It's double trouble, with a unique twist: A 32-year-old woman from Alabama who was born with two uteruses is now pregnant in both.
Kelsey Hatcher, who is documenting her story on her Instagram account "doubleuhatchlings," knew from the age of 17 she has "uterus didelphys," a rare condition where a person has a double uterus, thought to affect about 0.3 percent of females.
It was during a routine eight-week ultrasound visit in May that the massage therapist and mother-of-three learned not only that she was having twins this time around – but that a fetus was present in each of her uteruses.
"We were kind of blown away! During that first ultrasound we had LOTS of laughs," she wrote in an Instagram post.
"Most likely what happened is that she ovulated separately and had one egg come down each fallopian tube, meaning coming down on each side of the uterus, and then sperm traveled up on each separate uterus and fertilization occurred separately," Shweta Patel, the obstetrician-gynecologist caring for Hatcher at the University of Alabama at Birmingham's Women & Infants Center, told ABC's "Good Morning America."
Although women with a double uterus often face pregnancy complications, all three of Hatcher's previous children were born healthy at full term.
Pregnancies in both uteruses are exceedingly rare – Hatcher said she was told the odds were 1 in 50 million – with the last widely known case occurring in Bangladesh in 2019 when Arifa Sultana, then 20, gave birth to healthy twins 26 days apart.
Hatcher is hoping to go into labor and give medicated natural birth to both Baby A and Baby B, or "the girlies" as she affectionately calls them, with a due date of Christmas. Both are said to be "thriving."
But the uteruses will contract at different times, which could be minutes, hours or even days apart, and Kelsey and her husband Caleb Hatcher are aware Cesarean sections – for one, or both – could be needed, depending on how things unfold.
"They like to tell me at every doctor's visit that 'You are aware, we've never had a situation like this before, this is a new case for us altogether'…But I feel like I have the best team for this situation and I'm at the best hospital at Alabama for what's going on," she said.