What To Expect While Carrying Twins and Multiples

Carrying twins means double the fun for the parents to be. But what exactly are your chances of having twins?  

Over the past few years, the birth of twins has significantly increased. An average of 16 sets of twins are born per 1,000 births in the United States. An estimated 1 in 250 natural pregnancies will result in twins. 

You might have also heard that “twins run in families.” Very true! If you have a mother or a sister who has had twins, then you are more likely to carry fraternal twins.  

A twins pregnancy is very different from single pregnancies. A multiple pregnancy could be scary, even if you’re not a first-time parent. To know more about what to expect when carrying twins (or multiples), read more below! 

These are some things you can expect when carrying twins: 

Severe fatigue 

A single pregnancy is already tiring, but twin pregnancies take more effort and will require you to take more rest. If you need to take a nap, then go ahead!  Your body is essentially working overtime for 2 or more babies, and this can enhance your exhaustion and tiredness. With your body undergoing hormonal changes, you may experience more severe kinds of pregnancy symptoms such as morning sickness and the inability to eat. 

Increased risk 

Twin or multiple pregnancies pose more risks for both mother and child. Some complications include premature labor, preeclampsia, hyperemesis gravidarum (a severe form of morning sickness), or worse, fetal death.  Even if you consider yourself to be healthy, be aware that your carrying more than one baby adds extra work—and risk—to your body. 

More prenatal care 

In connection with the risks being increased with multiples, you will also need more prenatal care. You might need to visit your doctor more frequently than you would carrying a single baby to monitor the additional stress on your body. You probably won’t need lots of extra blood tests, but you will probabaly need more ultrasounds.  

It is generally recommended that you have ultrasounds at 12-13 weeks, 20 weeks, and then every 4 weeks until your babies are born if your twins have separate placentas. But if your pregnancy involves your babies sharing one placenta, then you would probably have more ultrasounds. 

Drinking more water 

With twin pregnancies, it is important for you to continuously hydrate yourself. You should drink plenty of water, even if you don’t feel thirsty. Dehydration can cause complications for your pregnancy.  

Plan carefully for your delivery 

In most cases it is possible to deliver twins without a C-section, and even without an episiotomy. You obstetrician needs to discuss your options for delivery with twins or multiple births. If your twins are not vertex/vertex (both head down), what is your obstetrician’s comfort level with managing the delivery? It’s gotten so many obstetricians prefer to deliver twins by C-section, and even breech babies by C-section. When I was in residency, we were taught how to deliver breech babies and twins without C-sections.  

 

Twins are usually born at 37-38 weeks instead of the 40 to 42 weeks considered the norm for single births. However, the risk of premature births is high with multiple pregnancies, so it doesn’t hurt to be ready for premature birth. About 60% of twins are born before 37 weeks.  

One kind of delivery cannot be avoided and shouldn’t be—babies born on different days. I’ve had twins deliver on separate days, separate months, and even separate years (New Year’s Eve / New Year’s Day)! I’m not sure what the parents did about birthday parties.  

Giving birth to twins offers more risks for everything related to your pregnancy, but my experience is that it’s not twice as much risk. 

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Dr. Alan Lindemann

Obstetrician-Gynecologist (OB/GYN)​

He is an obstetrician and maternal mortality expert with 4 decades of medical practice beginning in Minnesota and presently in North Dakota. He has delivered around 6,000 babies with zero maternal deaths.