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First trimester (7)
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- Prenatal care: 2nd trimester visits
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Twin pregnancy: What multiples mean for mom
What twin pregnancy means for mom
Taking good care of yourself is the best way to take care of your babies. During a twin pregnancy, you can expect:
- More-frequent checkups. You'll see your health care provider often to track your babies' growth and development, monitor your health, and watch for signs of preterm labor. You might need frequent ultrasounds or other tests, especially as your pregnancy progresses.
- More emphasis on certain nutrients. You'll need more folic acid, calcium, iron, protein and other essential nutrients. If you're already eating a healthy diet, keep it up — and be sure to take a daily prenatal vitamin. Your health care provider might recommend an iron supplement as well.
- More weight gain. Gaining the right amount of weight can support your babies' health. It also makes it easier to shed the extra pounds after delivery. For twins, the recommendation is often 37 to 54 pounds (about 17 to 25 kilograms) for women who have a healthy weight before pregnancy — which might require about 600 extra calories a day, depending on your activity level. Work with your health care provider to determine what's right for you.
- More precautions. Your health care provider might ask you to limit some of your activities — such as work, travel and physical activity — as your pregnancy progresses. Although bed rest hasn't been proved an effective way to prevent preterm labor, it's sometimes suggested as a precaution to encourage fetal growth and reduce the risk of complications.
Healthy multiples are born every day. Still, it's important to be aware of possible complications. For example:
- High blood pressure. Mothers of multiples are more likely to develop high blood pressure during pregnancy. When high blood pressure is combined with protein in the urine, the condition is known as preeclampsia. Careful management is needed to prevent serious complications for both mother and baby.
- Premature birth. The more babies you're carrying, the less likely you are to carry your pregnancy to term. If you have signs of preterm labor, you might be given injections of a steroid medication to speed your babies' lung development. Even then, however, the smallest preemies might fight to survive. Complications might include low birth weight, breathing and digestive difficulties, and underdeveloped organs. Rarely, one baby is delivered prematurely and the other baby or babies are able to continue developing in the uterus. This is known as a delayed-interval delivery.
- Twin-twin transfusion. With identical twins, it's possible for a blood vessel in the placenta to connect the babies' circulatory systems. This causes one baby to receive too much blood and the other too little. This is a serious complication for both babies that might require aggressive intervention during pregnancy. Often, babies in this situation are delivered as soon as the benefits of early birth outweigh the potential problems of prematurity.
- C-section delivery. For twins, vaginal delivery is often possible if the first baby is in a head-down position. If not, a C-section might be recommended. In some cases, complications after the vaginal delivery of the first twin might require a C-section delivery for the second twin. For triplets, vaginal delivery isn't necessarily out of the question — although C-sections are generally suggested for triplets and higher order multiples.
Caring for multiples
Healthy multiples have the same needs as other newborns. Yet with twins, you'll have a double dose. You might need more rest and support than you imagined, especially if your babies are born prematurely or need special medical care after birth. Take time to enjoy your babies — and ask friends, loved ones and others for help when you need it.Previous page
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- Mandy GT. Multiple births. http://www.uptodate.com/home/index.html. Accessed Sept. 13, 2011.
- Chasen ST, et al. Antepartum issues in management of twin gestations. http://www.uptodate.com/home/index.html. Accessed Sept. 13, 2011.
- Chasen ST, et al. Delivery of twin gestations. http://www.uptodate.com/home/index.html. Accessed Sept. 13, 2011.
- Porreco RP, et al. Delayed-interval delivery in multifetal pregnancy. http://www.uptodate.com/home/index.html. Accessed Sept. 13, 2011.
- Having twins. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp092.cfm. Accessed Sept. 13, 2011.
- Cleary-Goldman J, et al. Multiple gestations. In: Gabbe SG. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-443-06930-7..50030-X&isbn=978-0-443-06930-7&uniqId=281485244-3#4-u1.0-B978-0-443-06930-7..50030-X. Accessed Sept. 13, 2011.