Among the first questions a woman asks when she first discovers she’s pregnant is “am I pregnant with twins”. This is always a possibility until the doctor confirms that there is only one baby. Some women have higher chances of having twins, including those with fertility assistance, those who have had twins before, and those with twins in their families. Since some forms of fertility assistance are known to increase the chances of multiple births, most doctors will mention it very early during the consent and pre-conception assessment portions of fertility treatment.
Early Signs of Twin Pregnancy
1. Higher HCG Levels
Testing the HCG levels only requires a simple blood test, but not all women will automatically receive this blood test. In most cases, this test is only done if you have had a previous miscarriage or undergone fertility treatments. If you do get an HCG test done early in your pregnancy, and the levels are very high and doubling incredibly quickly, you may be pregnant with twins.
2. Excessive Morning Sickness
Some women will notice morning sickness at a very early stage in their twin pregnancy. Most women notice it around 6 to 8 weeks. If it starts affecting you severely earlier than this, around 4 weeks or so, this may indicate twins.
3. Being Larger for Date
A positive answer to “am I pregnant with twin” is measuring larger than normal for the gestational age. Women with multiple babies will expand more quickly as the fetuses need more room.
4. Early and Frequent Fetal Movement
Most women will notice the initial fetal movement during their first pregnancy at 18 to 20 weeks. If you notice fetal movement sooner than this and lot more often, it may indicate twins. It is also a sign of potential twins if you notice movements at extreme ends of your stomach, such as one very low following by another very high.
5. Family History
A family history of twins can also increase your chances of having them. This isn’t a fool proof method, but you should prepare for the possibility of twins if there is a family history of them.
6. Two Heartbeats
If your doctor hears two heartbeats using a fetal Doppler, then you have a definitively positive answer to “am I pregnant with twins”. It is possible to get a false reading, but most experts can tell for sure whether there are one or two heartbeats.
When Can I Find Out If I’m Pregnant with Twins?
The only sure way to confirm that you are having twins is via an ultrasound. Because of this, many women don’t know they are pregnant with twins until they have their first ultrasound scan at 10 to 13 weeks of pregnancy. Keep in mind, however, that if there are more babies, it becomes harder to tell how many there are.
In the cases of pregnancy complications like bleeding or a pregnancy following fertility treatment, your first ultrasound may be sooner, probably around 6 weeks. This will confirm the pregnancy. At this point, however, you may or may not notice both babies. In some cases, a woman will conceive twins, but only one develops, something known as vanishing twin syndrome.
Precautions for Twin Pregnancy
1. Take Extra Folic Acid
Some research has shown that women who are having twins need extra folic acid to prevent birth defects. Doctors suggest 1 milligram daily of folic acid for pregnancies with twins compared to 0.4 milligrams for those with only one bun in the oven. This can reduce the risk of spina bifida and other neural tube birth defects.
2. Do More Ultrasounds
If the answer to “am I pregnant with twins” is yes, expect to have more ultrasounds done. Your doctor will want to do these tests more frequently to check on growth.
3. Spotting May Be Common
Spotting during the first trimester can indicate a miscarriage. Miscarriages occur more frequently in women with twins, triplets, or quadruplets. As such, you should expect more spotting within your first trimester if you have twins. Don’t worry about a little bit of spotting, however, as it is completely normal and doesn’t necessarily indicate a miscarriage or other issue without active bleeding, passing clots, or cramping.
4. Expect More Weight Gain
You will gain more weight if you are pregnant with twins than a single baby. There are two babies along with additional amniotic fluid. Because of this, you will also need to consume more calories. Most pregnant women with one child gain about 25 pounds which increases to between 30 and 35 for twins.
5. Pay Attention to Gestational Diabetes and Preeclampsia
The risk of gestational diabetes is higher in pregnancies with twins. The greatest risk factors are needing a C-section and having larger babies. Because of this, gestational diabetes is more common, but has a lower morbidity. Keep in mind, however, that developing gestational diabetes increases your risk of later type 2 diabetes.
Preeclampsia also occurs more commonly in twin pregnancies. It includes protein within the urine, high blood pressure, and possible swelling of the hands, feet, and legs. It indicates the potential for eclampsia, which can be fatal.
6. Be Careful About Preterm Labor
While the average single pregnancy involves labor at 40 weeks, most moms of twins give birth at 36 or 37 weeks. You should not be too concerned if your twins are born following 34 weeks, although they will still be premature babies with certain risks. Because they are typically born earlier, twins tend to have lower birth weights which increase their risk of health problems. There isn’t an effective method of stopping preterm labor.
7. Prepare for C-Section Delivery
You are more likely to need a C-section if you are pregnant with twins. This is partly due to the increased chance of the babies being in a breech position which typically requires a C-section.