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A twin pregnancy is a double joy and also a pregnancy that needs more attention. You will have more visits and scans, a higher chance of some complications and a more careful plan for delivery.
Most women with twins still go on to have healthy babies. This guide explains the types of twins, the risks, the extra care you can expect and how to prepare.
Types of Twins
According to Womenshealth.gov and Cleveland Clinic:
- **Fraternal twins:** Two separate eggs are fertilised by two sperm. Each baby usually has its own placenta, and they can be the same sex or different. This type is more common and tends to run in families.
- **Identical twins:** One fertilised egg splits into two babies. They are always the same sex. They may have separate placentas, but about 70 percent of identical twins share one placenta, according to Cleveland Clinic. This matters because sharing a placenta carries extra risks.
Fertility treatment is also linked with multiple pregnancy, mainly fraternal twins. Our article on IUI vs IVF explains the treatments.
Early Signs of Twins
Only a scan can confirm twins. Possible clues include fast weight gain early on, strong nausea, very tender breasts and a bump larger than expected for your dates. Many women with these symptoms have one baby, so wait for an ultrasound. Our early signs of pregnancy guide covers common symptoms.
Risks to Know About
Cleveland Clinic lists these higher chances in twin pregnancy:
- Preterm birth, the most common concern, which can mean low birth weight and breathing or feeding difficulties for the babies
- Preeclampsia, at about twice the rate of single pregnancies. Read preeclampsia warning signs
- Gestational diabetes. See gestational diabetes
- Anaemia. See anaemia in pregnancy
- Slower growth in one or both babies, and problems with the placenta or amniotic fluid
- For twins sharing a placenta, twin-to-twin transfusion syndrome, in which blood flows unevenly between babies. Cleveland Clinic says it occurs in 5 to 15 percent of these pregnancies, which is why they are watched closely
Risks are higher with age over 35, a high body mass index and fertility treatment, but anyone can be affected.
Extra Monitoring and Care
Womenshealth.gov says you will need more frequent antenatal visits so that your doctor can watch you and both babies. Cleveland Clinic notes that care is often led by maternal-fetal medicine specialists.
Expect:
- More frequent blood pressure and urine checks
- More ultrasound scans to track each baby's growth
- Blood tests for anaemia and diabetes
- Early discussion of birth options
The exact schedule differs between hospitals, so follow your doctor's plan. See our guides to checkups month by month and high-risk pregnancy.
Nutrition and Weight Gain
Cleveland Clinic suggests about 300 extra calories a day per baby, around 600 for twins, and enough protein and water. Another page says twin pregnancies commonly gain about 50 pounds, compared with about 30 for a single baby, but Womenshealth.gov says your doctor will advise your own target. Sources differ, so ask your doctor and use our pregnancy weight gain calculator only as a rough guide for single pregnancies.
- Eat small meals often if you feel full quickly.
- Include pulses, eggs, milk products, vegetables, fruit and whole grains. See foods to eat during pregnancy.
- Ask your doctor about iron, folic acid and other supplements. Your doctor may prescribe what suits you.
Tip: Keep a daily food and symptom note. It helps your doctor spot early changes, such as sudden swelling or very fast weight gain.
Planning the Delivery
- **Timing:** Cleveland Clinic says reaching 37 weeks is the goal for twins and that preterm labour is the main concern. Some twins arrive early. Planned timing varies, so guidelines vary and your doctor will advise.
- **Mode of birth:** The NHS says many twin births are vaginal, and a vaginal birth is more likely if the first twin is head down. A caesarean may be advised if the first baby is breech, one twin lies across the womb, the placenta is low, the twins share a placenta, or after a previous difficult birth.
- **Second twin:** Some women deliver the first twin vaginally and need a caesarean for the second.
- **Monitoring in labour:** The NHS says each baby's heartbeat is usually monitored with a belt, and an epidural is usually recommended for a planned vaginal birth so that help is quick if needed.
- **Place of birth:** The NHS advises hospital birth for twins because complications are more likely.
Read normal vs caesarean delivery and see Chaitanya Hospital's normal and C-section deliveries page.
Myths and Facts
- **Myth:** Twins always need a C-section. **Fact:** Many are born vaginally, depending on position and health.
- **Myth:** You must eat double. **Fact:** Needs rise, but not by a full second meal.
- **Myth:** Strict bed rest prevents early birth. **Fact:** The sources we reviewed do not recommend it. Ask your doctor about safe activity.
When to be cautious: Twin pregnancies can turn quickly. Do not wait to see whether bleeding, leaking fluid, regular tightenings or a drop in baby movements settle on their own.
When to See a Doctor
Contact your doctor or go to hospital if you have:
- Painful contractions or a regular tightening before 37 weeks
- Fluid leaking or a gush of water
- Vaginal bleeding
- Severe headache, vision changes, sudden swelling or pain under the ribs
- Reduced movements from either baby. See reduced baby movements
- Any symptom that worries you
For emergencies, see our emergency page. Delivery and emergency care at Chaitanya Hospital is available 24/7.
After the Birth
Twins mean double feeds and less sleep. Plan help from family and friends, as Womenshealth.gov suggests, and read about postpartum depression signs and support, because the strain can be heavy. Cleveland Clinic notes that early babies may need special care, so ask about this before delivery.
Talk to a Doctor
If you are expecting twins, early planning helps. Book an appointment or call +91 944 103 0587. Read about high-risk pregnancy care.
This article is for general awareness and is not a substitute for a doctor's advice.
References
This article was written in our own words from the following public health sources.
Educational content
Please note. This article is for general awareness and is not a substitute for a doctor’s advice, diagnosis or treatment. If you are worried about your health, or in an emergency, call +91 944 103 0587 or visit the hospital.
