Having twin babies can be an amazing experience. Although it can come as quite a shock when moms are first told the surprising news — that there are not one, but two babies in there! Since 1975, the number of twin births have jumped over 75 percent. Experts say the rise is mainly due to the rise in fertility treatments along with the rise of obesity. In 2015, the rate of having multiples was 4 percent. This includes twins, triplets, and other multiple pregnancies.
There are certain things that can raise a woman’s likelihood of conceiving twins, even without fertility treatments. If twins run in the family, a woman is twice as likely to have multiples. This only counts for the woman’s side of the family. It doesn’t matter if twins run in a man’s side of the family. No one should think they’re off the hook if they already have one set of twins. On the contrary, having one set of twins increases the likelihood that someone will conceive twins yet again. A woman’s change also increases slightly if she has given birth before. Other factors that increase a woman’s chance of conceiving twins is if their BMI is over 30, if they are over 5’8”, if they’re African-American, or if they’re over 35 years old.
Whether expecting mothers of twins are excited or nervous, they should be aware that being pregnant with twins does make a woman a high risk patient. Here are 15 things a woman should worry about when pregnant with twins.
15 Fraternal Or Identical Twins Make A Difference
One of the things you should worry about and definitely talk to your doctor about is if your babies are identical twins or fraternal twins. Why should this matter? Well, identical twins all share one placenta, while fraternal twins usually have their own. If your babies each have their own placenta, there is a lower risk of complication in regards to the baby getting enough nutrients and growing appropriately.
When twins share one placenta, there is a higher likelihood that one twin will get more nutrients while the other will suffer. Having a shared placenta may cause Intrauterine growth restriction (IUGR). This occurs when one or both babies has a fetal weight below the 10th percentile. Your doctor will probably monitor you more often if your babies do share a placenta, just to be proactive. If the doctors see something they don’t like, it’s possible that they may induce you earlier than normal.
14 Labor Will Probably Come Early
Once of the main things you need to worry about when pregnant with twins is that you are at a higher risk for preterm labor and delivery. While 40 weeks is full term for a single pregnancy, between 36 and 37 weeks is considered full term for a twin pregnancy. With triplets you deliver even earlier. A good rule of thumb is that you will probably deliver about a month early for each baby. More than half of all twins are born before 37 weeks, and 10 percent are born before 32 weeks.
While it’s common for twins to be delivered early, and while the babies will usually be okay, they’re still considered premature. This means they will probably have a low birth rate and possible have respiratory issues. Be prepared for at least one, if not both, of your babies to need special attention after they’re born. There is no evidence that bedrest alone will prevent preterm labor and delivery, but you should still listen to your doctor and take it easy.
13 Mom Will Become Bigger, Faster
While this is not something you should be overly concerned about, you should be aware that you will probably get bigger than moms with single pregnancies, and it will happen faster. When I say be aware, I really meant to say prepare yourself for all the people asking if you’re ready to pop when you’re still in your second trimester. It will happen, and I don’t want you to be surprised when it does.
When you are carrying twin babies, you are also carrying two placentas (probably) and more amniotic fluid — hence the extra weight. The average weight gain for a mom with a single pregnancy is about 25 pounds while the average weight gain for a mom pregnant with twins is more like 30-35 pounds. Your doctor will have a more accurate number if you are really concerned, so make sure you talk to your doctor. Oh, and don’t be surprised when even your maternity clothes don’t fit.
12 Higher Risk Of Gestational Diabetes
The risk of gestational diabetes with twin pregnancies is higher in twin pregnancies. Gestational diabetes is a form of diabetes, but it’s temporary, lasting only during pregnancy. Though moms who develop gestational diabetes during pregnancy are more likely to develop type 2 diabetes later in life. Gestational diabetes occurs when your body doesn’t produce enough insulin to regulate sugar.
There are also other factors that make a woman more likely to have gestational diabetes such as being over 35 years of age or having a BMI over 30. The main concern when a pregnant woman has gestational diabetes is that they will have larger babies and will require a C-section. However, since twin babies don’t often make it to full term, the chance of having large babies is unlikely. If you are diagnosed with gestational diabetes, it’s not the end of the world. Make sure you listen to your doctor and follow the steps provided to ensure a healthy pregnancy.
