Pregnant Twins

Pregnant Twins
Pregnant with Twins: What to Expect Blog , Pregnancy , Uncategorized

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Learning you’re pregnant with twins likely causes a rush of emotions. Some women are excited about the prospect of twins — double the cuteness and baby snuggles! Others may feel a little uncertain or even overwhelmed. After all, there are two babies rather than just one. Not to mention, twin pregnancies come with added risk compared to a typical single-baby pregnancy (or “singleton” pregnancy).
Let’s look at how twin pregnancies differ from single-baby pregnancies, from conception to birth.
There are some early signs to watch for that could indicate you’re pregnant with twins, but every pregnancy will be a unique and different experience for each woman.
Some women who have twin pregnancies will have more severe morning sickness and faster weight gain. Does that indicate twins? Maybe, maybe not. These symptoms can happen in any pregnancy, so they are not definitive signs of twins.
Blood tests can also reveal the likelihood of twins within the first few weeks after your missed period. Higher than expected beta results could indicate twins.
But the only definitive answer to whether you’re having twins is an ultrasound. You’ll most likely find out if you are pregnant with twins when you have your first-trimester ultrasound , which is scheduled for around 7 or 8 weeks gestation.
Mothers expecting multiples can expect to have a bit more on their plate. You should plan on finding support through friends, family, and local support groups. Your doctor may have some insight into resources available in your area.
Even uncomplicated pregnancies with twins can cause women to feel more tired than they would if they were only carrying one baby. Ensure you eat enough nutrient-dense foods during pregnancy to meet your body’s nutritional needs, too. Pay close attention to your iron intake. You may want to supplement iron through prenatal vitamins and eat plenty of iron-rich foods.
Women expecting twins can also plan on delivering their babies before the 40-week mark of pregnancy. Even in twin pregnancies considered lower risk, delivery may be recommended by 36 to 38 weeks.
Breastfeeding twins has unique challenges but is still possible. Connect with a lactation consultant to help overcome challenges associated with nursing twins so you can continue breastfeeding for as long as possible.
Weight gain during pregnancy is expected — and healthy. Your body will be growing two tiny humans! That means you can expect to gain, on average, about 45 pounds during a twin pregnancy. This is about 10 pounds more than a singleton pregnancy.
Keep in mind pregnancy weight includes:
Many people are already familiar with the differences between fraternal and identical twins. Fraternal twins occur when two eggs are released, fertilized, and implanted. They are the more common type of twins. Identical twins occur when a single egg is split into multiple identical embryos.
But there is another way multiple pregnancies are classified, which affects how closely they are monitored.
There are three main types of twin pregnancies:
Di/Di twin pregnancies carry the lowest risk of the three types because both babies have their own placenta and amniotic sac. When both babies share one placenta, there is the risk of one baby getting the majority of the blood flow. Twin transfusion syndrome occurs in 10 to 15 percent of Mono/Di twin pregnancies.
Prenatal appointments for multiples will be very similar to singleton pregnancies for the first two trimesters unless the pregnancy is high risk.
Prenatal appointments for singletons typically include:
Because fundal measurements are not an accurate way to estimate the babies’ growth during a twin pregnancy, as they are in typical pregnancies, you can expect to get regular ultrasounds after the 20-week mark.
For low-risk twin pregnancies, expect to get ultrasounds at 24, 28, 32, and 36 weeks. Higher-risk pregnancies, such as mono-chorionic twins, may have ultrasounds every two weeks starting as early as 16 weeks gestation.
You can also expect regular non-stress tests every two weeks in the third trimester, during which your doctor will listen to the babies’ heartbeats for 20 to 30 minutes. This helps to assess how well the babies are tolerating pregnancy.
Everyone wants to know what their chances of having twins are. It turns out, older women are more likely to get pregnant with twins. At the age of 20, a woman has a 1% chance of getting pregnant with twins, but at age 40, that likelihood jumps to a 7% chance.
There is also some genetic tendency with twins. If someone in your immediate family had twins or if you are a twin, then you may be more likely to get pregnant with twins.
Women who are taking fertility prescriptions to induce ovulation may have a greater likelihood of having twins.
If a woman is using IVF to get pregnant, she can request a twin pregnancy. However, it is important to note that twin pregnancies carry more risk than single-baby pregnancies.
But there are no known herbs, supplements, foods or sex positions that are proven to increase the odds of having twins.
Although some women may think a twin pregnancy is more desirable, given that one pregnancy results in two babies, most practitioners would caution them about the increased risk of complications.
Common risks of being pregnant with twins include:
Recommended delivery timing varies depending on the type of twin pregnancy and is as follows:
If you are pregnant with twins, it isn’t certain that you’ll have to have a C-section, but it is fairly likely. The capability of a woman to deliver twins vaginally depends on the position and sizes of the babies. If the first baby is head down and the babies are the same size or baby one is larger, then a vaginal delivery for both babies can be attempted.
At Madison Women’s Health , we often encourage women to have an epidural when delivering twins. Having an epidural in place can save time if an emergency C-section is needed. It can also make the experience more tolerable if the second baby is breech (positioned feet first) and needs assistance.
If a woman wants to deliver twins vaginally, the delivery will begin in a normal labor room where the baby and mother will be monitored closely. When the mother begins to push, she will be moved to the Operating Room (OR) in case an emergency C-section is needed. There will likely be a pediatrician, anesthesiologist, surgical tech, and an ultrasound technician present to monitor the vital signs of the mother and baby.
The healthcare team knows that twin deliveries carry more risk, so these measures should be taken to keep the mother and baby safe.
Talk with your provider about making the experience as relaxing as possible by incorporating calming music and having a support person present. (Want some ideas for making your birthing experience as calm as possible? Read this blog post.) Assuming your babies don’t need medical support when they are born, you should still be able to do skin-to-skin contact immediately after delivery.
When you learn you’re having twins, you will probably have many questions. At Madison Women’s Health, we’ve delivered many twins. Some of us have even had twins ourselves! But we know some of the best advice, tips, and tricks for how to cope when you’re outnumbered by babies comes from other parents who have been there, done that!
We encourage you to get involved in a community support group for parents of multiples. In Madison, we recommend “ Moms of Multiples.” You’ll also want to speak with a lactation consultant.
Finally, if you have supportive friends and family nearby, remember to ask them for help. Chances are they would love a few extra moments to snuggle your little ones so you can get some much-needed rest. If you have any questions or concerns about having twins, please speak with your OBGYN . We’re here for you every step of the way.
Dr. Dickmeyer has been providing healthcare for women in the Madison area since 1998 and is a founding member of Madison Women’s Health. Her specialties include minimally invasive surgical techniques, high and low risk obstetrics, pelvic floor disorders and postmenopausal medicine.
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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.

