What not to do when youre pregnant with twins?

Twin Pregnancy

A twin pregnancy means there are two fetuses in the uterus. This is a rare occurrence that can be due to family history, fertility treatments or other factors. Healthcare providers can detect twins early using ultrasound. A twin pregnancy raises the risk of complications for the pregnant person and fetuses, which is why more frequent prenatal care is necessary.

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What is a twin pregnancy?

Twin pregnancies occur when there are two fetuses in your uterus at one time.

What are my chances of having twins?

The chances of conceiving twins, a type of multiple pregnancy, are low. Twins occur naturally in 1 out of every 250 pregnancies.

What are the signs of a twin pregnancy?

Certain circumstances are consistent with carrying more than one fetus. But experiencing the signs of a twin pregnancy doesn’t always mean a person is carrying two fetuses.

These signs, some of which occur in the early weeks of pregnancy, include:

Early fetal movement.
Fetal movement in more than one area.
Fundal height is greater than gestational age. The baby bump is measuring larger than expected.
Gaining weight quickly.
Having high levels of hCG, a pregnancy hormone, or alpha-fetoprotein (AFP), a protein made by the fetus’s liver.
Hearing more than one heartbeat on a fetal Doppler.

What are twin pregnancy symptoms?

Twin pregnancy symptoms are similar to those of a single fetus (singleton) pregnancy but may be more intense.

You may experience:

Breast tenderness.
Fatigue.
Frequent urination.
Increased appetite.
Morning sickness.

How is a twin pregnancy confirmed?

The most reliable method of confirming a twin pregnancy is prenatal ultrasound. This test uses sound waves to produce images of your uterus. Ultrasound makes it possible to see whether there are two fetuses.

How is a twin pregnancy belly different from a singleton belly?

With a twin pregnancy belly, your bump will show early on. You may need maternity clothes shortly after finding out you are pregnant. Your expanding bump may also cause you to outgrow clothes quickly because of extra weight gain. It’s common to put on around 50 lbs. during a twin pregnancy, compared to 30 lbs. for a singleton baby.

What are the different types of twins?

Twins are either fraternal or identical.

Fraternal twins occur when two sperm fertilize two eggs in one cycle. This results in a separate placenta for each baby. Fraternal twin DNA is like that of siblings of different ages. They may be the same or of different sex.
Identical twins happen when a single embryo from one egg and one sperm divide in two. The twins may share one or have separate placentas. Identical twins are always of the same sex.

Conjoined twins are extremely rare and occur when an identical twin embryo does not fully divide. The babies’ bodies are fused and may share vital organs. Common points of fusion are the chest or abdomen. This can result in a shared liver or heart.

How can I get pregnant with twins?

Circumstances that increase your chances of having twins include:

Age: People over the age of 35 are more likely to release multiple eggs during ovulation.
Family history: If your mother’s side has a history of fraternal twins, there is a chance you could conceive twins naturally.
Fertility treatments: Twin pregnancy is more common in people who have fertility treatments, such as in vitro fertilization (IVF).
Having obesity: People with a body mass index (BMI) higher than 30 are more likely to conceive twins.
Personal history: If you carried twins during a previous pregnancy, you’re more likely to conceive twins again.

How do fertility treatments raise the likelihood of twins?

Fertility treatments can lead to a twin pregnancy:

When you take drugs causing you to release more than one egg per cycle.
If you have IVF and have more than one embryo implanted.
After IVF, if an implanted embryo splits in the early stages of pregnancy.

What is considered full-term for twins?

A full-term pregnancy is 37 weeks. Twin pregnancies rarely last this long, with the typical twin pregnancy lasting 35 to 36 weeks. Many people go into labor sooner.

Few treatments are available to prevent preterm labor, and they’re not always successful. Once you go into active labor, there’s no way to stop labor from progressing.

How is prenatal care different with a twin pregnancy?

With twin pregnancies, both the pregnant person and twins face a higher risk of complications. Prenatal checkups occur more frequently with twin pregnancies, making it possible to detect issues in earlier stages.

