For many moms, finding out you are having a baby can be the most wonderful and possibly terrifying moment of your life. Those feelings multiply when they tell you that there’s more than one heartbeat on your first sonogram. If you don’t have any twins or triplets in your immediate family, this may come as a complete shock to you. Let’s discuss multiple gestation in-depth to answer the most commonly asked questions about this special kind of pregnancy.

First things first, multiple gestation is a term used to describe a pregnancy with more than one baby. It covers pregnancies with twins, triplets, quadruplets, or more. 

Maybe you are reading about it because multiple pregnancies run in your family, or perhaps you are currently experiencing a multiple pregnancy. 

No matter what your situation is, we’re here with all the information you need. Keep reading to find out more about multiple gestation, from how it happens to how likely it is to happen to you. We also have some great tips on how to cope with a multiple pregnancy, and how to stay healthy (and sane!) throughout the process. 

What is multiple gestation? 

When a mom is pregnant with more than one baby, this is called multiple gestation or multiple pregnancy. There are two types of multiple pregnancies; the first type happens when more than one egg is released during a woman’s menstrual cycle. If more than one egg is fertilized, more than one embryo can survive. If this occurs, a woman may give birth to fraternal twins (or even triplets!).

Identical twins or triplets happen when one fertilized egg splits into two, three, or more. According to the CDC, 33 out of every 1000 births in the US were twins in 2017.  

The number of multiple pregnancies has increased in recent years because of the use of fertility drugs and the use of In Vitro Fertilization (IVF). Women over the age of 35 are also more likely to have a multiple pregnancy since they are more likely to release more than one egg during their menstrual cycle. 

Sometimes multiple pregnancies can run in the family as well. A woman can be genetically more likely to release more than one egg during menstruation, which could result in fraternal twins. A woman is also more likely to have fraternal twins if she is a fraternal twin, if she has siblings who are, or if she has already had twins herself. 

Studies have also shown that women of certain ethnic groups are more likely to have a multiple pregnancy, as well as women who have already had children. Despite all these possibilities, many instances of multiple pregnancies don’t have any known reason or cause!.

Symptoms and signs of a multiple pregnancy

If you think you may be experiencing a multiple pregnancy, here are some possible signs and symptoms:

  • Extreme morning sickness
  • Excessive weight gain, usually quicker than a regular pregnancy
  • High hCG levels (the pregnancy hormone)
  • Extreme fatigue
  • Early fetal movement 

Although the above could also occur during a normal pregnancy, many women with multiple pregnancies have experienced these symptoms. Most multiple pregnancies are confirmed through an ultrasound test, so if you think you may be carrying more than one baby, the best thing you can do is check with your doctor.

How is a multiple pregnancy different than a regular pregnancy?

If you do find yourself experiencing a multiple pregnancy, you may be wondering how it differs from a regular pregnancy. Everyone experiences pregnancy differently. But in the case of a multiple pregnancy, your levels of hCG, the pregnancy hormone, will be higher than those of a mom carrying just one baby. The elevated levels of this hormone may cause increased morning sickness and increased fatigue. 

Women going through a multiple gestation also tend to gain more weight than women carrying just one baby, and there is an increased risk for certain health complications. 

Potential health complications for Mom during multiple gestation

One of the possible complications with multiple gestation is spontaneous or preterm birth. Preterm birth is defined as any birth that takes place before 37 weeks. Spontaneous preterm birth is when labor starts too soon, often because of the premature rupture of membranes. The higher the number of babies being born, the greater the risk there is of preterm birth. 

The average age of delivery of babies of a multiple pregnancy is 37 weeks for twins, 33 weeks for triplets, and about 28 weeks for quadruplets. More than half of all twins are born preterm, and triplets or quadruplets are almost always born preterm. 

When you’re carrying multiples, you’re also more at risk for anemia, or iron deficiency. Some of the symptoms of anemia are:

  • Shortness of breath
  • Extreme fatigue
  • Heart palpitations
  • Pale skin

If you notice any of these symptoms, be sure to let your doctor know so that you can be tested for iron deficiency. One of the best ways to prevent anemia is to eat foods rich in iron, which can be a part of your healthy diet. Foods like leafy green vegetables, beans, peas, fortified cereals, and meat are all high in iron and can help keep your levels up. 

Preeclampsia, a blood pressure disorder, is also more common with multiple gestation and can often be more severe than in a regular pregnancy. If preeclampsia occurs, the babies may need to be delivered sooner, even if they are not yet developmentally ready. 

Potential health complications for babies

Preterm birth might have some effects on your little ones as well. Babies born prematurely have an increased risk of certain health problems such as breathing problems, low birth weight, and feeding problems.

