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What to expect when you are expecting twins

27 Nov, 2023

The first time you hear you are carrying two babies is an incredible moment. After the emotions wear off a little – shock, excitement, denial, happiness, or feeling a tad terrified – you’ll probably start wondering what a twin pregnancy will involve.

I’m an obstetrician and I’ve delivered many sets of twins, so I understand professionally what lies ahead. I’m also a father of twin boys, so I also have a personal understanding. Let’s help clear up some common queries about twin pregnancy.

The majority are healthy pregnancies

You may have been told this classifies as a high-risk pregnancy. While this is true, there’s no need to stress unnecessarily because most twin pregnancies turn out fine, with healthy babies at the end. However, it is also true that the risk of complication is higher than singleton births (yes, singleton is the official term for a single-baby pregnancy).

Showing earlier

Women carrying twins and other multiples show earlier or appear to be further along in pregnancy than if they were carrying a single baby. In fact, the larger ‘baby bump’ is a tell-tale sign you may be carrying twins.

Exaggerated pregnancy symptoms

In addition to showing earlier, you may find you are hungrier or more fatigued, and – sorry to be the bearer of bad news – your morning sickness may be worse. These exaggerated symptoms mean women carrying multiples suspect twins before an ultrasound confirms it.

Maternal health complications

Gestational diabetes, preeclampsia and anaemia are unfortunately more likely in those expecting twins. Speak with your obstetrician about supplements, try to eat well, don’t drink or smoke, be physically active wherever possible, and attend all of your obstetrics appointments.

Back pain

You’re carrying more weight so you may experience worse back pain or back pain sooner in your pregnancy.

Placental abruption

This means the placenta has either partially or fully detached from the uterine wall. This occasionally can be a very serious complication and the risk is increased in twin pregnancy.

Twin to twin transfusion syndrome (TTTS)

This serious disorder affects around 10 per cent of all identical twin pregnancies, where they share a placenta. If the blood vessels are connected abnormally, one baby receives significantly more blood than the other. If the condition is not treated, it can be fatal to one or both babies. There are various treatments available.

Delivering earlier and low birth weight

Pre-term births are more common in multiple pregnancies, with half of all twins born before 37 weeks. There is also a higher chance of intrauterine growth restriction, so babies can be born with a low birth weight.

Vaginal vs. caesarean birth

Caesarean births are far more likely in twins. This is often because of positioning problems due to a lack of room in the womb, and also because mothers may choose to deliver this way. A successful vaginal twin delivery often depends on:

  • The larger baby coming first
  • The larger baby in a head-down position
  • Whether the babies are in distress.

As with any new arrival, there are challenges and wonderful times in store for parents. Twins are no exception. Enjoy this time and the unique experiences that lie ahead for you.

Article supplied by Ramsay Health Care

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