Every woman remembers finding out they are with child. For most women, it’s a positive pregnancy test after a missed menstrual cycle, followed by a sonogram showing one little baby in the womb. For other women, it’s going to a sonogram expecting one baby and finding two, or three, or four!
Having multiples is an amazing privilege, though many women need time to recover from shock when they find out more than one baby will be living in their body and then coming into the world expecting mom to care for them all. However, conceiving multiples is becoming more common, and in the United States, four percent of all babies born will be multiples, with twins being born more than triplets or quads.
There’s no doubt that expecting multiples is exciting, but what some women don’t know is that it’s also riskier, and the entire pregnancy will probably be much more difficult than a singleton pregnancy. While this isn’t true for all women, research shows that risks for women carrying multiples are higher, and risk to the babies increases as well.
That’s not to say that mom can’t have a good pregnancy and deliver healthy babies. It’s just a warning that there are certain factors to consider when carrying more than one child and certain multiple-specific issues that can arise. Being prepared for these can help mom feel a bit more in control of a situation that sometimes seems like riding a roller coaster blindfolded. Plus, carrying multiples is truly a different experience from anything mom will ever go through for the rest of her life.
15 Higher Risk Of Death
Let’s get the worst of it out of the way up front. Yes, multiples are more likely than singletons to have issues inside and outside of the womb that can lead to death. There’s a reason they call a pregnancy with multiples a high-risk pregnancy.
Multiples face certain risks that singletons don’t, plus they are at an increased risk of suffering from issues, like preterm labor, than singletons. How high risk a pregnancy is will depend on several factors, like how many babies are in the womb (the more babies, the higher the risks) and what type of multiples they are.
For instance, fraternal twins usually have their own placenta to draw nutrients from, but identical twins, who were created by the splitting of one egg, may share a placenta. The twins who share a placenta are at a higher risk for issues since an uneven distribution of nutrients and blood can cause tragedy for one or both babies.
Unfortunately, the risks don’t stop when the babies are born. Because they are often born early, there is a strong chance that they will face issues related to prematurity, and some of those can lead to delayed development or death. In fact, twins are five times more likely to succumb to death than singletons in their first 12 months of life.
14 Risk Of Twin-To-Twin Transfusion Syndrome
Twin-to-twin transfusion syndrome(TTTS) can be an issue for any multiples sharing a placenta, the source of nutrients and blood for a child during their time in the womb. When the blood vessels of the placenta are connected, one baby can receive more blood than the other, resulting in complications for both children.
This condition can affect twins or pregnancies where mom is having more than two children, but two of them share the same placenta.
Around 15% of all multiple pregnancies will have this problem, and there is absolutely nothing that can be done to prevent it. There is no hereditary link, and doctors still don’t know why it happens to some babies and not others.
While it’s not preventable, there are treatments. Amniocentesis and laser surgery inside the womb are options, though both come with risks and there is no guarantee either will work. Mom may also be able to deliver her babies early if they are developed enough to have a shot at life outside of the womb in a neonatal intensive care unit.
Left untreated, twin-to-twin transfusion syndrome can lead to death for the babies involved.
13 Bed Rest Is Common
Due to common complications in pregnancies with multiples, mom will probably find herself on some form of bed rest during her pregnancy. Sure, rest sounds great, especially when mom is huge and exhausted, but due to the way bed rest affects every area of life, it can be an unneeded source of stress during an already crazy time.
If mom is showing signs of preeclampsia or preterm labor, doctors will often tell her to go on some form of bed rest. Depending on her situation, she may be hospitalized so doctors can keep an eye on the situation.
If she's sent home, she may be offered the option of modified bed rest where she is resting on her side the majority of the day but has the option to move around a certain amount of hours. Other women are placed on full bed rest, meaning they don’t leave the bed or couch unless they need to go to the bathroom.
The reason for bed rest is that it takes some of the strain off of mom’s body, and having her in a lying position can slow down potential problems. While moving around is good for the body in a normal pregnancy, it can cause contractions or problems with blood flow and blood pressure in high risk situations.
12 High Likelihood Of A C-section
Multiples can be delivered vaginally, but there is a higher likelihood of a C-section if mom is carrying more than one baby. As is true with most things on this list, how many babies mom is carrying matters. Any more than two will almost definitely be delivered by C-section.
For twins, there are many factors that come into play when deciding how they should enter the world. If the first baby is not head down, a C-section is pretty much guaranteed. The first baby is the one who exits the womb first, and that one needs to be head down to ensure things start out smoothly.
However, positioning is not the only factor. If twins share an amniotic sac, most doctors will push for a C-section because of complications that can take place during a vaginal delivery. Twin-to-twin transfusion syndrome is also a factor, and if the babies are struggling with it, a C-section will be done.
