Pregnant with twins

Pregnant with twins

Finding out you're pregnant with twins

If you have very early and noticeable pregnancy symptoms like nausea or vomiting, you might wonder whether you're having twins.

You might also suspect you're having twins if you've had fertility treatment - especially if you had more than one embryo transferred, or if you used certain fertility drugs to help get pregnant.

The only definite way to find out whether you're having twins or other multiples is to have an ultrasound scan.

The best time to have this ultrasound is at 10-12 weeks of pregnancy. This is usually when your health professional can say for sure how many fetuses, placentas and amniotic sacs there are. This information can tell you whether you have identical or fraternal twins. And the information also helps your health professionals recommend the right pregnancy care for you.

You can't rely on hormone tests to find out whether you're pregnant with twins.

Pregnant with twins: antenatal care and birth options

Because a twin pregnancy can be more complicated than a single pregnancy, health professionals usually recommend specialist antenatal care, rather than shared care or midwife-only care. If you have any complications, specialist checks can pick them up early, which means they can be treated early.

You might be advised to see an obstetrician. Obstetricians are skilled and experienced in providing antenatal care for twin pregnancies.

Also, health professionals will usually recommend that you give birth in a hospital, rather than in a birth centre or at home. Hospitals have the facilities needed to manage any complications of a twin pregnancy, like premature birth.

Find out about antenatal care and carers, as well as birth settings, with our award-winning Birth Choices interactive guide.

Tests, checks and appointments during twin pregnancy

If you're pregnant with twins, you'll need a higher level of care, which means more appointments and tests during your pregnancy.

You probably won't need lots of extra blood tests, but you will need more ultrasounds.

If you have twins with separate placentas, it's generally recommended that you have ultrasounds at 12-13 weeks, 20 weeks, and then every four weeks until your babies are born. You might have more frequent ultrasounds than this.

A twin pregnancy with babies sharing one placenta might be more complicated, so it's generally recommended that you have ultrasounds about every two weeks from 12 weeks.

If you're pregnant with twins, you'll have more frequent antenatal appointments. Antenatal appointments are a good chance to get health and lifestyle support if you need it. You can also get information about pregnancy, labour, birth and early parenting.

Potential health complications in a twin pregnancy

Women with twin pregnancies are more likely to have pregnancy health problems and complications like gestational diabetes, pre-eclampsia, premature labour and bleeding.

Twins who share a placenta might have extra complications. Sometimes their blood supply is shared unequally, which can cause health problems for both twins. Or if the placenta itself is shared unequally, this can mean that one twin doesn't get enough nutrients and doesn't grow as well.

You can't stop some of these complications from happening. But you can reduce your risk of having them - or stop them from getting worse - by going to your antenatal appointments and telling your obstetrician, doctor or midwife if you have any physical symptoms or you feel that something is wrong.

Not all pregnancy health problems are physical. If you have emotional changes that last longer than two weeks or that get in the way of your daily life, it could be a sign of depression or another problem. Talk with your midwife or doctor about any emotional changes. You can also call Lifeline on 131 114, Beyond Blue on 1300 224 636 or PANDA on 1300 726 306.

Twin pregnancy symptoms and body changes

Many women who are expecting twins find that they have quite noticeable and very early pregnancy symptoms, including tiredness, emotional ups and downs, nausea, vomiting and constipation.

Also, body changes with a twin pregnancy are much more obvious than with a single pregnancy.

If you're pregnant with twins, you might gain 16-20 kg (compared to 10-15 kg with a single pregnancy). Unfortunately, stretch marks, bloating, varicose veins and haemorrhoids are all more common in a twin pregnancy. These changes might affect the way you feel about your body.

You can talk with your doctor or midwife about the changes in your body and how you feel about these changes.

Keep up to date with the changes in your body and your babies' development with our week-by-week pregnancy emails.

Healthy eating and twin pregnancy

Healthy eating in pregnancy is about a healthy, well-balanced diet, full of vitamins and minerals.

When you're pregnant with twins, your doctor or midwife might recommend that you get expert advice about your dietary intake of protein, carbohydrates, folate, iron, calcium, iodine, fats and overall nutrients. Dietitians have qualifications and skills to give you expert nutrition and dietary advice.

Will your twins be born early?

Health professionals usually aim for twins to be born at 37-38 weeks unless problems develop earlier or there's a good reason to delay birth.

About 60% of twins are born before 37 weeks, while single babies are born at around 40 weeks.

If you know your twins will be born early, you can get ready for premature birth.

Vaginal or caesarean birth

It's good to talk with your obstetrician and midwife about your health and your babies' health and whether vaginal or caesarean birth will be better for you and your twins.

If you're having twins, you're almost twice as likely to have a caesarean birth.

You can discuss with your obstetrician the most appropriate time and 'way' for you to give birth to your twins.

Preparing for parenting twins

Parenting twins can be very rewarding, and very challenging at times too. Here are ways to get ready for parenting twins:

  • Communication with your partner is an essential part of continuing a healthy relationship. Pregnancy is a great time to discuss and share your thoughts and expectations for the future. You might like to watch our video on relationships in pregnancy and early parenting and read about pregnancy and healthy relationships.
  • Look at our resources on breastfeeding. You can breastfeed your twins, and it's good for you and your babies. You can ask for help from a lactation consultant or your midwife. You can also ask your birth hospital if there are classes specifically for expectant parents of twins.
  • Read about services and support. As parents of twins, you and your partner will find that life is very busy, so it'll help to have support from family and friends.
  • Enrol with the Australian Multiple Birth Association (AMBA). The AMBA offers a range of support services and links to other services for new parents of twins. You might also like to register your twins with Twins Research Australia.