Finding out you’re pregnant with twins

If you have very early and noticeable pregnancy symptoms like tiredness, emotional ups and downs, nausea and vomiting, or constipation, you might wonder whether you’re having twins.

You might also suspect you’re having twins if you had fertility treatment – especially if you had more than one embryo transferred – or used fertility drugs to help with getting 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 11-13 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.

Pregnant with twins: antenatal care and birth options

A twin pregnancy can be more complicated than a single pregnancy, so health professionals usually recommend specialist antenatal care. Specialist antenatal care usually involves seeing an obstetrician and a midwife in a complex pregnancy clinic or a hospital twins clinic.

Specialist antenatal checks can pick up any complications early, which means they can be treated early too.

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

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 a lot 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 4 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. It’s generally recommended that you have ultrasounds about every 2 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 reduce the risk of complications – or stop them from getting worse – by going to your antenatal appointments. At these appointments it’s important to tell your midwife or doctor if you have any physical symptoms or you feel that something is wrong.

Pregnancy health problems can be both physical and emotional. If you have emotional changes that last longer than 2 weeks or that get in the way of your daily life, it could be a sign of antenatal depression, antenatal anxiety or another mental health condition. 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.

Physical changes during a twin pregnancy

Physical changes with a twin pregnancy are more obvious than with a single pregnancy.

If you’re pregnant with twins, your weight gain during pregnancy might be 16-20 kg, compared to up to 16 kg with a single pregnancy. Also, stretch marks, bloating, varicose veins and haemorrhoids are common. These changes might affect the way you feel about your body.

You can talk with your midwife or doctor 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 involves a healthy, well-balanced diet, full of vitamins and minerals.

When you’re pregnant with twins, your midwife or doctor 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.

Health professionals might say the pregnancy can go longer than 38 weeks if both babies are well 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 for twins?

It’s good to talk with your midwife or doctor about whether vaginal birth 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 midwife or doctor the most appropriate time and ‘way’ to give birth to your twins.

Preparing for raising twins

Raising twins can be both rewarding and challenging. Here are ways to get ready for parenting twins:

• Work on communication with your partner, if you have one. Communication is an essential part of 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 whether there are classes specifically for expectant parents of twins.
• Read about support for parents. Seeking and accepting support is good for you and your children.
• 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.