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Twins and Pregnancy Questions

If you have just found our you're having twins or suspect you may be pregnant with twins, then it may have come as either a big shock or a nice surprise! Whatever your reaction to the news, a twin pregnancy can be an anxious time for parents and most have a lot of questions. Some of the most common questions are covered below but for more detailed answers on specific questions, please refer to our other articles in Twins Tips. If you can't find an answer to your question, please contact us and one of our specialist advisors may be able to help. Please note: we do not give medical advice to individuals but sometimes just talking to us can help reassure you or give you guidance and support.

What are the chances of a Twins Pregnancy?

In the UK, twin pregnancies occur around 1 in 65 maternities. The twinning rate (how many twins are born per 1000 maternities) has increased by over 50% in the last 20 years. The main factors behind this increase are more women are leaving motherhood until later, primarily waiting until they have established their career and access to assisted reproductive techniques is more widely available (e.g. IVF and other fertility treatments).

Do twins run in the family?

It is true that there are a number of pre-disposing factors that can influence the likelihood of having twins and these include;

  • Family history, but only on the mother's side e.g. mother, grandmother etc. However, this is only linked with fraternal twins (non-identical). There seems to be less influence if twins are on the father's side of the family. Identical twins are entirely random and occur 1 in every 280 pregnancies.
  • Maternal Age - women in their mid-late 30s or older are more likely to conceive twins. Women in their 40s show the highest incidence of twins.
  • Parity (no. of previous pregnancies) - the chances of having twins increases with the number of children you already have and particularly after more than 4 pregnancies.
  • Race whether you may have twins also seems to be dependent in part on your ethnic background, with the highest number of twins being born to African women and the lowest to those of Oriental origins.
  • There are other influencing factors see our other articles under Multiple Pregnancy for more information.

How are twins formed?

Twins occur in one of two ways:

  • Two eggs may be released at the same time and fertilised by separate sperm. These will result in non-identical or fraternal twins and can be of opposite sexes. They will look no more alike than any other siblings.
  • One egg may become fertilised and will split into two within the next 2 weeks. These twins will be of the same sex and they will be genetically identical.
  • This is the simple answer! However, there are some more unusual ways in which twins may occur and for more information on conception of twins and triplets, see our other articles under Twins Tips - Multiple Pregnancy. You may also find our Twins Statistics, Facts & Trivia section interesting too.

Will I have really bad morning sickness?

Probably, Yes! A lot of the normal common complaints associated with early pregnancy can be worse with twin pregnancies. Symptoms such as morning sickness and fatigue are caused as your body gets used to the increase in hormone levels and normally level off at about three months. However, with twin pregnancies the hormone levels are even higher which is why some mothers experience worse sickness and feel more tired.

Will I have more antenatal tests with a twin pregnancy?

Unless there is a reason to think otherwise, (like having IVF treatment for instance), most people don't know they are expecting twins until the first ultrasound scan, usually between 12-16 weeks. So, for the first four months expect the same routine tests and examinations as for any pregnancy. Once a twin pregnancy is confirmed you will have more scans than for a single pregnancy, usually every four weeks until 32 weeks then fortnightly until birth. Routine blood tests remain the same as in any pregnancy unless there is a medical problem. See our article on Antenatal Tests in a Multiple Pregnancy for more information.

How much weight will I gain?

As in any pregnancy weight gain is only a rough guide and some women will put on more while others put on less. In a twin pregnancy. you can expect to gain between 35 and 45lbs (2.5-3 stone) which is roughly 10lbs more than in a single pregnancy. In the first trimester expect to gain 5-10lbs and then roughly 1-2lbs for each subsequent week. For more guidance on weight gain and nutrition see our article Pregnancy Diet and Nutrition with Multiples.

Are there more complications in a multiple birth?

All multiple pregnancies are classed as high risk but there are varying degrees of risk and it will depend on your individual case. The main risk associated with a multiple pregnancy is premature labour and birth. Around 50% of twin pregnancies are delivered before 37 weeks (triplets around 32-34 weeks) which is classed as term for a twin pregnancy. A rare complication of a pregnancy with identical twins is twin-to-twin transfusion syndrome (TTTS) which, if not detected and treated, can lead to premature labour or even death of one or both babies. For more information please see our detailed articles including Twins and Multiple Births : Potential Risks and also our article on Twin to twin Transfusion Syndrome and Monochorionic-Monoamniotic Twins.

Will my babies be born prematurely?

