Recently I was having a chat with a twin mama-to-be and we were talking about how pregnancy is different when you have two buns in the oven (or more). Surprisingly there isn’t much information around about what a twin mum should expect with her pregnancy or how it’s different to a pregnancy with one baby. So I thought I’d fill the gap in the market and tell you EXACTLY what to expect with twins during pregnancy.
The early days
When you first conceive twins (I’ll write twins from here on out, but it is interchangeable to triplets if you are so endowed) the early days will be HARD. Due to the double embryo situation, you will be producing double the amount of hCG (human chorionic gonadotrophin) – the pregnancy hormone.
This means you may well suffer from pregnancy sickness earlier than if it were a single pregnancy. Many women with twins get Hyperemesis Gravidarum. or HG for short, a very severe type of pregnancy sickness whereby you won’t be able to keep anything down. In fact, if a woman is admitted to hospital with HG, they almost always do an early scan to see if it is a twin pregnancy.
If you are suffering, then it can be really hard to keep your pregnancy quiet before the 12-week mark and if you’re suffering earlier, it may be a secret that’s harder to keep and for longer.
Along with the delights of sickness, your breasts will possibly feel the most tender they’ve ever felt, you may be on a hormonal rollercoaster and your partner/family may think you’ve turned into the devil. Alternatively, you may have the appetite of a bear and feel like your trousers are getting tighter much earlier than you were expecting. The pregnancy bloating and water retention will be increased for a multiple pregnancy as well.
Your dating scan
If you manage to get to your first scan between 9-13 weeks and weren’t already aware you were carrying a brood, then this would be the point you would find out. And that is a shock. If you’re finding yourself here after your first scan then I’ll give you a high five, have you managed to dodge the vomit-bullet? Let me know in the comments below.
Just because you may not have realised you were having twins, many feel that it “all makes sense” when they get told at their first dating scan, perhaps there was an inkling that there was more than one?
If you opted for screening tests at your scan, you would need to have further information about the risks of the test on a multiple pregnancy. Now I don’t mean that the scan and blood test would endanger your pregnancy, but what you would do with the information that one pregnancy was high risk for chromosomal abnormalities and the other is a normal/low risk? Would you have an invasive diagnostic test and risk the low-risk pregnancy? It’s unlikely but something you may have to think about.
The second trimester
As you finish the 13th week and leap into your second trimester, most, if not all, women know they are expecting twins at this point. At this point, your bump may be growing faster than you expected and you’ll probably have let the cat out of the bag that you’re pregnant with two. You’ll have also been referred to a consultant obstetrician who will cast a watchful eye as your pregnancy progresses. You may well be feeling sick still as the hormones will be sky high, but as your second trimester passes the sickness will start to wane for most women.
During the second trimester, there will be extra scans along the way. Your anomaly scan at 20 weeks will be longer as the sonographer will have to check both babies and their growth and health will be closely monitored as the weeks progress.
As you move through the weeks you may notice that your bump grows massively, your legs and hands start to swell and you may struggle with work. Twin mamas very often finish work earlier as growing two can take a toll on your body. You are more likely to experience sciatica, pelvic girdle pain, and heartburn. Sorry, it’s hardly glamorous, is it?
The third trimester
As you sail into the final stretch, your obstetrician will be keeping a closer eye on the growth of the babies and your health. You are more likely to suffer from pre-eclampsia so your blood pressure will be closely monitored. Expect you will be very busy with appointments left right and centre in the last 13/14 weeks so don’t plan anything too exciting.
You will also be having a discussion with your doctor about the method the babies will be delivered. There is no preferred way to deliver multiple babies, but there will be recommendations made based on your history. You, unfortunately, are more likely to have a caesarean overall, but it isn’t a definite, in fact, the first delivery I ever witnessed was a vaginal birth of twins.
You may be having heartburn that keeps you awake all night, aside from the insane pregnancy insomnia you’ll be experiencing. If that isn’t keeping you awake, then you’ll lie awake worrying about how they’ll both come out. You may struggle to walk far and will possibly be the size of a house.
If you are labouring naturally, then you will be closely monitored during the process, if you are having a caesarean, then the date will be booked for you to go in and give birth. Should you labour naturally, then don’t expect two full labours, you will dilate to 10cm as with a single pregnancy but the injection to help deliver your placenta will not be given until the second baby is born (if you choose to have it), the second baby is usually born from 5 minutes to 1 hour after the first.
The theatre team will be on standby to take you in, should a complication develop at any point and an obstetrician and paediatrician may be in the room as you give birth for “back up”. You are, unfortunately, more likely to suffer from post-partum haemorrhage, so a drip may be set up in case they need to use it. You don’t have to have an epidural to have twins vaginally, pain relief is exactly the same as with one, so have a look at your options before you go in.
After the birth
The little bundles of joy will need the routine checks that all babies need a hearing screen and physical check, but they will most likely share a cot. Don’t forget to keep their leg bands on to tell which is which.
After that it is exactly the same as being a mum of one… but with double poo, double feeds and double crying. If you’ve got this far then you’ll be fine.
Good luck mama, you got this (x2).
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