Twin pregnancies are high risk because there are many potential complications. Many people receive prenatal care from maternal-fetal medicine experts. These obstetricians specialize in preventing, detecting and caring for complications of high-risk pregnancies.

What types of complications are associated with twin pregnancies?

Twin pregnancy complications include:

Anemia.
Congenital conditions, including spina bifida.
Gestational diabetes.
High blood pressure during pregnancy (preeclampsia).
Intrauterine growth restriction (IUGR).
Low amniotic fluid (oligohydramnios).
Placental abruption.
Premature labor.
Too much amniotic fluid (polyhydramnios).
Twin-to-twin transfusion syndrome, in which only one twin receives adequate blood supply in the womb.

Premature twins are at risk for additional complications, which may include:

Brain bleeds.
Breathing issues from underdeveloped lungs, including apnea.
Difficulty staying warm.
Feeding issues.
Low birth weight.
Vision problems (retinopathy of prematurity).

How are twins delivered?

A cesarean birth (c-section) is likely with twin pregnancies. If you’re pregnant with twins and not having complications, it’s possible to try for a vaginal delivery.

A note from Cleveland Clinic

Finding out you’re pregnant with twins can be exciting, but you might also feel overwhelmed. A twin pregnancy requires more frequent prenatal visits because there are higher chances of complications. Most people who are pregnant with twins deliver just before they’re considered full-term. Though twins are often born via c-section, talk to your provider about the possibility of a vaginal delivery. They’re there to help with any questions or concerns you may have.

Last reviewed by a Cleveland Clinic medical professional on 06/01/2022.

References

Afzal AR, Montero FJ. Conjoined Twins. (https://www.ncbi.nlm.nih.gov/books/NBK560839/) [Updated 2021 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Accessed 6/1/2022.
American College of Obstetricians and Gynecologists. FAQs Multiple Pregnancy. (https://www.acog.org/womens-health/faqs/multiple-pregnancy) Accessed 6/1/2022.
American Pregnancy Association. Complications in a Multiples Pregnancy. (https://americanpregnancy.org/healthy-pregnancy/multiples/complications-in-a-multiples-pregnancy/) Accessed 6/1/2022.
American Pregnancy Association. Twin Pregnancy Symptoms. (https://americanpregnancy.org/healthy-pregnancy/multiples/twin-pregnancy-symptoms/) Accessed 6/1/2022.
American Society for Reproductive Medicine. Fertility Drugs and the Risk of Multiple Births. (https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/fertility-drugs-and-the-risk-of-multiple-births/) Accessed 6/1/2022.
American Society for Reproductive Medicine. Multiple Pregnancy and Birth: Twins, Triplets, and High Order Multiples (booklet). (https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/multiple-pregnancy-and-birth-twins-triplets-and-high-order-multiples-booklet/) Accessed 6/1/2022.
March of Dimes. Being Pregnant with Twins Triplets and Other Multiples. (https://www.marchofdimes.org/complications/being-pregnant-with-twins-triplets-and-other-multiples.aspx) Accessed 6/1/2022.
Pregnancy, Birth and Baby (Department of Health, Australia) Types of Twins. (https://www.pregnancybirthbaby.org.au/types-of-twins) Accessed 6/1/2022.
Science. Having Fraternal Twins Is in Your Genes — and Your Hormones. (https://www.science.org/content/article/having-fraternal-twins-your-genes-and-your-hormones) Accessed 6/1/2022.
Twins Trust (England). How I Knew I Was Having Twins or Triplets. (https://twinstrust.org/blog/pregnancy/how-i-knew-i-was-having-twins-or-triplets.html) Accessed 6/1/2022.

8 Things You Can’t Do When You’re Pregnant With Twins

If seeing the plus sign on the pregnancy test is exciting, seeing two little dots on an early ultrasound is a special kind of bliss. Unless you were expecting a twin pregnancy, the game plan changes in an instant and you’re rethinking everything from your nursery setup to your feeding technique to your college fund. And then, of course, there are the things you can’t do when you’re pregnant with twins to consider, too. And while no one should be policing your body — pregnant or not — there are a few things to think over as you navigate a pregnancy with multiples.