While some twins may share a placenta and an amniotic sac, that is not the
case for the vast majority of pregnancies. Here are three major
possibilities that exist:

A common misconception surrounding twin pregnancy is that you need to
double your caloric intake to provide your babies with enough nutrients.
However, pregnancy nutrition guidelines aren’t simply based on the number
of babies you’re carrying. Instead, they’re based on your

body mass index

at the time you became pregnant.

Your doctor will make individualized recommendations based on your starting
weight. On average, it’s estimated that a woman’s caloric requirements will
increase about 40 percent for a twin pregnancy. What’s most important,
though, is that a woman eats as healthy as possible.

If you’re pregnant with twins, you should take the same prenatal vitamins
you would take for any pregnancy, but your physician will recommend extra
folic acid and iron. The additional folic acid and extra iron will help
ward off iron-deficiency anemia, which is more common when you’re pregnant
with multiples.

While every pregnancy is different, most women carrying twins will have
more frequent prenatal visits than women carrying only one baby. If your
twins are sharing one placenta, you will automatically have a more frequent
monitoring schedule.

If your pregnancy doesn’t have complications, your prenatal visits may not
differ much from a singleton pregnancy until you get to the end of your
second trimester. At that point, you’ll be seen more frequently because
there is a higher risk of

pre-eclampsia

and preterm labor.

Maternal-fetal medicine specialists see high-risk pregnancies, but not
every twin pregnancy will fall into this category.

To find the best care provider for your twins, make sure that the physician
is comfortable managing twins, including vaginal delivery of twins rather
than only offering a

cesarean section

(C-section) for delivery.

A little more than half of twin pregnancies end in preterm delivery (before
37 weeks). While 40 weeks is the full gestation period of the average
pregnancy, most twin pregnancies are delivered at approximately 36 weeks (range 32-38 weeks depending on the type of twin pregnancy).

Unfortunately, preventing preterm labor with multiples is more challenging
than with a singleton pregnancy because the interventions used with
singleton pregnancies are not as effective with multiples.

Scientific data show that bed rest does not prevent preterm delivery. In
fact, bed rest can increase your risk of developing blood clots and have
negative financial and social consequences.

Although bed rest is not prescribed as frequently as it once was, your
doctor may suggest reducing your activity level if you’re showing signs of
early labor at the end of your second trimester or early in your third
trimester.

Labor

is generally the same whether you’re having one baby or two. During
delivery is when things differ significantly.

When it’s time to deliver your twins, you will go to an operating room even
if you are delivering vaginally. This is a safety precaution known as a
double setup. Following the vaginal delivery of the first baby, there is a
small risk of an emergency cesarean section for the second baby. There is also the
possibility of the second twin being delivered breech, which is a safe form
of vaginal delivery if the obstetrician is experienced in this type of
delivery.

Of women giving birth to twins over 32 weeks, only about 4 percent who try
for a vaginal delivery will have a combined vaginal and cesarean section delivery.
While it doesn’t happen very often, by delivering both babies in the
operating room, physicians are better prepared to protect the health of the
mother and the babies.

Although being pregnant with twins can seem very different, your doctor
will treat your pregnancy like any other unless a complication occurs.

One of the best things you can do to protect and improve your health is to stay informed. Your Health is a FREE e-newsletter that serves as your smart, simple connection to the world-class expertise of Johns Hopkins.
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