Twin pregnancy tips

Twin pregnancies are considered high risk, requiring special care for moms and their babies.

Finding out you’re carrying twins can be exciting … and a little scary, too. Twin pregnancies are considered high risk, so you and your babies need special care and monitoring. Knowing what to expect with a twin pregnancy can reduce your anxiety and help you take good care of yourself and your twins. 

When you find out you’re expecting twins

“The most reliable time to determine whether a pregnancy involves twins is during the early first trimester, typically between 6 and 10 weeks,” said Dr. Justin Moore, perinatologist and maternal-fetal medicine specialist. “An ultrasound at this stage allows us to see each embryo and the separation between the twins.”

Types of twin pregnancies

The most common type is fraternal twins. These twins form when 2 different sperm fertilize 2 separate eggs. Each twin has its own placenta, which provides nutrients and oxygen, and its own protective amniotic fluid sac. “There is approximately a 15% chance that the twins will be identical, which means they will appear very similar and be the same sex,” Dr. Moore explained. “Otherwise, fraternal twins have the same genetic relationship as siblings born at different times. We typically monitor these pregnancies with a growth ultrasound every 4 weeks – and we usually plan delivery around 38 weeks.”

The next most common type is identical twins who share a placenta but have separate amniotic sacs. Sharing 1 placenta can sometimes cause complications, as approximately 15% of these pregnancies develop Twin to Twin Transfusion Syndrome (TTTS). “In TTTS, one baby receives too much fluid, while the other does not receive enough,” Dr. Moore said. “Therefore, these twins require ultrasounds every 2 weeks from 16 weeks until delivery that we usually plan for 37 weeks.”

Pregnancy and delivery risks

Twin pregnancies are associated with increased risks for you and your babies. For you, persistent high blood pressure – a condition called “preeclampsia” that can hurt kidney and liver function and cause blood-clotting issues – can happen during or after pregnancy. Women carrying twins are also more likely to have gestational diabetes and morning sickness.

For the twins, they are at risk of being smaller at birth and arriving early. “A full-term pregnancy is 40 weeks, but the average gestation of birth for twins is 35 weeks,” Dr. Moore said. “About 60% of twins arrive before 37 weeks and 20% before 34 weeks.”

When it comes to delivery, the Centers for Disease Control and Prevention states 75% of twin births in the United States are done via Cesarean section. “But vaginal delivery is generally considered safe for twin pregnancies if “baby A” – the one closest to delivery or lowest in the pelvis – is head down, making the head the presenting part,” Dr. Moore shared.

Dr. Justin Moore

Tips for a healthy pregnancy

Gaining the right amount of weight is important. “Talk to your health care provider about the amount of weight gain that’s right for you and your babies,” Dr. Moore recommended. “We’ll explain how many extra calories you’ll need each day and healthy ways to consume them.”

Find a good balance between rest and activity. Getting ample rest, especially in the second and third trimesters, can help you feel less tired. Staying active with light exercise can reduce stress and improve your quality of sleep.

Another way to reduce your stress is to prepare for your babies’ arrival. Buy two of essential items like cribs and car seats. Cook and freeze food, or ask your loved ones to prepare meals you can freeze. Pack your hospital bag early because of the likelihood the babies will arrive early. If you have other kids, find age-appropriate ways they can help you get ready for the twins.

“By taking good care of yourself, getting the checkups and tests you need, and relying on your support system, you’ll do all you can to help your twins get off to a strong start,” Dr. Moore said. “And never lose sight of the fact that what you’re doing – carrying and nurturing 2 babies – is incredible.”