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Is it normal to feel anxious about expecting twins?

день открытых дверей в Киеве 01/03/2019

It's perfectly normal. Finding out that you're expecting twins may come as a bit of a shock. Even if you suspected you'd conceived twins because of your family history or fertility treatment, it can still take time to adjust.

It's natural to worry about complications with your pregnancy or birth. In fact, most mums expecting twins or more give birth to healthy babies, and serious complications are relatively rare. 
You should see an obstetrician and midwives who are experienced in twin pregnancies. They'll do their best to ease any worries you may have. Your health and your babies' health will be carefully monitored throughout your pregnancy. 
Expecting multiples can make you more vulnerable to anxiety or depression during pregnancy. Some twin mums-to-be worry about body image, because it's normal to put on extra weight with twins. 
Whether you're affected by depression does depend on your circumstances, though. If you are pregnant with twins as a result of assisted conception, for example, you are less likely to become depressed during pregnancy than a woman who conceived twins unexpectedly. 
Talk to your midwife or doctor if you are feeling down about your pregnancy. They will understand how you are feeling and offer suggestions or support from a specialist, if you need it. 
There's help available, too, if you're feeling overwhelmed at the prospect of coping with more than one newborn at once. Ask your midwife about attending antenatal classes specially for multiples. This will prepare you for life as a parent, and you'll meet other parents-to-be in the same situation as you, giving you a vital support network.

Will I have different care if I'm pregnant with twins?

Yes. You'll be offered more antenatal appointments, tests and scans than if you were carrying one baby. Your doctor or midwife should explain what each test or scan is for, and why you need it.
The exact number of appointments and scans depends on:
Your individual situation.

Your hospital's policies regarding multiples pregnancies.

Whether you've experienced pregnancy complications.

Whether or not your babies share a placenta (monochorionic twins). Monochorionic twins are more likely to experience complications than twins who each have their own placenta.

The extra scans will monitor your twins and check how well they are growing. 

You'll have regular blood pressure and urine checks. That's because women expecting twins have a higher risk of developing high blood pressure and pre-eclampsia.
If your midwife thinks there's a chance you could develop gestational diabetes, she'll offer you a glucose tolerance test (GTT) later in pregnancy.
Your midwife will also offer you an extra blood test for anaemia when you are between 20 weeks and 24 weeks pregnant, as well as the test all pregnant women have at 28 weeks.
You're more likely to give birth by caesarean section. If you'd like to try for a vaginal birth, raise it early on with your obstetrician. Then you'll have plenty of time to discuss and think through your birth options. Many mums of twins have a vaginal birth.

Are pregnancy symptoms worse with twins?

You may have stronger pregnancy symptoms if you're expecting twins, but it's not a given.
You're more likely to have light bleeding or spotting in early pregnancy than in singleton pregnancies. So this may reassure you if you do have some spotting. 
However, sadly, it's also true that miscarriage rates are higher in multiple pregnancies. If the spotting gets heavier and you get cramps too, the safest option is for you to visit an early pregnancy assessment unit (EPAU). See or call your doctor or midwife as soon as possible, so they can refer you to your nearest EPAU.
You may feel very nauseous. With two babies growing inside you, your levels of the pregnancy hormone human chorionic gonadotropin (hCG) are higher. 
You'll also feel the effects of higher levels of the hormone progesterone, which can: 
Make you feel short of breath, especially early on in pregnancy.

Cause heartburn and indigestion by relaxing your muscles.

Cause constipation, often made worse if you have to take iron tablets for anaemia.

You'll also feel the physical demands of carrying two babies. Later in your pregnancy you'll notice a strain on your muscles, and back pain may be a problem. Having two babies pushing up against your diaphragm can also make indigestion and breathlessness worse.
If you experience back or hip pain as your pregnancy progresses, ask your midwife to refer you to a women's health physiotherapist.

Which worrying pregnancy symptoms do I need to watch out for?

The danger signs to look out for are the same as in any pregnancy. But do be alert to any unusual symptoms.
Trust your instincts, and if you're not sure about a symptom, or just don't feel right, call your midwife or doctor. Keep a close eye on your babies' movements. Depending on how they're lying, you should soon get to know their usual pattern of movements. If they start to move around more than usual or less than usual, call your hospital.
It's always worth checking if you have any concerns, because the risk of complications is higher when you are expecting twins. It's most likely your midwife will reassure you're fine, as serious complications are uncommon and the vast majority of twins are born healthy.
Premature birth, before 37 weeks, happens in more than half of twin pregnancies. Call your midwife if you think you are in labour, or if you are really worried, call your maternity unit direct to arrange to go straight to hospital. 
Pre-eclampsia is more common in women who are expecting twins. It's a potentially serious complication, related to high blood pressure, that needs immediate medical attention. 
Pre-eclampsia is usually picked up by the blood pressure and urine tests that take place during your antenatal appointments.

Will I gain more weight if I am expecting twins?

You are likely to put on more weight than if you were pregnant with just one baby. Try not to feel disheartened about this. Gaining extra weight is normal in twin pregnancies. You need the weight to help your babies grow well and to give you the energy for labour and birth.
As in any pregnancy, try to eat a healthy diet to provide you and your babies with the right nutrients.

How can I cope with a twin pregnancy?

You'll need to take it easy, as you will be tired while carrying two babies. You shouldn't need extra bed rest, but put your feet up when you can. Sleep may be hard to come by as your pregnancy progresses, which will add to your tiredness. 
Make rest a priority. If you have older children, ask a friend or relative to look after them occasionally, so you can rest. If you're working, have a rest at the end of the day, before getting on with your evening.
It will actually boost your energy levels during the day and help you sleep at night if you take gentle exercise. Yoga, Pilates or swimming are ideal. But check with your doctor or midwife before starting any new exercise programme. You don't want to put a strain on your body.
If you're working, consider taking maternity leave as early as you can. Most mums-to-be of multiples stop work at 28 weeks. This makes sense because carrying twins is hard work, and most twins arrive earlier than single babies. 
More than half of twins are born before 37 weeks and it's very common for at least one baby to need a stay in special care. Going to a twins-specific antenatal or parenting class may help you to prepare. Try to book on a course that starts in the second trimester or very early third trimester. 
Work out the timing so that you have the best chance of completing the course before 34 weeks pregnancy, if you are expecting twins, or before 30 weeks if you are expecting triplets.

Where else can I find support?

If you're having twins or more, it's important to ask for help. If friends and family offer to lend a hand, let them. If they don't offer to help, ask. It's worth contacting a support group for advice and to meet other mums of twins.

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