Pregnant with Multiples

If you are pregnant with multiples congratulations! Multiples can bring great joy, but there are some issues to be concerned about. If you are pregnant with twins as a result of fertility treatment, they are most likely fraternal twins, meaning they each have their own placenta and amniotic sac. These twins can be boys or girls or one of each. Similarly, higher order multiples can take on any gender.

Prenatal care

When you are pregnant with multiples it is important to get special prenatal care. Your experience will be different from your friends or family members who were pregnant with singletons. Many doctors recommend seeing a high risk obstetrician if you are having multiples. Because twins are more common, you can see a regular obstetrician who is experienced with twin pregnancies. You will most definitely see your doctor more often and may have more testing than a singleton pregnancy. Also, look into special childbirthing classes for parents of multiples.

Good nutrition is a crucial part of good prenatal care. Every woman is different so we recommend talking to a nutritionist about your nutritional requirements. Women who are pregnant with multiples will need extra vitamins and minerals and will need to gain more weight than a standard pregnant woman. In the first half of the pregnancy it is recommended that you gain 1 pound per week. Again, this varies according to the individual.

Avoid standing for long periods of time and be sure to get enough rest. Talk to your doctor about your job and the possibility of bed rest. Bed rest is common during the last trimester for women carrying multiples. The risk of complications with multiples is greater than with a singleton pregnancy. Anemia and high blood pressure are among the most common risks. Be sure to be in constant contact with your physician, as early detection can lead to prevention of problems.


For most multiple births term is 37 weeks not 40 weeks. However, it is important to keep the babies growing as long as possible, so in the last trimester you should be alert for the signs of preterm labor.

Warning Signs of Preterm Labor

Call your doctor if you notice any of these sign:

  • Discharge from your vagina, change in type (watery or bloody) or an increase in amount
  • A feeling of pressure in your lower abdomen or pelvic area
  • Constant low, dull backache
  • Mild abdominal cramps like a period, with or without diarrhea
  • Regular contractions or a tightening of the uterus
  • Your water breaks

Possible complications of multiple pregnancy

Special Considerations


Most multiples must be delivered by cesarean section. However, in some instances twins can be delivered by vaginal delivery. How your babies are born will depend upon their position, weight and health, as well as your health.