11 Risk Of Preeclampsia Is Higher
Preeclampsia is yet another risk that is elevated when you are pregnant with twins. You are three time more likely to get preeclampsia when you’re pregnant with twins compared to just one baby and nine times more likely if you are expecting triplets. This is because having more than one baby places extra strain on the placenta.
Symptoms of preeclampsia are high blood pressure and protein in your urine. Sometimes you will also see swelling in your feet, legs, and hands. If you have a family history of preeclampsia, are older, or are overweight, you are at an even higher risk. However, your doctor will monitor closely for preeclampsia if you are pregnant with twins. You will probably need to get your blood pressure taken at every appointment as well as give a urine sample. There are steps that your doctor will take if you do happen to develop preeclampsia.
10 Mom Has To Take Additional Folic Acid
There is a good chance that you will need more folic acid if you are pregnant with twins. If you don’t get enough folic acid, your baby or babies are more likely to be born with a birth defect. These include a neural tube defect like spina bifida. Neural tube defects are actually one of the most common types of birth defects that occur in the United States.
In general, mothers with one baby will need about 0.4 milligrams per day and mothers pregnant with twins will need about 1 milligram per day. They will probably already be present in your prenatal vitamin, but you might need additional folic acid. However, your doctor will know best, so it’s best to consult your doctor if you have any questions. It is possible for a pregnant woman to take too much folic acid, so don’t go crazy with the stuff or anything.
9 More Morning Sickness, Aches, And Pains
Unfortunately, there is a higher likelihood that you will experience more morning sickness with a twin pregnancy. The main culprit of morning sickness is thought to be high levels of human chorionic gonadotropin (HCG). And with twin pregnancies, women have higher levels of this hormone than when they’re carrying a single baby -- thus causing moms pregnant with twins to become sicker. But don’t worry, it won’t cause you to have morning sickness any longer than normal. It might be really bad for a little while, but hopefully abate after the first trimester and allow you some time to really enjoy your pregnancy.
And that’s not all, pregnant moms with twins complain of more back pain and difficulty sleeping. They also report worse heartburn as well. But maybe you can think of it like this — you will have it a little worse for a while but then you will get two babies!
8 Spotting Is More Common
One of the things you should definitely be worried about if you are pregnant with twins is spotting. Up to 30 percent of women pregnant with twins report spotting compared to only 20 percent of moms with single pregnancies. While spotting is more likely in twin pregnancies because of higher pregnancy hormone levels, take all precautions necessary and see a doctor if you are at all concerned. If you are experiencing light spotting but not cramping or passing clots, that is a good sign.
However, it’s possible that spotting can be a sign of something more serious. Bleeding while pregnant can mean many different things. It could mean you are having a miscarriage or in early pregnancy indicate a chemical pregnancy. It could also be a ectopic pregnancy, molar pregnancy, or sub-chronic bleeding. If bleeding occurs later on in pregnancy such as the second and third trimesters, it could mean placenta previa or placental abruption. It could also be a uterine rupture.
7 Different Delivery Scenarios Are Possible
You most definitely have a higher risk of having a C-section if you are pregnant with twins. However, it can be safe for you to deliver both babies vaginally, depending on the babies’ positions.
There are a couple different scenarios. If both babies are head down, it’s almost as safe as having a single baby. There is a slight risk that the umbilical cord will slip out in front of baby number two, after baby number one is delivered. In this case you will probably have to deliver baby number two by C-section. However, this combination only happens in about 4 percent of twin births. If baby number one is head down but baby number two isn’t, your doctor might still let you do a vaginal birth. It depends if your doctor thinks they can turn baby number two after delivering baby number one. If baby number one is not head down, or if neither baby are head down, you will be having a C-section. If there are any complications or risks to you or the babies, it’s possible that the doctor will perform a C-section early anyways.
6 Vanishing Twin Syndrome Is A Possibility
While miscarriage in the first trimester is common in any pregnancy, the risk of miscarriage while you’re pregnant with twins is even higher. Experts argue that it’s difficult to say how much that risk increases, but that twin pregnancy rates are definitely higher. It’s also hard to take into account the number of extremely early miscarriages.
