If you are having twins, or multiple births, you may have different needs than a single-birth pregnancy.
What are the different types of twins?
Fraternal (non-identical) twins and multiples occur when two (or more) separate eggs are fertilized by two (or more) different sperm (one sperm per egg). This means the twins do not share the same DNA and will not be identical. They can be of the same or opposite sex. Each baby will typically have their own placenta and amniotic sac.
Identical twins occur when a fertilized egg splits and develops into two (or more) fetuses. They are genetically identical – they will have the same sex and share physical traits and characteristics. Rarely, identical twins will fail to completely separate and be born as conjoined twins. Identical twins can share a placenta and an amniotic sac or they might share a placenta but each have a separate sac.
Triplets and higher multiples can be identical, fraternal or a combination of both!
What to do if I’m having twins?
During a multiple pregnancy you can expect more pregnancy related symptoms including nausea & vomiting, heartburn, fatigue, varicose veins.
If you are having twins you will need more frequent checkups. This will be used to track your babies’ growth and development and monitor your own health. You will be watched closely for signs of preterm labour which is more common in multiple births. You may be sent for more frequent ultrasounds and other tests, especially as the pregnancy progresses.
You should be prepared for an earlier delivery. If you don’t then you should expect to have your birth planned before your due date either by an induction of labour or by caesarean section. The timing of birth will depend on the type of twins and any other associated pregnancy complications.
Complications with multiple births
If you are having multiples you need to be aware of the possible complications. This is so you can be prepared and seek medical attention if needed. Just because you are having twins (or more) does not mean you will experience these complications – healthy multiples are born every day.
During pregnancy you have an increased risk of gestational diabetes. An endocrinologist will help you manage your blood sugar levels during pregnancy. You are also more likely to develop high blood pressure. In identical twins, where they are sharing a placenta, a twin-twin transfusion may occur where one baby receives too much blood and the other too little. This is a serious complication and will need to be closely monitored by special ultrasounds performed by specialists.
Twins may be born early. This may result in complications including breathing difficulties, vision problems, infection and jaundice amongst others depending on how early they are born.
Postpartum care of twins
You may need more rest and support than you have anticipated with twins. This is especially the case the babies were born prematurely or need special medical care.
Frequently asked questions about twin pregnancies
Why do twin pregnancies occur?
Twin or triplet pregnancies may occur randomly by chance. In other cases they occur due to specific factors such as being older (as hormonal changes cause multiple eggs to be released) or due to the use of assisted reproductive technologies ( Such as IVF). The latter also increases the risk that you have triplets or higher multiples. There can be a family history of twins and higher order births.
How will I know if I am having twins?
Twin or higher multiples are discovered on an ultrasound. Having an early ultrasound, prior to 12 weeks will identify the type of twin pregnancy( identical or non identical). Identical twin pregnancies need to be monitored more closely with frequent ultrasound scans than non identical twin pregnancies as they could have more complications due to sharing of placenta.
Will my twins be early?
The more babies that you are carrying the more likely you are to have a premature birth and not carry them to term.
If you have signs of preterm labour you would need to be carefully assessed in the hospital and you may need to be admitted and given steroid medications to speed up the development of your babies’ lungs.
This gives them the best chance if they are born early.
Depending on how preterm the labour is, you may need to be transferred to a hospital with adequate nursery support for preterm babies.
Do I need a C-Section if I am having twins?
Vaginal delivery is still possible for twins. If you go into labour naturally and the first baby is in the correct (head-down) position you may be able to try and deliver vaginally. In some cases you may still need to have the second twin by a C-section if there were complications after the vaginal delivery of the first. If the first twin is not in the correct birthing position a C-section may be recommended. For higher order multiples a C-section is more common.
Depending on whether you have other complications, you may be induced earlier or have a scheduled C-Section during your third trimester.