her twin girls, now 8 months, out in the car by herself. Even then, she made a checklist of everything she needed.
She sets a goal of trying to get one thing done a day, like putting in a load of laundry or emptying the dishwasher. "As soon as they nap, I get in the shower, eat breakfast," she said. As children get older, the parenting issues become more about identity. Do they stay in the same class? Share a bedroom? Have a split birthday party?
Crowe's twin girls, for example, will read cards if they each receive one but toss them if they come addressed to both together, she said. "From a very young age, they've wanted people to know they're not a package deal," she said.
Sherri Newman's identical twins, Shira and Becca, 4, are in different preschool classes but must wear shoelaces with colored beads at the end so teachers know who is who on the playground. Parents of identical newborns sometimes paint one baby's toenail so they can quickly tell them apart.
Most mothers of twins say they can't imagine having three. Lynn Hobbs splits her life in two: before triplets and after triplets.
She juggles three soccer teams, with practices four nights a week and five hours devoted to games on Saturdays.
After talking to another mom of triplets while pregnant, Hobbs was reassured she could handle three without a nanny.
"I knew my husband and I could survive," she said. "We just didn't sit down for years."