All the advances in medical technology have increased the chances of survival for babies born at 28 weeks to 90 percent. However, babies who are born prematurely are at risk for some long-term health problems such as:

  • Learning disabilities
  • Developmental delays
  • Breathing problems
  • Cerebral palsy  
  • Vision problems

How to manage a pregnancy with multiple gestation

Managing a pregnancy with multiples may seem like too much to handle, but staying positive and taking care of yourself can help ease some of the stress. 

Generally, with multiple gestation, you will have more frequent doctor visits. Your healthcare provider may schedule appointments every two to three weeks. Once you’re in the second trimester, you can expect to have at least two visits a month. In the third trimester, you will likely be visiting your doctor once a week. 

Since women carrying multiples have a higher risk of certain complications, frequent doctor’s visits can help your healthcare provider monitor your health and the health of your little ones. For most pregnancy complications, prevention and early detection are key. The earlier you know, the better off you are. 

Staying healthy during a multiple pregnancy

Staying healthy during all types of pregnancies is so important because your body is working hard to grow your little ones! When you’re pregnant, everything you eat or do could affect your baby’s health as well as your own. And any woman who has been pregnant before knows you need all the energy and strength you can eat. 

Energy and strength are going to come from eating a healthy diet and staying active to avoid fatigue. A healthy diet should include lots of fruits, vegetables, and whole grains. 

Women who are pregnant with multiples tend to gain more weight than women with regular pregnancies. It is recommended that you eat an extra 300 calories a day for each baby you’re carrying. 

Even during a multiple pregnancy, exercise is an important part of your health. However, you will want to avoid strenuous exercise and focus on low-impact activities such as swimming, walking, or prenatal yoga. Aim for about 30 minutes of exercise a day.

With the increased risk of complications that often come with multiple pregnancies, it’s more important than ever to eat right and get regular exercise. Staying healthy can significantly reduce your risk of complications, and will just help you feel better overall. 

Multiple birth: c-section vs. vaginal delivery

Many women who experience multiple gestation wonder what their options are for delivering their babies. C-sections are more common with multiple pregnancies, but twins can be delivered via vaginal birth. In fact, many women pregnant with twins do give birth vaginally. You are more likely to be able to have a vaginal birth if the first twin is in the proper birth position. Many babies change positions frequently in the womb, so don’t be discouraged if your little one is not quite there yet. 

If you can, choose a healthcare provider who has experience with delivering multiples. You also want to make sure you find a healthcare provider who supports your decisions when it comes to your baby’s birth. Things may not go exactly the way you planned. Still, if the healthcare provider you’ve chosen isn’t willing to discuss all potential options with you, you may want to search for another healthcare provider. 

The method of delivery depends heavily on the number of babies, as well as your health during pregnancy. Remember that your health and safety, as well as your baby’s, is the most important thing. Talk to your doctor or midwife to see what options you have to ensure the best outcome for you and your little ones. 

Speech Development in Twins

Preparing for life after birth of multiples

Now that you know what multiple gestation is and what happens during the pregnancy, you may be wondering what life will be like after your little ones are born. Life with even one new baby can be a pretty extreme adjustment for some couples, so we understand why the idea of bringing multiple babies home can be so overwhelming.

Knowing that you have all the support and help you need from the people around you can be a huge burden off your shoulders. Here are some tips for preparing to bring your little ones home and staying sane after you do!

  • Attend a childbirth class: Knowledge is power when it comes to your birth, no matter what type of delivery you have. A great childbirth class will not only provide you with helpful information about birth but also about caring for a newborn and what to expect post-delivery. 
  • Talk to other moms of multiples: Lean on your village- there’s nothing wrong with asking for help! If you’re able to find a mom or two to talk to who has survived bringing twins or triplets home, you will be encouraged and find hope in the fact that if they can do, so can you. You can also learn from their experiences for a quicker adaptation process. 
  • Prepare as much as you can by 30 weeks: Since so many moms of multiples don’t make it full term, it’s best to plan ahead and have everything ready to go by the 30-week mark. 
  • Find your post-delivery support ahead of time: Depending on the circumstances you’re in, you may need some additional help those first few weeks after coming home from the hospital. Whether the support you need comes from a postpartum doula, a lactation consultant, or a nanny, if you can make your plans ahead of time, that’s one less thing you’ll have to think about post-delivery. And trust me, you will need help!
  • Prepare siblings: If you’re giving birth to multiples, but they’re not your only little ones, it’s a good idea to talk with the older siblings about how things are going to change around the house after their new baby siblings come home. Preparing your other children can help make it a smooth transition for everyone. 
  • Give yourself grace: You’re carrying more than one human being! Give yourself permission to relax and take a break when you need it. If you’re feeling overwhelmed, talk to your partner, friends, and family, and see how they can help support you in this process. 

None of us were made to do this alone, and especially when you’re pregnant, it’s essential to take it easy when you’re feeling stressed.