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Pregnant with Twins

Katlyn Joy | 8, November 2010


Pregnant with Twins

Being pregnant with twins does indeed change a pregnancy. Your nutritional needs are higher, your weight recommendation is likewise more, and your morning sickness is likely more intense than those only carrying one bundle of joy.

Twin pregnancies are on the rise. According to the American Congress of Obstetricians and Gynecologists, twins occur once in every 41 births. Twins can be identical, which is more rare, when one fertilized eggs splits into two genetically identical fetuses. Twins are more commonly fraternal, which happens when each twin develops from separate egg and sperm and have separate placentas and amniotic sacs.

What to Expect

You'll be seeing quite a lot of your obstetrician. Most likely you'll be seeing a specialist, not a family doctor or midwife, although that may depend on your provider's (and your own) comfort level with the situation and experience with such births.. Multiple pregnancies are generally considered high risk, so you'll also be giving birth in a hospital equipped to deal with any complications that may occur with twins. Most women pregnant with twins see their doctors every other week in the second trimester and every week during the last.

More tests. You'll likely have more ultrasounds than your friend who is pregnant with one child. There may be other special tests ordered as well. It's nothing to worry about; just a little extra precaution. You might be given a nonstress test to monitor the babies' heart rates according to their own activity level. You may also get your cervix checked earlier in the pregnancy to keep a watchful eye for signs of preterm labor. Your doctor will also want you to keep a kick count daily to monitor the frequency of the babies' movements.

More limits. While other pregnant women may travel up until the end of their pregnancies, exercise without many restrictions, and work until it's time to deliver, women carrying twins may be put under stricter guidelines. While it's not always seen as necessary, many times those pregnant with twins are put on bedrest for a significant portion of their pregnancies. Try your best to deal with whatever limits you have recognizing it's for the best and won't last forever.

What You Can Do

Get your feet up, take naps and make sure you get a good night's rest each evening. Growing a baby is difficult work, growing two at once is even more demanding on your body. As the babies grow and more of a toll is exacted from your system, you might need some extra assistance around the house.

Eat a healthy diet. Nutritional needs for pregnant women of average weight require a daily intake of 2,700 calories. Your doctor will likely have you take additional prenatal vitamins, especially to ensure you get enough folic acid, protein and iron. Women with multiples frequently suffer from anemia.

Gain weight. You'll be aiming for 35 to 45 pounds if you started in the average weight range. This typically averages out to a pound a week in the first half of your pregnancy and a bit more in the second half. This isn't an excuse to go crazy with unhealthy foods with the eye on the scale. You want to gain weight with healthy foods that will nourish both you and your growing babies.


Preterm labor is one of the most common complications of twin pregnancies. This includes any labor that begins before the end of the 37th week. You may be given steroids injections to help the babies' lungs to mature if you start labor early. You'll be monitored closely to check for signs of premature labor, as about half of all twins are born prematurely. Different interventions may be tried depending on the timing and the development of the babies. Remember even one extra day in the womb can be highly beneficial.

High blood pressure/pre-eclampsia. When high blood pressure in the mother is combined with protein in the urine, it is considered pre-eclampsia. This condition must be monitored carefully. With proper care, it can be kept to mild levels and serious complications such as fetal or maternal death, stroke, and organ damage can be avoided. Your physician will alert you to signs of pre-eclampsia such as headaches, visual disturbances known as floaters, dizziness or reduced fetal movement.

TTS. This is twin-twin transfusion syndrome and occurs only in identical twins who share a placenta and have a shared circulatory system that provides too little blood for one twin and too much for the other. This syndrome requires serious intervention to avoid major problems. Often twins with this syndrome will be delivered as early as developmentally possible to protect them.

C-section. Often one of the twins will be in a breach position and sometimes this requires a cesarean section. Sometimes one twin will be delivered vaginally and the other by c-section.

Preparing for Labor & Delivery

Plan for the very likely early arrival of your babies by doing everything well ahead of time. Take childbirth classes at four or five months. Have your baby shower in your six month. Learn about common twin pregnancy conditions like preterm labor or pre-eclampsia so you recognize any possible warning signs. Prepare yourself for a c-section in advance, just in case.

Don't give up on breastfeeding. Twins are not necessarily easier to bottle feed. Talk to a lactation consultant prior to giving birth to learn how to handle the added responsibility of two nurslings.

Get support from twin or multiples support groups, and gather valuable advice from those who have been through all this before. While you will experience some added stresses in being pregnant with twins, you'll have double the joy as well.

Katlyn Joy is a freelance writer, and just graduated with a Master's of Arts in Creative Writing. She is mom to seven children, and lives in Denver, Colorado.

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Chelsea Aug 10, 2012 08:49:12 PM ET

Happyparents, Just two days ago my husband and I experienced almost the same story as you! We went in for our first ultrasound at 21 weeks 2 days and found out... surprise! It's TWO boys!!! This is my first pregnancy, so it's a lot to take in. I would love advice from anyone who's been in this situation before!!!

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Happyparents Mar 31, 2011 12:56:40 AM ET

Were 5 months today and went in for our first sonagram....just hoping to find out if we were having a boy or girl. Big suprise when we were told we were having twin girls! My wife was in shock and our son...who is 6 yrs old.... Was sooo upset he cried for almost a half hour! We went from a family of four to six instantly. We are so grateful but realize the tough road ahead.. Can anyone relate?

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j Nov 12, 2010 09:32:05 PM ET

I have twin girls they are so cute and so different its pretty kewl. i also have a 2 year old son

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