Pregnancy - Expecting Twins or More

If you are pregnant and expecting twins or multiple babies, you are in for quite a journey over the next nine months and beyond. Though this is an exciting time for any mother you are also likely to have many concerns and questions that you would like to ask your doctor or midwife. Many people have twins, triplets or even quads, and it can often be a special and hectic time for mothers trying to plan for their babies and deal with the pregnancy hormone overload due to having more than one baby.

Twins

When a pregnant mother is diagnosed as having two babies this means she is expecting twins. People often get excited with the thought of having more than one baby, but some mothers can feel nervous about being able to cope with more than one baby. Twins are often delivered earlier, and it is still possible in many cases to have a natural birth.

Triplets

Triplets define a pregnancy where the mother is expecting three babies. Although quite rare many pregnant mothers around the world have conceived triplets. Often triplets are born earlier or by caesarean section to ensure the babies are delivered safely and quickly for the benefit of mother and babies.

Quads

Quads are very rare and this is when a pregnant woman is expecting four babies. Pregnant women expecting quads may have previously had IVF, as IVF increases the chances of multiple births. Quads may be delivered by caesarean section as it provides optimum safety for the pregnant mother and babies.

How are multiple babies conceived?

There are a number of ways in which multiple babies can be conceived, as described below:

• A single egg is released and splits into two resulting in identical twins. This process can occur with or without fertility treatment and there is a good chance that a fertile woman can get pregnant with identical twins naturally.
• When multiple eggs are released and there is two ovulation periods there is a chance that one or more eggs will become fertilised.
• IVF normally involves three or more fertilised eggs being placed into the uterus. The fertilised eggs may all implant, or one or two may implant. There is an increased chance of multiple babies following IVF treatment due to the number of fertilised eggs placed in the uterus.
• Multiple babies may have individual amniotic sacs and implantation locations, and it is important that this information is found out at your hospital check up.

How do I know if I am having more than one baby?

At your 12 week antenatal appointment the midwife or doctor will assess your tummy and may be able to feel if there is more than one baby present. If a doctor or midwife suspects that you are expecting twins or more, an ultrasound scan will be arranged to confirm how many babies are present. Your dating scan will also show how many babies you are carrying and this is often an exciting time for pregnant mothers and couples.

The doctor or midwife will check for the heartbeat of the baby and will be able to establish if they hear more than one heartbeat. Sometimes the doctor might hear multiple heartbeats; however, it may not be that you are expecting multiple babies but the ultrasound will be able to confirm this.

Some women have reported to having felt bigger and knowing that they are carrying more than one baby. This may also be ascertained by expectant mothers due to increased appetite and symptoms of pregnancy compared to prior experiences. However, a multiple pregnancy cannot be determined due to severe pregnancy symptoms, as pregnant mothers can suffer from severe symptoms without having a multiple birth.

Women often notice a more substantial growth in the area of their uterus if they are carrying more than one baby. Also, many pregnant mothers expecting multiple babies tend to show their pregnancy ‘bump’ earlier than those in normal pregnancies. HCG levels are more prominent and can often be identified earlier with multiple pregnancies due to the increased level of HCG present as the pregnancy progresses.

What is the different between having a multiple pregnancy and a normal one?

There is no significant difference between the treatments you receive when having multiple pregnancies; however, you may require more specialised care. Multiple pregnancies may be considered high risk as the babies are more susceptible to needing a caesarean section.

You may need to increase your intake of protein enriched foods and ensure that you follow a healthy maintained diet. Your food cravings may be increased as you need extra food to ensure that you are energised and have enough nutrients.

Many pregnant women expecting multiple babies have regular checkups with their doctor or midwife to ensure that the babies are monitored effectively. There may be more prenatal tests required, including blood tests and ultrasounds to check the position of the babies and their overall wellbeing.

There may be higher risk when exercising and you would be best advised to consult your doctor on which exercises would be best when you are expecting multiple babies. Many pregnant women feel exhausted and tired even if they are expecting one baby so when you are expecting more than one you are inevitably going to feel more tired after a short period of exercise. Your doctor may give you light foot exercises and other gentle exercises which aid in preparing your body for labour.

What questions should I ask my doctor about multiple births?

The following list of questions is a good start if you are expecting twins or more:

How much weight will I gain during pregnancy?

Pregnant women expecting multiples will inevitably put on more weight and it is a good sign if you put on the expected amount of weight while pregnant. A healthy balanced diet can aid in maintaining an ideal weight for the pregnancy and birth; however, pregnant women should remember that the most important thing is the health of the babies. The weight may very well slip off quickly after birth.

What is the typical gestation for multiple pregnancies?

The period of gestation when having a multiple pregnancy varies according to the pregnant woman’s medical history and individual circumstances. On average twins and multiple babies are born earlier, either prematurely or at an earlier time than their given due date. There is no particular method of finding out the due date of when your baby will be born; however, an EDD (estimated due date) will be given by your doctor.

Should I attend an antenatal class on multiple births?

It is always worth taking antenatal classes whether you are expecting one, two or three babies. Antenatal classes can be as being a refresher for second time mothers or can give information to new mothers. It may be a daunting experience if you are a first time mother expecting multiple babies but help is always at hand and your local hospital may be able to offer you some free antenatal classes.

If my babies are born prematurely what will happen?

If your babies are born prematurely they may be taken to a Neonatal Intensive Care Unit (NICU) which is a special area of the hospital for babies born prematurely. The NICU provides intensive care for the babies where they are monitored closely to identify any problems and ensure that their wellbeing is maintained. Many multiple babies spend the first few days or weeks in the NICU before they are ready to go home, as they need to strengthen and learn the skills to survive in the outside world. Some premature babies are too tiny and need special care and assistance to be ready to go home. The hospital will be able to further advise you on the NICU and its services for premature multiple babies.

How do I know if my babies are identical or non identical?

Often mothers who want to know if their babies are identical find it difficult as there is no sure guarantee to see whether the babies are identical or not. Determining whether the babies are identical may be possible through a DNA test.