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Understanding Multiple Pregnancy

Finding out you’re pregnant with twins or more can be both exciting and scary. You might be wondering, "How will this pregnancy be different than what I was expecting?" and "How will this affect my health and my babies’ health?"

Multiple pregnancy can happen when couples use assistive reproductive techniques such as artificial insemination. Or it can happen naturally. Sometimes twins run in the family. In any case, a multiple pregnancy is usually identified early in the pregnancy so that good prenatal care can begin.

Prenatal care for women pregnant with multiples

A multiple pregnancy is considered a high-risk pregnancy, because of the increased risk for problems. Prenatal care may involve more visits with your healthcare provider, more tests, and planning for possible problems such as an early delivery. Prenatal care for multiple pregnancy involves:

  • More prenatal visits. This helps your healthcare provider closely monitor your health and the health of your babies. It’s important to check their growth and development in the womb. Your healthcare provider will also watch for complications, and monitor your weight and nutritional status.

  • Frequent ultrasounds. These are used to check fetal growth and the volume of amniotic fluid. Starting your second trimester, you may have ultrasounds every 4 to 6 weeks.

  • Tests to check your health. This includes earlier glucose screening to check for gestational diabetes and testing for iron-deficiency anemia. Your healthcare provider will also check your blood pressure often.

  • Other tests to check babies’ health. These may include amniocentesis or chorionic villus sampling (CVS) to test for birth defects, or a non-stress test to check fetal heart rate.

  • Preparing for delivery. Multiple pregnancy increases the risk for preterm birth and cesarean delivery. It’s important to discuss these possibilities with your healthcare provider.

You’ll also need guidance on nutrition, prenatal vitamins, activity, and expected weight gain during your prenatal visits.

Complications of being pregnant with multiples

Being pregnant with twins or more increases your risk for nearly every complication of pregnancy. This is why extra prenatal care is needed. Many of the possible complications can be managed, especially if found early.

During pregnancy

  • Low red blood cell count (anemia)

  • Gestational diabetes

  • Gestational high blood pressure (preeclampsia)

  • Severe morning sickness and fatigue

  • Preterm birth (before 37 weeks)

  • Baby is not gaining weight normally (fetal growth restriction)

  • Monochorionic babies. This is when babies share a placenta and amniotic sac. This can increase the risk for twin-to-twin transfusion syndrome (TTTS). This is unbalanced blood flow between the twins.

After birth

  • Health problems of premature babies and NICU care

  • Postpartum depression

  • Heavy bleeding after birth (postpartum hemorrhage)

  • Low birth weight

  • Birth defects

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

  • Fever

  • Symptoms of postpartum depression

  • Heavy bleeding

  • Eclampsia symptoms

  • Headaches

  • Increased in blood pressure

Online Medical Reviewer: Donna Freeborn, PhD CNM FNP
Online Medical Reviewer: Irina Burd, MD, PhD
Date Last Reviewed: 6/1/2020
© 2000-2020 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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