Pregnant with Twins

Reviewed by James Brann, MD
With identical twins, one egg becomes fertilized by one sperm, and then it splits soon thereafter, forming two embryos. An embryo is what a doctor calls a baby as it starts growing into a child. In the case of identical twins, all of their genes are the same. They’ll be the same gender and look the same. Having identical twins is less likely than giving birth to fraternal twins.

With fraternal twins, two different eggs become fertilized by two different sperm. This becomes two embryos, which each growing into a baby. In the case of fraternal twins, they’ll share only some of the same genes. They’ll share a birthday, but may be two boys, two girls, or one of each.

What makes me more likely to have twins?

Some women are more likely to have twins than others are. Factors include women that:
  • Take medicine to get pregnant
  • Are in their 30s or older
  • Are of a certain race - Black women more commonly have twins than white women or Asian women.
  • Go through “in vitro fertilization”, or IVF, to get pregnant
  • Have a history of twins in the family
While these factors may increase a woman’s chances of giving birth to fraternal twins, it won’t affect her chances of having identical twins.

Your doctor or midwife will be able to tell you if you’re having twins during an exam. If you’re having twins, you’ll likely have a larger uterus based on your due date. An ultrasound may also be used, taking sound waves to develop a picture of your body on the inside. This will show if more than one baby is in your womb.

What about special care?

Pregnant women who are having twins will need some special prenatal care. If you’re having twins, you’ll probably need to go to your doctor or midwife more often. You’ll also likely have more frequent ultrasounds checking on your babies and how they’re growing. Later in your pregnancy, you may also need some other tests.

What do moms with twins need to know?

Obviously, having twins is slightly different from just having one baby at a time. Your doctor or midwife will tell you how active to be, and how much weight they recommend you gain.

They’ll also talk to you concerning potential problems with twins. Most commonly, twins are born earlier than week 37 of pregnancy. That’s at least a full three weeks before you’re actually due. Your doctor will call your baby preterm or premature if your baby is born too early.

A preterm baby is typically smaller than full-term babies, and may need to stay in the hospital for a while. Preterm babies are also at an increased risk of medical problems, including breathing problems.

As for moms of twins, these pregnant women are at an increased risk of high blood pressure.

What about delivery?

How you deliver your babies depends on the position they are in while in your uterus, as well as your babies’ health and your health. If everyone is healthy and your first child is positioned head first, there’s a chance you could deliver vaginally. Otherwise, your doctor will need to use a C-section, a surgery to take your babies out.

Finding out if my babies are fraternal or identical

If you have two opposite sex babies, they are fraternal. If you have two babies that are the same sex, they can be either identical or fraternal.

With same sex babies, your doctor or midwife may be able to figure out if they’re identical by looking at your placenta. That’s the organ in your uterus that carries nutrients and oxygen to your baby, and carries waste away. Sometimes, though, you’ll only know whether your babies are identical if you do a blood test.

Can I breastfeed?

The answer is up to you. In most cases, women will make enough breast milk to feed both babies. If your twins end up being born too early, though, you may need to start pumping your milk and storing it until your babies can drink it.

You’ll probably need a lactation consultant, or a breastfeeding expert, to help you. They’ll be able to help you figure out the best way to breastfeed your babies, and help you come up with a feeding schedule.

What if I need help?

If you find yourself having trouble, don’t be afraid to ask for help. Twins can be extremely stressful and tiring. You’ll want to lean on some relatives or friends. You may also find it helpful if you join a twins support group. This gives you the opportunity to talk with other parents who are going through the same things.

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