Common Questions About Twin Pregnancy

Questions Twin Pregnancy

What are the odds that you might have twins? More than three in 100 women are pregnant with multiples—twins, triplets or more—each year. Multiple pregnancies differ from singleton pregnancies in multiple ways. Here are some common questions that moms expecting twins may ask.

Q: What kind of twin am I having?

A: Twins can be fraternal or identical. Fraternal twins are conceived when two sets of eggs are fertilized by two different sperm. Fraternal twins can both be girls, boys or a boy and a girl.

Identical twins are conceived when one egg is fertilized by one sperm and the fertilized egg splits to becomes two babies. Identical twins usually share a placenta and fraternal twins usually don’t, but there are exceptions. Because they share the same DNA, identical twins are usually the same sex, look alike and have similar characteristics. It’s possible for identical twins to be different sexes, but it’s very rare.

Q: Will I have to go to the doctor twice as often?

A: Mothers of twins can expect to see the doctor more often than those expecting a single baby. Not only is it necessary to monitor the babies’ development, but regular check-ups watch out any maternal health problems and check for signs of preterm labor. Carrying two babies may require more ultrasounds and tests.

Q: What are the complications associated with having twins?

A: There are some additional risks for mothers and babies during twin pregnancies. Women carrying twins may be more likely to develop gestational diabetes or problems with high blood pressure that can potentially lead to preeclampsia. When expecting twins mothers  may experience more pregnancy discomfort, including more back pain or trouble sleeping, and higher rates of anemia. A little spotting is not uncommon during a twin pregnancy but if spotting continues or is accompanied by cramps, always call your doctor.

Q: Will I be more likely to deliver early?

A: Yes. Carrying twins makes it more likely that labor will be preterm. Generally, moms who carry twins go into labor at 36 to 37 weeks, rather than completing the usual 40 weeks of pregnancy. Twins born prematurely may weigh less and face health problems. Sometimes moms of multiples are prescribed bed rest during the last weeks of pregnancy although there is no evidence that it’s effective in postponing the due date.

Q: Am I more likely to have a C-section?

A: The odds of a C-section increase during a twin pregnancy because there’s a higher likelihood of a baby being born in a breech position. Vaginal delivery is possible if the first baby is facing in the head-down position. Even so, after a vaginal delivery for the first twin, a C-section delivery might be required for the second twin.

Q: Are some women more likely to have twins?

A: Having twins does run in families but that’s only true for fraternal twins. Identical twins are a random event, prompted by the egg splitting in two. Age is also a factor. Twin pregnancies are more likely as you get older due to hormonal changes that encourage the release of multiple eggs at once. Reproductive technologies,  such as in vitro fertilization, also increase the odds of multiples.

Q: How much more weight should I gain?

A: It is advisable to gain more weight during a twin pregnancy, since more calories are needed to nourish and supply a healthy environment for two babies. The average recommended weight gain during a singleton pregnancy is around 25 pounds, but moms carrying twins are advised to gain 35 pounds or more. The recommended weight gain depends on how much the mom weighs to begin with. Women who are considered overweight or obese may have to gain less. Talk to your doctor about the best and most nutritious way to add those calories to your daily diet.

Some moms of twins experience worse morning sickness during the early months because of higher hormone levels. This can result in early weight loss.

Q: Will I need to take more vitamins?

A: Carrying twins may require taking more folic acid, which is helpful in preventing neural tube defects in the baby. Talk to your health care provider about the amount you need to take.

Q: What is vanishing twin syndrome?

A: Vanishing twin syndrome is a form of miscarriage that happens in a small percent of twin pregnancies. It’s called “vanishing” twin syndrome because the baby is not expelled, as happens during a miscarriage, but is gradually reabsorbed by the other twin or the mother. It can happen without any miscarriage symptoms, such as bleeding or cramps. Before ultrasounds a mother might never have known she was carrying two babies. Vanishing Twin Syndrome has become more common with the availability of in vitro fertilization.

Q: How should I prepare for the birth of my twins?

A: Caring for twins can be twice as exhausting as caring for a single newborn. It’s advisable to get organized early in your pregnancy. Stock up on basic equipment—twin strollers, two car seats, plenty of clothes that mix and match. Enlist help with feeding and baby care. Establish a routine as soon as possible. Try to keep both babies on the same feeding and sleeping schedule, so that you can also get some rest. Twins have been described as double trouble but also as a double blessing.

Joan MacDonald
Joan Vos MacDonald has written about health and fitness for newspapers, magazines and websites. She is a member of the National Association of Science Writers and the author of two books on health-related topics, "Tobacco and Nicotine Dangers," for young adults, and "High Fit Home," a design book about fitness and architecture. She lives in upstate New York near her children and grandchildren.

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