Discovering you are pregnant with twins brings a mix of joy and excitement, not to mention maybe a touch of anxiety. We know that pregnancy is special but carrying twins means you will need additional support and specific medical care.
Here’s what you need to know about twin pregnancy and parenting multiples.
Types of Twin Pregnancies
Twins can be fraternal or identical. However, there are other subtypes but they are rare.
Identical Twins
Identical or monozygotic twins are conceived from one fertilised egg that separates into two embryos after it has started to divide. Hence, two babies. Monozygotic twins share the same genomes and are most often the same sex.
Identical twins may have slight differences in how they look because of the environment which they are born.
Fraternal Twins
Not all twins are identical. The term for this is fraternal twins, from the scientific term “dizygotic” or from two fertilised eggs. They are formed when the mother releases two eggs at the same time. Two different sperm will fertilise each egg.
Fraternal twins share the same percentage of chromosomes as any other siblings since they are a result of different eggs and different sperm.
The Signs That You’re Carrying Twins
A woman’s chances of conceiving twins are low, about 1 out of 250 pregnancies. There are some tell-tale signs of twin pregnancy. But please be informed that experiencing these signs does not mean you are carrying two foetuses.
- Foetal movement in more than one area
- Early movement of the foetus
- Your baby bump is larger than what’s expected
- You are gaining weight fast
- Your body has high levels of hCG or AFP (a pregnancy hormone and protein made by the foetus’s liver, respectively)
- More than one heartbeat is heard on a foetal Doppler
How Are Twins Diagnosed?
The only way to find out or confirm a twin pregnancy is through a prenatal ultrasound. Only through ultrasound that we are able to see whether there are two foetuses or just one.
The Look of Your Belly Compared to a Singleton Belly
This is perhaps the most obvious sign of twin pregnancy—your bump showing early on. You may need maternity clothes as soon as you find out that you are pregnant. It’s only a matter of time before you outgrow your clothes quickly because of the weight gain.
For a singleton baby, you may gain around 13 kg, compared to having twins wherein you might put on around 22 kg.
Risks and Complications of Twin Pregnancy
A plus-two in the family could also mean that there are complications you MAY experience. Let’s enumerate them for easy reading.
- Anaemia
- Congenital disorders including spina bifida
- Gestational diabetes
- Preeclampsia or hypertension during pregnancy
- Intrauterine growth restriction
- Low or too much amniotic fluid
- Premature labour
- Placental abruption
- Twin-to-twin transfusion syndrome (TTTS)
Most of these complications are rare, but every expectant parent should err on the side of caution. Never downplay these complications. Ask your doctor about them.
Medical Care and Monitoring
Twin pregnancy needs you to be more vigilant because you are carrying two humans. This means more appointments and tests throughout your pregnancy. The tests will be more ultrasounds, not blood tests.
Having twins with separate placentas
If you are having twins with separate placentas, experts recommend that you have ultrasounds at 12-13 weeks, 20 weeks, and then every four weeks until your twins are born. Expect more ultrasounds. So it’s best that you ask your gynae about this.
Twins sharing one placenta
A twin pregnancy in this scenario might be more complicated. The general recommendation is to have ultrasounds about every two weeks from week 12 of your pregnancy.
Never miss any of your antenatal appointments no matter how frequent they are. If you’re really having multiples, expect more tests and follow-ups to be conducted.
Screenings and Tests You Will Need
Here is a quick list of the various tests you might undergo throughout your twin pregnancy.
First Trimester
- Dating and viability scan
- NIPT (Non-Invasive Prenatal Testing)
- Complete blood count
- Blood type and Rh factor
- Routine pregnancy blood tests
Second Trimester
- Detailed anatomy scan
- Glucose screening test
- Cervical length measurements
- Blood pressure monitoring
- Urine tests for preeclampsia screening
Third Trimester
- Regular growth scans
- Foetal position checks
- Biophysical profiles
- Non-stress tests when needed
- Group B streptococcus screening
Signs You Should Watch For
Immediately contact your gynaecologist or healthcare provider if you experience any of the following. They will decide if this should be a cause of concern or not.
- Vaginal bleeding
- Regular contractions before 37 weeks
- Decreased foetal movement
- Severe headaches or changes to your vision
- Sudden swelling
- Persistent abdominal pain
- Leaking fluid
- High blood pressure symptoms
Are fertility treatments worth my money if I want to have twins?
If you are really into birthing and taking care of twins, it might be your best choice. It’s possible to conceive twins with different fertility treatments like IVF and fertility drugs.
These drugs cause you to release more than one egg per cycle. As for in vitro fertilisation, you can only have twins if the implanted embryo splits in the early pregnancy stages.
Preparing for Twin Delivery
Besides understanding what to expect, delivering twins requires special preparation. It’s not our usual planning for singleton births. Sometimes, different medical approaches are needed, too.
Delivery Options
The method of delivery will discuss with you the safest option based on several factors like the position of your babies, their growth, and your overall health.
Vaginal delivery is possible for twin pregnancies when the first twin is in a head-down position. Otherwise, a caesarean section will be recommended if either of them is in a breech position.
Even with a planned vaginal delivery, you will still deliver in an operating room for immediate access to caesarean delivery for the second twin.
Timing of Delivery
Twin pregnancies deliver earlier (at 35-37 weeks) than singleton pregnancies (full term: 40 weeks). Your healthcare team will monitor you and your babies closely to determine the timing of delivery by balancing the benefits of longer gestation against the risks of continuing the pregnancy.
Hospital Preparation
You will need a more comprehensive hospital bag than for a singleton birth.
Pack two sets of everything for your babies like coming-home outfits in different sizes. Keep important documents like your birth plan, hospital registration forms, and insurance information.
Don’t forget to pack extra items for yourself because hospital stays usually take longer than singleton births.
What to Expect During Recovery
The recovery is also longer. Your body has carried more weight and undergone more stretching. You may experience more intense postpartum contraction as your uterus returns to its normal size.
NICU Preparation
Twins are likely to be born prematurely. So you must familiarise yourself with the Neonatal Intensive Care Unit facilities at your chosen hospital. Take a tour and discuss with your healthcare provider what circumstances might warrant NICU care.
Immediate Post-Birth Period
The first hours after birth are crucial for bonding with your twins. Arrange for skin-to-skin contact with both babies. Discuss with your doctor and the whole team how to manage initial feeding, especially if you plan to breastfeed.
You might need extra support from lactation consultants and nursing staff.
Emergency Preparations
Always BE prepared for unexpected situations. Have a plan B and C for everything. Discuss all possible scenarios with your doctor. Your healthcare team will guide you and keep you well-informed so you feel more confident as you approach your delivery date.
Conclusion
Planning or delivering twins might stir mixed emotions. But don’t you worry! Your healthcare team is there to help you with your twin pregnancy journey. Do not hesitate to raise all your questions so you can rest assured and have peace of mind that everything will be alright!
A gynaecology clinic in Singapore is a good starting point. Do you have one already? If not, try contacting us and we will try to answer some of your concerns regarding twin pregnancy. Who knows, we may become your go-to gynaecologist.