There is a greater risk of premature labour in twin pregnancies but it is not a foregone conclusion that you will give birth prematurely just because there is more than one baby. Half of all twin pregnancies go to full term and many are only a few days or weeks early. Taking extra care of yourself, eating well and getting plenty of rest, especially in the very tiring third trimester will improve your chances of a full term pregnancy. However. Whether for medical reasons or not, sometimes labour comes on unexpectantly or an early delivery is needed and it's important to remember that there may be nothing you or the maternity staff do can prevent this.

Do I have a choice for a natural birth or will I have to have a caesarean section?

Well, yes you should but it can depend on a number of factors. Firstly, if your hospital has a 'policy' on multiple births - they may prefer to do c-sections due to the potential risks or they may allow you to choose. However, whether you have a vaginal delivery or a Caesarean section will also depend on how your pregnancy progresses and nearer the due date, also which way round the first baby is lying. In most twin pregnancies, both babies are delivered head-first. although breech (bottom-first) babies are more common than in single pregnancies. If the baby is head-first, a vaginal delivery is usually planned. In labour. the first twin is handled no differently from a single pregnancy. If the first baby is breech. vaginal delivery is still possible but a number of decisions need to be made to ensure the safety of the babies and the mother. Sometimes. as in single pregnancies, emergency Caesareans are needed and occasionally routine Caesareans are planned for medical reasons. For more information read our article on Giving Birth to Twins - Caesarean and Vaginal Birth and Twin Pregnancy - Labour and Birth.

Will my twins go to Special Care?

Many twins need some time in a Special Care Baby Unit (this may also be referred to as Neo-Natal or High Intensive Care (NICU). If they are born before 32 weeks or weigh less than 3.5lbs then they will need some special care from trained professionals in the hospital. Remember, it may not be both twins that require special attention and they may be released at different times. Twins with TTTS or other medical problems usually spend some time in SCBU.

Special care baby units aim to provide the care that babies would have had in the womb. supplementing this with help with breathing. feeding and warmth. Depending on their condition at birth, your babies may or may not be incubators. They will probably have wires connected to them to monitor their hearts and breathing. Sometimes they may be ventilated which means they will have tubes in their mouths or noses to help them breathe until they are strong enough to do it on their own. If they are small they may have trouble feeding and a feeding tube may be inserted into their noses. This is a tiny soft tube which goes into their tummy through which either formula or expressed breastmilk is put. Tiny babies find feeding very tiring and this method of feeding keeps them nourished without getting over-tired.

For further information on special care please see our more detailed article on Premature Birth - Twins & Triplets in Special Care and also Breastfeeding Premature Twins.

Is it really possible to breastfeed twins?

The simple answer is Yes! Although it can seem daunting, breastfeeding twins is no different in principle to breastfeeding a single baby. The important thing is to get support from a breastfeeding counsellor if possible and make sure the positioning is right for you and your babies. It is a learned skill for you and each of your twins so dont rush it it can take up to 6 weeks to establish breastfeeding. It is recommended that you learn to latch on each baby first before attempting tandem feeding (that's feeding both at the same time) and getting a twin Feeding Cushion is a must! Your body will make enough milk to feed two babies but it is important for you to eat healthy and get some rest. For further information on breastfeeding twins and multiples, see our more detailed articles under Breastfeeding and Weaning. Our Useful Links list organisations that help support parents wishing to breastfeed.

Will my twins take longer to reach developmental milestones?

It really depends on the individuals but generally twins are a little behind their peers in the beginning on some things but most catch up by school-age. Twins are often slower to talk than single children but not always. It is quite normal for twins to be as much as six months behind singletons and to speak in shorter simpler sentences. Most grow out of it but some may continue to have speech difficulties. Sometimes the cause is down to their premature birth but studies are currently researching for a better understanding. You can help your children by spending one on one time, reading and talking to them from an early age. Twins may also be a bit behind physically but you can help them by encouraging floor play and tummy time. For more information on Language and Development see our more detailed articles.

I'm exhausted! Will this ever end?

In a word, YES! Really, honestly believe me it will! The first 12 months are the hardest but your twinfants will soon grow and although it never gets easy, it will get easier. Establishing a routine and remaining flexible to their changing needs together with a support network will help you get through the early daze!

Our Resource Centre and Twins Tips articles are there to help and support you with bite-size tips but you can also call our specialist advisors on our helpline. We cannot give any medical advice for individual cases but weve all experienced what youre going through and will do our best to help you in any way we can. If you haven't yet joined us as a member, Register Today and receive a free copy of our Twins & Multiple Births Essential Guide.

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