With twin pregnancies, it’s possible for only one baby to be lost to miscarriage. If it happens early on, it will have no effect on your surviving twin and you might not even know. The embryo is actually so small that it’s often reabsorbed into your womb. This is called the vanishing twin syndrome and it happens in up to 30 percent of twin pregnancies. There aren’t many symptoms, so often times a mother won’t even know it’s happening. The only way to be sure if you had an early scan that originally showed two embryos.
5 Anaemia Is More Common
Anaemia occurs when your body can’t produce the amount of blood cells it needs to make additional blood. Anaemia is common in any pregnancy, as your body produces more blood to support your baby. However, it’s even more common in twin pregnancies, so it’s something you need to watch out for. Your body will do everything it can to make sure your babies get enough iron before you get yours, so it’s not usually harmful to your babies. You actually will need to worry more about yourself.
Mild anemia can make you feel especially tired, which is not good when you’re already tired from growing two babies! Your doctor will probably check your iron levels routinely to make sure you’re okay by doing an extra blood test. Your prenatal vitamins will probably have extra iron in them, but your doctor could also make you take additional iron if they are concerned.
4 Mom Is More Prone To Develop Liver Issues
Obstetric cholestasis (OC) is a condition that affects the liver, which is more common in twin pregnancies. It's caused by estrogen and progesterone, which of course are higher in moms with twins. OC happens when there is a reduced flow of bile down the bile ducts, which then leak out into the bloodstream. Once these bile salts circulate, they can cause symptoms such as extremely itchy hands and feet. If you are having trouble sleeping at night because you are itchy, that’s definitely something you should mention to your doctor.
There are several things that will happen if you are found to have OC. It’s possible that you could be admitted to the hospital if your tests are really bad. Otherwise, you will probably have to go in every couple of days to check your blood pressure, temperature, urine, and to get fetal heart monitoring. They might give your baby steroids to develop your babies’ lungs in case of preterm labor.
3 Babies Have Higher Risk For Structural Abnormalities
When your baby’s chromosomes don’t develop normally, they have structural abnormalities. Twin pregnancies are twice as likely to have structural abnormalities than single pregnancies. The most common abnormality is a heart defect, usually able to be treated by a specialist. Other abnormalities might affect their brain or spinal cord. Your doctor might have you take extra medication to protect against these abnormalities.
When you get an ultrasound, structural abnormalities are one of the many things that your doctor will look for. While it’s not something you want to hear, it’s a great thing if your doctor is able to catch it early. This means your baby can get the best care and treatment possible, and hopefully have no lasting problems. While structural abnormalities are still a risk, the risk is still really low, even in twin pregnancies. So while it’s still something you should be worried about, don’t try to think about it too much unless your doctor seems to have any concerns.
2 Stillbirth Rates Are Higher
While stillbirth is not something that any pregnant mom wants to think about, it’s important to know that twin pregnancies have a higher number of stillbirths than single pregnancies. While five babies per 1000 are still born each year from single pregnancies, about 12 babies per 1000 in twin births are stillborn. In triplet births, that rate increases even more to 31 babies per 1000 births.
However, not all twin pregnancies hold the same risks. If your babies share a placenta, that risk is higher because of the many issues that accompany shared placentas. If you don’t have any other complications during your twin pregnancy, your risk decreases. Your doctor will do everything possible to monitor you closely. If your doctor sees anything they don’t like, it’s highly likely that they will suggest a planned birth by c-section. Don’t consider it a bad thing if your doctor suggests this as they are just thinking about the best way to get you two healthy babies.
1 Mom Is At Risk For Placental Abruption
Placental abruption is when the placenta separates from the uterine lining. This is very dangerous as your placenta is what transfers oxygen and nutrients to your baby. If your placenta separates from you uterine lining when you aren’t in labor, it will no longer be able to transport the oxygen and nutrients your baby needs. Placental abruption is most common in the third trimester and occurs in about 1 percent of pregnant women.
There are different types of placental abruptions. Its severity depends on how far along you are in your pregnancy, the location of the separation, and whether it’s a partial or complete separation. If it’s only a partial separation, it’s possible that you will be fine with bed rest. However, if it’s a total separation, it’s highly likely that the baby will need to be delivered immediately. In rare cases, a transfusion may be needed as well as other emergency treatments.