If you go into labor before 34 weeks, your medical team may be able to delay your labor for a few days. They’ll use this extra time to treat your babies with corticosteroids, drugs that help a baby’s lungs and other organs develop faster to greatly increase the chances of survival. Your babies may also receive magnesium sulfate, which helps reduce the risk that they’ll develop cerebral palsy.
Find out what it means when a twin vanishes during pregnancy. Is it considered a miscarriage? Where does the disappearing twin go?
If you’re carrying identical twins who are sharing a placenta, the loss of one twin after the 20th week can be very dangerous to the surviving baby. If your babies don’t share a placenta, there’s a good chance that your remaining baby can develop normally.
What are the chances that I’ll lose one or more of the babies?
Sibai BM, et al. 2000. Hypertensive disorders in twin versus singleton gestations. American Journal of Obstetrics and Gynecology 182(4):938-42. http://www.ncbi.nlm.nih.gov/pubmed?term=10764477 [Accessed March 2016]
Babies born before their time may not be completely ready for the outside world. Their lungs, brain, and other organs may not be fully developed, their immune system may not be ready to fight off infections, and they may not be able to suck or swallow.
Twins and other multiples are common these days. Learn why and find out your chances of having twins – or more.
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Research shows that 10 percent to 15 percent of all singleton births may have started off as twins; often one is lost early in pregnancy in a phenomenon known as “vanishing twin syndrome.”The odds of having identical twins (the result when a single fertilized egg splits in two) are about 3 1â„2 in 1,000.
If you’ve had nonidentical, or fraternal, twins (the result when two eggs are released at ovulation and both are fertilized) without having taken fertility drugs, your chance of having a second set is about 1 in 3,000.
More than half of twins are born before 37 weeks; plan your maternity leave accordingly so you don’t leave your employer in the lurch.Twins conceived naturally (i.e., without fertility treatment) are most common in the African-American population, followed by Caucasians, Hispanics and Asians.
Taller women are also more likely to have twins.For most women pregnant with twins, gaining 24 pounds by week 24 is advised; a total weight gain of 35-45 pounds is generally desirable.The twin who is developing closest to the exit (your cervix) is called Baby A.
In 75 percent of cases, Baby A is head down before delivery; Baby B may be either head down or breech.Though vaginal delivery is usually an option, you’re more likely to give birth via Cesarean section than if you were having one baby.
Sometimes Baby A is born vaginally, then Baby B is delivered by C-section. This is often the case if Baby B is breech or shows signs of distress because he’s gone through two rounds of uterine contractions.
The average birth weight of full-term twins (37 weeks or later, compared to 39-40 weeks for singletons) is around 5 ½ pounds each, though one baby often weighs more than the other.
Prepare yourself with a list of questions to ask about bedrest so you’ll know exactly what to expect.
ACOG. 2014. Task force report on hypertension in pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/Resources_And_Publications/Task_Force_and_Work_Group_Reports/Hypertension_in_Pregnancy
The earlier a baby is born, the greater the risks. Premature babies born between 34 and 37 weeks generally do very well. Babies born before 28 weeks may survive, but they’ll need intensive medical care and a little luck.
Educate yourself about the most common risks and complications of twin pregnancies, but don’t obsess about all the things that can go wrong. Become familiar with the warning signs of preterm labor. Make sure you are well nourished and well hydrated. Finally, don’t miss any prenatal appointments and make sure to follow your provider’s instructions.
Stillbirths — the loss of a baby after 20 weeks — are slightly more common in multiple pregnancies, but they’re still rare. Only about 1 to 2 percent of twins or triplets are stillborn, compared with about 0.5 percent of singletons.
Aside from preterm labor, there are several possible problems:
Hernández-Díaz S, et al. 2009. Risk of pre-eclampsia in first and subsequent pregnancies: Prospective cohort study. BMJ 338:b2255. http://www.bmj.com/content/338/bmj.b2255 [Accessed March 2015]
Also, find out exactly what you can and can’t do and for how long. Bedrest can mean anything from curtailing your activities to literally not getting out of bed for any reason. Even if your pregnancy is going smoothly, most doctors and midwives advise taking it easy beginning early in the third trimester.
According to the March of Dimes, close to 60 percent of all twins and more than 90 percent of triplets are born prematurely (before 37 weeks). The average twin pregnancy lasts 35 weeks. Triplet pregnancies average 33 weeks, and quad pregnancies average 29 weeks.
Find the best gear for your baby. See the 2018 Moms’ Picks winners.
UpToDate. 2013. Twin pregnancy: Prenatal issues. http://www.uptodate.com/contents/twin-pregnancy-prenatal-issues [Accessed March 2016]
That’s because there are growing numbers of older moms (hormonal changes are believed to be responsible for the release of more than one egg at ovulation) and more successful fertility treatments.
Some babies are lost at the end of a pregnancy and are delivered along with the surviving baby. In rare cases, a stillborn twin can be delivered several weeks before the surviving twin.
Here are some other facts about twin pregnancies that you might not know, from Pregnancy Day by Day editor-in-chief Maggie Blott, M.B., B.S.; and consultant editor Paula Amato, M.D. (Dorling Kindersley):
The twin birth rate in the United States is close to 1 in 31, a nearly 40 percent increase since the early 1980s.