Regardless of your health or age, a twin pregnancy is always considered «high-risk,» according to BabyCenter. The extra weight and demands put on your body by one or more additional fetuses mean that you’ll need to take extra precautions that you might not have needed if you were having a singleton pregnancy. You may need to see a perinatologist, which is a specialist in high-risk pregnancies, along with or instead of your regular obstetrician.

In addition to your medical care, you’ll have to change the way you exercise, eat, dress, and shop in ways that moms of singletons don’t. Because you’ll be more likely to deliver early with twins, according to the American College of Obstetricians and Gynecologists (ACOG), your baby shower may even have to be moved up. Of course, every pregnancy is different and the only advice you should take to heart is that of your health care provider. But if you’re expecting twins and you’re wondering what you’re in for, here’s a list of things you’ll probably have to give up for the duration of your pregnancy:

Skipping Your Checkups

Moms expecting twins are more likely to experience health complications such as anemia, preeclampsia, and gestational diabetes, than moms with singleton pregnancies, according to the March of Dimes. The fetuses are also at risk of birth defects, low birthweight, and other health issues. To safeguard your health and that of your future babies’, you’ll need to see your OB more often than you would if you were carrying only one child. BabyCenter explained that after the 24th week, moms of twins typically see their doctor every other week.

(And make no mistake, you shouldn’t be skipping your OB-GYN appointments if you’re pregnant with a singleton, either.)

Riding A Bike

Carrying all that extra weight can throw off your balance, making it more likely that you’ll fall over if you try to ride a bike, explained WebMD. To minimize risk, stick to the stationary bikes in the gym when you’re looking to clock a few miles. Also out for the duration: sports that put you at risk of falling, such as skating or skiing, and lying-down yoga poses, which may cut off circulation to your uterus.

Avoiding Nosy People

Having two babies means that you’ll start to show earlier than moms of singletons, and as your bump grows so will the curiosity level of everyone around you. Scary Mommy contributor Heather Milner wrote about the nosy questions people asked when she was expecting twins. «Your larger belly is like a neon sign that the public can’t help but notice. Some questions are fine, but some will make you cringe.»

Expect to be asked whether you «had help» getting pregnant and how close you are to your due date. You might also get some unsolicited suggestions on names which, for better or worse, isn’t exclusive to moms with twin pregnancies.

Twin Pregnancy: Answers from an Expert

When you’re expecting twins, you know you’ll need two of everything for your registry. But what about staying healthy during your pregnancy? Do you need to double your food intake, weight gain and visits to the doctor? With regard to the babies, are there two placentas and two amniotic sacs, or can they share these?

Johns Hopkins maternal-fetal medicine specialist Jeanne Sheffield answers eight commonly asked questions.

Do twins share a placenta and an amniotic sac?

Two placentas and two amniotic sacs. A twin pregnancy with two placentas and two amniotic sacs is the optimal twin pregnancy, as each baby has its own nutritional source and protective membrane.
One placenta and two amniotic sacs. In pregnancies with one placenta and two amniotic sacs, you will definitely have identical twins. Additionally, when your babies share a placenta, there is a greater risk for complications, such as twin-to-twin transfusion syndrome. Your physician will closely monitor your pregnancy to check for potential problems.
One placenta and one amniotic sac. This is the riskiest and rarest type of twin pregnancy. Fetal complications can arise due to tangling of the umbilical cords or an imbalance in nutrients, blood or other vital life supporting systems.

Do I need to double my caloric intake during a twin pregnancy?

Do I need to take different prenatal vitamins for twins?

Will I need to visit my doctor more frequently?

Do I have to see a maternal-fetal medicine specialist for a twin pregnancy?

Are all twin pregnancies delivered preterm?

Can bed rest reduce the risk of preterm delivery?

Is labor and delivery significantly different with twins?

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