It's important for mom to remember that even if she delivers her first baby vaginally, she could still end up with a C-section. Once the first twin is out, if the second one flips into a transverse position or goes into distress, mom could end up with a C-section after already delivering one baby vaginally.
11 More Weight Gain
This may be obvious, but the more babies in the womb, the more weight gain is necessary. Mom won’t be eating for two. She’ll be eating for three, four, or five, and it’s important for her to keep up her caloric intake for the sake of her babies.
Since there is a good chance the babies will be born early since that happens often with multiples, doctors will encourage women carrying multiples to gain weight quickly. By halfway through the pregnancy, doctors want to see the number on the scale skyrocketing, because the more weight mom gains, the better chance her kids have if they come early. They need fat, and mom provides it.
It may sound great to have a doctor say “Go eat!”, but there is one complication. Mom is carrying more than one child meaning her internal organs are smashing together like never before. No matter how much mom knows she needs to eat, it’s not easy with kids inside giving mom the feeling that her intestines are being crammed into her backbone.
That’s why it’s important to drink shakes or anything else that packs calories but doesn’t require mom to create room in her stomach that doesn’t currently exist.
Mom should also know that all this extra weight is going to make her pregnancy even more uncomfortable. Sorry. Do it for the babies!
10 Swelling Everywhere
Swelling during pregnancy, also called edema, is common. Over half of all pregnant women experience the condition. However, if mom is pregnant with multiples, there’s an almost 100% chance she is going to struggle with swelling during her pregnancy.
The causes of edema are not completely understood, but it’s believed that the hormones estrogen and progesterone play a role. Hormone changes coupled with blood moving back to the heart slower because the vena cava is under pressure causes excess fluid retention. The fluid basically leaks from veins to tissues and causes swelling in the feet and ankles.
If mom happens to be pregnant with twins in summer, the news is even worse. Hot weather does not help with edema, and women carrying multiples during the hottest months of the year may feel like a balloon that is about to burst.
Edema should go away after the babies arrive, but if mom’s swelling becomes excessive, she needs to let her doctor know.
9 Worse Morning Sickness
The term morning sickness is a misnomer if there ever was one, but whatever mom wants to call it, if she’s carrying multiples she should plan to have a lot of it.
The nausea and vomiting associated with the first trimester of pregnancy is caused by a high level of human chorionic gonadotropin(HCG). Most women are elated when they hear their HCG level is high because that’s a good sign for the pregnancy, and that’s why many women are congratulated for being as sick as dogs the first trimester.
Tons of nausea is thought to equal a healthy baby, and while that is excellent news, two or more very healthy babies means mom may never leave the bathroom.
The silver lining is that just like in singleton pregnancies, morning sickness during a pregnancy with multiples should end somewhere around the beginning of the second trimester. If mom gets to the point where she can’t consume any food or fears she’s becoming dehydrated, she needs to talk to her doctor.
There are some natural remedies he can recommend, or he may just prescribe mom a safe anti-nausea medication to get her through the first trimester.
8 Doctors’ Appointments 24/7
Every mom feels like she is at her OBs office all the time when pregnant. What’s different when mom is pregnant with multiples is that she doesn’t just feel that way; she really is at a doctor’s office around the clock.
Since pregnancies with multiples are considered high-risk, doctors don’t take chances. Most women will have their primary OB, then they will also be referred to a high-risk specialist who will perform extra ultrasounds in between their visits with their OB. By the third trimester, mom will be begging to just set up a cot at both offices so she can rest in between appointments.
This is a necessary part of a pregnancy with multiples. Conditions like twin-to-twin transfusion syndrome can only be treated if they are found, and that’s why constant monitoring is necessary. Small issues can turn big quickly when mom is housing more than one child in the womb, so doctors try to stay on top of every little detail throughout the pregnancy.
7 Likelihood Of NICU Time
The neonatal intensive care unit is a special area of the hospital set apart for babies who came into the world earlier than expected. Because of the amazing medical advances that have taken place in the last few decades, NICUs are able to help children born as early as the second trimester survive until their little bodies can hold up on their own.
Because multiples are often born early, it’s likely that mom and dad will spend some time visiting their children in the NICU. If twins develop TTTS and have to be delivered early, the NICU is where they will stay so doctors can help with lung development, temperature stabilization, and any other problems that occurred because of the babies being born too early.
It’s a blessing to have NICUs, but having children who have to stay in one is a challenge. Parents won’t be able to take their babies home for a while, and it can be extremely stressful to continue living life when all mom can think about is her babies in the hospital. It’s all worth it to ensure multiples get the best chance at survival possible, but NICU time is a very difficult season of life.
6 Higher Levels Of Discomfort
Being pregnant is beautiful, but it is not always comfortable. As a child grows inside of mom’s body, mom starts to feel every kick and punch, and the weight of her child may cause her back pain.
