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What to expect with twins (or more)

Having more than one baby? Your pregnancy will be a bit riskier. But this information can help make sure you deliver your babies safely.

Is it a boy or a girl? Who will my baby look like? When will I feel the first kick?

In many ways, pregnancy is 40 weeks of surprises.

But some moms-to-be have more shocks than others. These are the moms who find out they're having not one baby, but two, three or even more.

Double your fun

With twins or more, your pregnancy is high-risk. Here's why. Compared with a woman who is having one baby, you're more apt to have:

  • High blood pressure.
  • Anemia.
  • Diabetes.
  • Your babies born too small or too early.

But here's what else you should know:

"Never before have women expecting multiples had a better chance of delivering their babies in good condition," says Barbara Luke, ScD, co-author of When You're Expecting Twins, Triplets, or Quads (HarperCollins, 2017).

A few things can reduce the risks. These include:

More monitoring. Your doctor will watch closely for any hint of trouble. That way, he or she can help quickly if a problem comes up.

Expect more tests. And you'll need prenatal checkups more often than a woman who's carrying one baby.

Be sure to tell your doctor right away if you have any warning signs of early labor. They include:

  • A vaginal discharge that is watery, bloody or heavier than usual.
  • Pressure in your lower belly or pelvis.
  • A constant, low, dull backache.
  • Regular or frequent contractions (even if they're painless).
  • Mild abdominal cramps, with or without diarrhea.
  • Your water breaking.

An extra eye on nutrition. Eating right is especially important when you're having more than one baby.

Eating enough healthy food will help your babies have a higher birth weight. Ask your doctor about the best diet and weight gain plan for you.

You also need to drink plenty of water. If you're dehydrated, you're more apt to have contractions. And that can lead to premature birth.

More rest. More babies means your body is working extra hard. Try to nap or rest daily. And don't be shy about asking for help with housework and other chores.

Also, ask your doctor if you should limit exercise or other activities.

Extra caution during delivery. Twins sometimes can be delivered vaginally. But they need to be in a head-down position.

Also, there is a greater risk of problems when twins arrive. So a pediatrician or neonatologist (a doctor specially trained to care for newborns) usually stands by.

Triplets and other multiples are almost always delivered by C-section.

Once your babies arrive

Having multiples brings extra joy. They also bring extra responsibility. Get advice from other parents of multiples. Visit the Multiples of America website.

Reviewed 12/12/2022

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