Julia is the independent one, the sister who takes charge of her fellow triplets – like a little mommy, says Dr. Amy Riley, the real mother of this well-behaved group of 4-year-olds. Vivian, or Vivi, is the smallest, a dainty girl who likes to wear skirts.
"And Alec is the only boy," says Riley, 40. "He likes to be the leader. He likes trucks and cars."
"And candy," says Alec, who's quick to assert his personality into the grown-ups' conversation. "I want a mint."
A reasonable enough request. One mint, coming up.
Talk about multitasking. Of the eight female obstetrician- gynecologists who deliver babies at Sutter Roseville Medical Center, three are the mothers of multiples.
Dr. Anna Almonte's twin daughters, Katherine and Elizabeth, are 6. And Dr. Jackie Ho gave birth to the babies of the group – twins Marissa and Ellie Ow – on May 16.
Even more impressive, all three doctors have older children as well. Clearly, they're well versed in the art of juggling the demands of home and family and a busy career.
"People will say, 'I can't imagine,' " says Riley. "But I can't imagine anything else."
For their patients, they set an encouraging example. Riley, Almonte and Ho understand the reassurance implicit in their care of nervous expectant mothers overwhelmed with the idea of carrying, delivering and raising multiples.
"I'm very encouraging about twins," says Almonte, 37, who immigrated from Ukraine a dozen years ago. "I always say, 'It's double trouble, but it's a double joy.' "
According to Centers for Disease Control and Prevention statistics, the twin birth rate – more than 32 per 1,000 births – has increased 42 percent since 1990 and 70 percent since 1980, in large part the result of delayed childbearing.
Beginning in their 30s, women are more likely to conceive twins naturally – and even more so when fertility treatments are involved.
In contrast, the birth rate for triplets and other multiples has declined slightly in recent years, the CDC says, following American Society of Reproductive Medicine recommendations limiting the number of embryos transferred during fertility procedures.
"When I was pregnant with my twins, I had four other couples at the same time in my practice carrying twins," says Ho, 39, herself a twin.
See? Twins, once a relative rarity, seem like they're everywhere these days. Scratch the surface of most elementary schools and you'll find a few sets of multiples.
And as Cindy Camarena, president of a local Moms of Multiples club, likes to say, when people see twins, they smile. Something about doubled- and even tripled-up siblings, whether identical or fraternal, still delights us.
For the record, Ho and Almonte both conceived their twin daughters the old- fashioned way, without the assistance of reproductive technology.
"It was nothing but nature," says Almonte, who is now single. Her older daughter, Alisa, 14, is a high school freshman in Lincoln.
"When I turned 30, my daughter said, 'When are we having brothers and sisters?' I had my first child back in the Ukraine in medical school and the twins the first year of my residency in New York. I asked the chief when was a good time to have a baby, and she said, 'Anna, never.'
"But from the beginning, they were nothing but a blessing."
On the other hand, when Riley and her husband, Damon, decided it was time to expand their family beyond their first daughter, Brenna, now 10, they struggled for several years.
"Then one cycle with in-vitro fertilization, and there were three more kids," says Amy Riley, who lives in Roseville. "It was like winning the lottery after four years of infertility."
Carrying multiple babies comes with multiple risks, including preterm labor and toxemia. As expectant ob-gyns, the doctors knew more about those risks than most pregnant women.
"I think knowledge is always good," says Ho, whose oldest daughter, Caroline, is 8. "When I found out I was having twins, I was very happy but at the same time worried about potential complications.
"I was as excited as I could be, but I thought, 'Am I going to end up having a C-section? Am I going to be able to take them home with me from the hospital, or will I have to leave them in the (neonatal intensive care unit)?'
"The extra knowledge caused extra concerns. But I also knew what to watch out for."
And what do the twins and triplets watch out for? Often as not, each other.
"When there are three," says Riley, "they learn to be more patient than other kids are. They all yell, 'Mom,' at the same time, but there's only one mom. So they help each other out. And they're very good at sharing."
Just now, for example, Vivi and Julia are sharing their colors, staying busy while they listen to their mom say good things about them.
"You teach your kids to be independent," says Almonte. "They entertain each other."
Riley nods.
"We had to constantly entertain our older daughter," she says. "But these guys entertain each other."
Meanwhile, Ho and her husband, Dr. Randy Ow, an ear, nose and throat specialist, make a point of devoting one night each week to their oldest daughter so she won't feel overlooked in their newly twin-centered Roseville household.
"Life is good," Ho says. "I have a very understanding husband. I'm still trying to be there as much as I can for my patients. When I leave work, I'm 100 percent with my kids. They keep us very busy, nonstop.
"We're so happy with them."
Call the Bee's Anita Creamer, (916) 321-1136.