Now imagine mom is pregnant with more than one child.
It’s true that moms who are pregnant with multiples are more likely to say they suffer from back pain, heartburn, and sleeping issues than moms carrying only one baby. It makes sense since moms of multiples gain more weight and have at least two little people kicking their bladder and smashing their internal organs.
Moms of multiples are also more likely to suffer from anemia, and the lack of oxygen going to the organs in the body will cause mom excessive fatigue and discomfort.
Just remember, research has shown that some moms of twins live longer than other women. Focus on that thought when dealing with the extremely high level of discomfort that comes with carrying more than one child.
5 Emotional Roller Coaster
Pregnancy is a time when mom’s hormones are all over the place. Due to changes in estrogen and progesterone levels, it’s normal for mom’s mood to be all over the place. As expected, this is even worse for moms carrying multiples.
Besides the hormonal issues, having twins can cause a certain amount of anxiety for mom, even if she is extremely excited about her babies. Carrying two or more babies means a riskier pregnancy, more physical changes, and more concerns about money and splitting time between more than one child. Taken all together, mom may not know when she is going to laugh or when she is going to cry.
It’s important for mom to realize she is stressed so she can figure out how to try to stay calm. Stress can have negative effects on mom and her babies, so prenatal yoga or pregnancy massages may help her calm down. Even just taking walks or discussing her feelings with someone else can help mom keep her emotions in check while she is pregnant.
4 People Will Make Comments
For whatever reason, some people now believe it is acceptable to predict a woman’s due date by simply looking at her stomach. Just for the record, it is not. A mom carrying multiples will probably experience this when a stranger says she looks like she is about to pop and she has to inform this person that she is only 18 weeks along, with more than one child.
It’s really hard to live in the world with inconsiderate people while carrying multiples. Though mom doesn’t owe anyone an explanation, she will oftentimes find herself correcting misconceptions just to give herself peace of mind. Unfortunately, constantly having to talk to strangers about the size of her body or how many children she is carrying causes as much stress as it does peace of mind.
Mom should feel free to tell people that her pregnancy is not public domain and she would rather not comment on her size, appearance, or due date. Sure, some people won’t take kindly to this, but that is not mom’s problem. Besides, it’s good for some people to be put in their place before a truly hormonal mom smacks them.
3 Labor Is Different
While it’s true that many multiple deliveries end in C-sections, even women who are able to birth vaginally usually have a different experience than women birthing a singleton.
For one thing, stage two of labor, the pushing phase, is generally longer for moms carrying twins. Since this stage can be extremely painful and exhausting, it’s not exactly good news that it’s going to take a while. Mom will also likely have to wear two fetal heart rate monitors during labor, and that seriously impedes her ability to move around.
However, she probably won’t be able to move because of an epidural. While women can birth twins naturally (I’m talking about twins because moms carrying more than two babies are usually not given the option of a vaginal birth) doctors usually recommend an epidural in case of an emergency. For instance, if the first twin comes out just fine but the second twin goes into to distress or turns to a transverse position, doctors may need to move quickly to perform a C-section. Having an epidural in place makes that possible.
No matter how mom brings her babies into the world, she rocks for getting them here. It’s just important for her to know that her labor experience will likely look different if she is carrying more than one baby.
2 Mom Needs More Calories For Breastfeeding
Just like mom needs more calories to support a pregnancy with multiples, she will need more calories to breastfeed them. The problem is once the babies are out, mom has to care for them which makes consuming food very difficult.
Though not every mom of multiples wants to take on the task of breastfeeding more than one child, many do, and they need to know going in that keeping up the proper amount of calories can be a challenge. To produce enough milk, mom needs to make sure she has enough nutrients, and for some women that means using an app to track how much she eats to make sure the calories are adding up.
Yes, this sounds like a dream problem to have, but it is difficult to sit down and eat a proper meal when trying to take care of babies. Mom should make sure she has snacks near her nursing chair and that she consumes water constantly.
1 Fear Is An Issue
Moms may have noticed by this point that a pregnancy with multiples is vastly different than a singleton affair. It’s true that risks are higher, and that awareness coupled with the constant doctor’s appointments can leave mom in a state of fear that prohibits her from actually enjoying her pregnancy.
Besides concerns about the actual pregnancy, mom may worry that she won’t be able to handle more than one child when they arrive. She may fear exhaustion or not being able to recover while taking care of babies.
These fears are valid, but mom has to face them head on so they don’t own her. Lining up help for when the babies arrive is a good idea, as is discussing her fears with her partner or friends. Sometimes fears left to fester in our minds become larger than they really are, and an outside perspective can help us view them more realistically.
Multiples are miracles, and so is the mom who carries them. Despite all of the risks, having twins or more is the adventure of a lifetime.