Expecting Multiples? Here’s what you need to know

You probably just got used to the idea that you and your partner are about to become parents, then you go in for your routine check-up and find out you are expecting not one but two more babies. Most couples at this point are both excited and terrified, especially if they are first time parents. There is no need to worry as this just means more babies to love and cuddle with. More importantly, you should expect a lot less sleep in the near future as multiple babies require multiple hands. Hence, the tag team method you might have spoken about will not always be effective here.

After this initial shock, there is a lot information you and your partner would have to catch up on as having multiple comes with a higher risk of complications during pregnancy and birth1. The most common complication associated with multiples pregnancy is preterm birth (birth before the 37th week) and most times, reaching the 36th week will be considered a success. It is better to have a specialist or doctor experienced in handling multiples pregnancy due to the complications associated with this type of pregnancy. In addition to this, you should note that women expecting multiples experience more severe side effects of pregnancy. Below is a list of what to expect:

  • You will most likely experience a more severe form of morning sickness (nausea and vomiting)2.
  • Your breast will a lot more sore as compare to a singles pregnancy.
  • You will get hungry faster and gain a lot more weight than women carrying singles in your first trimester.
  • Your HCG (Human chorionic gonadotrophin) or alpha-fetoprotein levels will be very high2.
  • Your uterus will be larger than usual. (This is where the fetus develops/grows)
  • You will experience movement in different parts of your belly at the same time.

Women who are pregnant with multiple need to consume more calories to ensure a healthy birth weight of their babies. In general, 300 extra calories a day for every baby; that is 600 calories for two babies. You will also need to rest more and avoid strenuous activities3. In some cases women are placed on bed rest towards the middle of their second trimester depending on health and physical condition of the mother. Finally, you should also expect more prenatal visits as you and your babies would have to be monitored very closely throughout pregnancy.

Causes of multiple pregnancy

There are many reason women become pregnant with multiple babies, in fact the percentage of multiples birth has drastically increased by 70% since 1980. This is also because women are waiting until later in life to start their families. Women who are 30 and older are more likely to have multiples than younger women. This is due to the fact that women 30 years and older are more likely to release 2 or more eggs each month than younger women are. Below are some of the reasons more and more women are becoming pregnant with multiple babies:

  • Hereditary: If multiples run in you or your partner’s family, you have a higher chance of becoming pregnant with multiples.
  • Older age: If the mother is 30 years or older.
  • Race: black women have a higher percentage of having twins while Caucasian women over the age of 35 have a higher chance of having higher order multiples than any other race. Asians and Native American’s have low rates of multiple pregnancy4.
  • Ovulation Stimulation medication: These are fertility drugs given to women to help them produce many eggs. If these eggs are subsequently fertilized, then a pregnancy with multiple babies will occur.
  • IVF (in vitro fertilization): Here multiple eggs are retrieved from the mother, fertilized with the father’s sperm and a few (usual 2 or 3 embryos) are then returned to the uterus. More than one is often returned to increase the chances of pregnancy as not all embryos take.

Risks associated with multiples pregnancy

There are many risks associated with multiple pregnancy, hence it is extremely important that you begin your prenatal care early and if possible see a specialist as multiple pregnancies are considered high risk pregnancies. For a more thorough assessment, visit us at 67th Street OB/GYN Total Women’s Health Care to schedule an appointment to speak with one of our obstetricians in Manhattan today. Below are a list of risks and complications associated with multiple pregnancies.

  • Gestational diabetes: women who are pregnant with multiples have a high chance of developing gestational diabetes which can increase their odds of developing preeclampsia.
  • Fetal growth: multiples are more likely to develop growth problems, especially identical twins as there may be an imbalance in the distribution of nutrients. One baby may receive too little, while the other receives too much. The earlier this starts the more health complications will arise for the baby receiving less.
  • Preeclampsia: high blood pressure associated with pregnancy, this usually starts after the 20th week or might occur after the childbirth. This can destroy the mother’s organs (kidneys, liver, brain and eyes) and in some cases lead to death. The odds of developing preeclampsia are higher in women pregnant with multiples and in some cases, the doctor will have an emergency delivery regardless of how developed the babies are. This is usually done to save the mother’s life, at this point the mother’s health takes priority.
  • Anemia: This is very common in women pregnant with multiples, often times this leads to preterm births. This is a condition in which your body does not have enough healthy red blood cells to carry oxygen. Health providers usually advise women pregnant with multiples to take their iron supplements regularly to prevent the iron-deficiency anemia associated with multiple pregnancy2.
  • Low birth weight: due to the frequency of preterm labor, lots of multiples are in danger of being born with low birth weight (lower than 5 pounds 8 ounces). The smaller they are, the more likely they would develop health complications later in life2.
  • Monochorionic babies: This happens with babies that share a placenta (identical). Here one baby may give too much blood to the other baby while the one may receive too little. The earlier this starts during pregnancy, the greater the risk of complications for both babies1.
  • Delivery: there is a higher risk of complications during delivery, and depending on the position/number of the babies, your health provider might advise that you have a cesarean. In some cases, the babies are delivered in an operating theatre in case there is a need for an emergency cesarean.
  • Birth defects: Multiples are more likely to develop birth defects than single babies. This is also due to the fact that they are sometimes born too early.
  • Neonatal death (death within 28 days): This is more common with multiples due to their premature birth2.
  • Postpartum depression: women who have multiples have a higher chance of developing postpartum depression.

Though the risks associated with multiples may seem scary, lots of women successfully have healthy multiple pregnancy and births. It is extremely important that you seek a specialist once you learn are pregnant with multiples as this will increase your chances of success. Our doctors are experienced in caring for more women pregnant with multiples. Visit for more information on our OB/GYNs in Manhattan today.

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