Multiple Pregnancy

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KEY POINTS

• Multiple pregnancy is a pregnancy with more than 1 baby such as with twins and triplets.
• The earlier you and your healthcare provider know that you are having more than 1 baby, the better it is for you and the babies. You and your healthcare provider will talk about what you can do to lower the risks for your babies.
• Keep all appointments with your healthcare provider for your prenatal checkups and tests. Talk to your provider about any concerns or problems you have.

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What is multiple pregnancy?

Multiple pregnancy is a pregnancy with more than 1 baby. Twins and triplets are examples of a multiple pregnancy.

How can I know if I’m having more than 1 baby?

Your healthcare provider may suspect or know that there is more than 1 baby if:

• Your uterus seems larger than expected for your stage of pregnancy
• Your provider hears more than 1 heartbeat
• An ultrasound shows more than 1 baby

What problems are more likely during pregnancy?

Problems that are more likely if you are pregnant with more than 1 baby include:

• Your water may break early, or you may go into early (premature) labor.
• You are more likely to have anemia (not enough red blood cells), high blood pressure, preeclampsia, or diabetes during pregnancy. Preeclampsia means that you develop high blood pressure and have more than the usual amount of protein in your urine. It can cause serious problems for you and your baby.
• You may have blood clotting problems or a blood clot in your lungs.
• There is a greater risk that the placenta will separate from the wall of the uterus before birth, or that the placenta will cover the opening to the birth canal. (The placenta is the tissue that carries oxygen and food from your blood to the baby’s blood.)
• You may have a lot of nausea, vomiting, or other digestive problems during pregnancy.
• You may bleed more than normal after birth.

What problems might the babies have?

There is a greater chance your babies will be born early (preterm) and will be small. More than half of twin pregnancies are born early, and most triplets and quadruplets are born early. Other examples of possible problems for the babies are:

• Problems with the umbilical cords, amniotic sacs, or placentas
• Birth defects
• Increased risk of stillbirth
• Anemia, which may mean the babies will need a blood transfusion after birth
• Complications if they are born too early

Do I need special treatment if I am pregnant with more than 1 baby?

Yes, the earlier you and your healthcare provider know that you are having more than 1 baby, the better it is for you and the babies. You and your healthcare provider will talk about what you can do to lower the risks for your babies. You will see your healthcare provider more often than if you were having just 1 baby.

After 5 to 6 months of pregnancy you may need more bed rest and less activity. During the last 3 months, you may need more tests to check the growth and health of the babies.

You may be admitted to the hospital right away if you have early contractions or other problems. If problems with the pregnancy get severe, your babies may need to be delivered early.

There is a greater chance that 1 or more of the babies will need delivery by C-section (an operation that delivers your baby through a cut in your belly and uterus). In some cases the first baby is born vaginally but the next baby by C-section.

How can I take care of myself?

Here are some things you can do to take good care of yourself during your pregnancy and prepare for the birth of your babies:

• Keep all appointments with your healthcare provider for your prenatal checkups and tests. Talk to your provider about any concerns or problems you have.
• Eat a healthy diet and ask your provider about foods you should avoid. Ask your healthcare provider about more food for the extra calories every day.
• Drink plenty of water each day.
• Follow your provider’s instructions about exercise.
• Do not smoke, drink alcohol, or take illegal or recreational drugs.
• Talk to your healthcare provider before you take any medicine, including prescription and nonprescription medicines, supplements, or natural remedies. Some medicines are not safe during pregnancy. Take prenatal vitamins and medicines as recommended by your provider.
• Relax by taking breaks from work or chores.
• Learn more about pregnancy, labor, and delivery. Read books, watch videos, go to a childbirth class, and talk with experienced moms.