Having twins or other multiples? What to expect

July 30, 2021 | by Lourdes Juarez, MD
Categories: Healthy Driven Moms

You just got the big news: you’re pregnant — and with more than one baby!

Multiple births are more common than they used to be. Now, about one in 30 babies born in the U.S. is a twin. More frequent use of infertility treatments and assisted reproductive technology, like in vitro fertilization, has likely contributed to this increase.

If you’re having twins, they could be identical (from a single fertilized egg) or, more commonly, fraternal (from two separate eggs that are fertilized at the same time). Triplets, quadruplets and other multiples can be identical, fraternal or a combination of both.

Having twins or any other multiple presents special challenges for parents. First, find a physician and hospital with experience in multiples and high-risk pregnancies. Now, what can you expect?

  • More frequent prenatal care visits. Preeclampsia, gestational diabetes, placental and fetal growth problems are more likely with multiples. You may have more frequent prenatal care visits with your OB-GYN, including special tests and regular ultrasounds, so your doctor can monitor your pregnancy and track how your babies are growing.

  • Weight gain during pregnancy. Mothers carrying multiples are expected to gain more weight during pregnancy than mothers carrying a single baby. In general, you should consume about 300 additional calories a day for each baby. Try smaller, more frequent meals.

  • A healthy diet is important. During pregnancy, your growing babies will need certain nutrients. Your doctor may recommend increasing your calcium, folic acid and protein intake. Your doctor may also prescribe an iron supplement, as low red blood cell count is common in multiple pregnancies.

  • Exercise in moderation. Staying active during multiple pregnancy is important, but you may need to avoid strenuous exercise or avoid it altogether if problems arise. If your doctor permits, try about 30 minutes a day of low-impact exercise, such as swimming, prenatal yoga and walking.

  • A C-section may be needed. The chance of cesarean birth is higher with multiples. Sometimes twins can be delivered by vaginal birth, but a C-section may be needed to help keep the babies safe, and most triplets and other multiples are born by C-section. Discuss your delivery options with your doctor.

  • Preterm (or early) labor is a possibility. The most common complication of multiple pregnancy is preterm birth (before 37 weeks). A typical, single pregnancy lasts about 40 weeks, but a twin pregnancy often lasts between 35 to 37 weeks, with more than half of all twins born preterm. Triplets and other multiples are almost always born preterm.

  • A NICU may be needed. Preemies are usually placed in a NICU for special care after delivery. Find a hospital with a specialized NICU in case you go into labor early or if your babies need special care after they are born.

  • More frequent check-ups for your babies. Because they are often born early, twins and other multiples tend to be smaller or have growth problems compared to the average newborn. You may need to consult your child’s doctor more frequently once your babies arrive.

  • Be on the lookout for postpartum depression and anxiety. If you have intense feelings of sadness, anxiety or despair that keep you from normal activities, talk with your doctor about resources for support.

The first days, weeks and months are often the most difficult for parents of multiples. Your babies’ pediatrician or primary care physician can provide advice and strategies for how to cope with the special parenting challenges involved, including feedings and sleep. Here are some tips for raising multiples:

  1. Join a support group for parents of multiples. Being able to talk to other families and learning what worked for them can be very helpful. Search classes and support groups.
  2. Enlist help. Ask family, friends and neighbors for help with household chores and daily tasks.
  3. Treat your children as individuals. Even identical twins have individual personalities. It’s important to recognize your children as unique, separate individuals from the beginning.
  4. Support their differences. Try not to constantly compare your children or force them to do the same activities as they grow up.
  5. Begin separating them occasionally as early as possible. Twins often choose to play only with each other and are not always happy about being apart. Try to occasionally separate them and encourage them to play individually with other children.
  6. Spend one-on-one time with each of them so they get some individualized attention.
  7. Take care of yourself. Raising multiples can be much more physically and emotionally demanding than having one baby. Self-care is essential.

As your babies grow up, just remember to do what’s right and practical for your family.

At Edward-Elmhurst Health, our physicians are experienced in handling high-risk pregnancies and provide expert care, close to home. We’re also fully equipped to handle high-risk deliveries and care for newborns who require special attention, with Edward Hospital’s Level III Newborn Intensive Care Unit and Elmhurst Hospital’s Level IIe Special Care Nursery.

Need an OB-GYN? Edward-Elmhurst Health has hundreds of board-certified physicians to choose from. You can book online today.

Find a maternal fetal medicine specialist.

Learn more about pregnancy and baby services at Edward-Elmhurst Health.

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