Your practitioner may put you on bedrest, especially if you develop complications such as preterm labor. There’s no proof that bedrest can actually prevent premature delivery for women carrying multiple babies, but there are some situations where it may be beneficial to reduce your physical activity or take frequent breaks off your feet. If your practitioner recommends it, ask her to discuss the pros and cons with you.
Is it true that the symptoms of pregnancy are worse with twins? What about the risk of birth defects? Get the facts.
Double Trouble! For real life stories about being pregnant with twins, go to fitpregnancy.com/reallife.
While many complications of twin pregnancies have little to do with your behavior or lifestyle, getting early confirmation that you are indeed carrying twins will give your healthcare provider plenty of time to catch and treat any complications that may crop up.
Find out all there is to know about having more than one baby at once, from conception and pregnancy to birth.
While the great majority of multiple pregnancies result in healthy babies, any pregnancy with twins or more is considered high risk. And the more babies you’re carrying, the higher your risk of complications. The greatest risk is that you’ll deliver the babies prematurely, which increases their chances of health problems.
If you’re pregnant with twins or more, you have unique nutrition and fitness needs. Find out how to eat well and exercise for a…
Your chances of having twins or more, possible complications, information about unusual scenarios involving multiples, and more
Bdolah Y, et al. 2008. Twin pregnancy and the risk of preeclampsia: Bigger placenta or relative ischemia? American Journal of Obstetrics and Gynecology 198(4):428.e1-428.e6. http://www.sciencedirect.com/science/article/pii/S0002937807017012
In either case, your practitioner will likely take a “watch and see” approach. If your remaining baby isn’t in immediate distress, there’s usually no reason to induce delivery early.
From c-sections to baby positioning in the uterus, giving birth to more than one baby can be complicated.
About half of all twins weigh at least 5½ pounds at birth. (Below 5½ pounds, or 2,500 grams, is considered a low birth weight, with a higher potential for complications.) In comparison, the average singleton weighs 7 pounds, but it’s not that she’s comparatively bigger, it’s because on average she’s hanging out in utero for another five weeks. That said, it’s not unusual for some women to deliver twins that each weigh around 7 pounds if the pregnancy lasts until week 37 (just think how much better you’d feel when you were done carrying that load around). The average triplet weighs 4 pounds at birth, and the average quad 3 pounds. While they might have to spend a few days in the NICU putting on some weight, the good news is, many preemies are considered “feeders and growers,” which means they’ll soon catch up to their peers. Keep a record of your babies’ every move throughout your pregnancy.
Suzuki S, et al. 2009. Risk factors for preeclampsia in Japanese twin pregnancies: Comparison with those in singleton pregnancies. Archives of Gynecology and Obstetrics 280(3):389-93. http://link.springer.com/article/10.1007/s00404-009-0932-4
In the days before ultrasound, these miscarriages went largely unnoticed. The only symptom is vaginal bleeding, and the remaining baby (or babies) usually develops normally.
Twins and triplets often don’t have a chance to reach a healthy weight before they’re born. While the average single baby weighs 7 pounds at birth, the average twin weighs 5.5 pounds. Triplets typically weigh 4 pounds each, and quads weigh 3 pounds each.
Babies born at under 5.5 pounds are considered to have a low birth weight.Babies with low birth weights are likely to have health problems even if they weren’t born prematurely. Low-birth-weight babies often have trouble breathing on their own.
They may not be fully prepared to fight infections, control their body temperature, or put on weight.For these reasons, almost all low-birth weight babies have to spend time in a neonatal intensive care unit before going home.
Preeclampsia is a serious condition characterized by high blood pressure and protein in the urine, or kidney or liver abnormalities. It develops in roughly 10 to 15 percent of women carrying twins, two to three times the rate of women carrying one baby.
The condition tends to develop earlier as well. And once it starts, it can be especially severe. When preeclampsia is severe, it can affect many of your organs and your placenta and cause serious or even life-threatening problems.
Gestational diabetes is more common in women carrying more than one baby. If you develop gestational diabetes, your practitioner will monitor you closely. You’ll most likely be able to keep your blood sugar levels under control with diet and exercise, but some women will require insulin shots or pills as well.
Poorly controlled diabetes can have serious consequences for you and your babies.Placental abruption, when the placenta detaches from the uterine wall before delivery, is also more likely when you’re carrying more than one baby.
It can happen any time in the second half of pregnancy and can lead to growth problems, preterm delivery, or stillbirth. In multiple pregnancies, abruption may occur just after the first baby has been delivered vaginally.
Once abruption has occurred, the other baby or babies may have to be delivered by cesarean section.Twin-to-twin transfusion syndrome is a rare but serious complication that occurs in identical twins when blood flows from one baby to the other through their shared placenta.
According to the March of Dimes, 10 to 15 percent of identical twins develop the syndrome. The condition can be treated by using laser surgery to seal off the connection between the babies’ blood vessels.
Will I be put on bedrest?
Are multiple pregnancies riskier than single pregnancies? What are the chances that I’ll deliver prematurely? What are the risks of premature birth? What are other potential complications of having multiples? Will I be put on bedrest? What are the chances that I’ll lose one or more of the babies? What can I do to reduce my risk of problems?
When a woman is carrying twins, one baby might miscarry early in pregnancy while the other stays in place. This situation — called a vanishing twin — occurs in about 20 percent of all twin pregnancies. If you’re carrying triplets, there’s a 40 percent chance that one or more will miscarry in the first half of pregnancy.