The symptoms in a twin pregnancy are the same as in a singleton pregnancy except they are typically stronger. If you would have nausea with a singleton pregnancy, you’ll feel EXTRA nauseous when you’re pregnant with twins. Your hCG levels will also be a lot higher than with a singleton pregnancy but you would only be able to know that with a blood test (which is typically done with reproductive assistance) but even then there’s no magic number to indicate twins. The only way to truly know if you’re having twins is to have a sonogram at your doctor’s office.

Twin pregnancy is typically a lot more difficult to manage than a singleton pregnancy. You may experience typical pregnancy symptoms in a more extreme manner, such as more nausea, more shortness of breath, more high blood pressure. But if this is your first pregnancy you probably will not know the difference — you may feel like this is how pregnancy is supposed to feel! On the converse, just because you’re pregnant with twins doesn’t mean that your symptoms will be hard to manage. A lot of twin moms report that they had typical pregnancy symptoms that can be compared to symptoms of a singleton pregnancy.

However, once you are getting around 32 weeks or later, you will really start to notice how difficult and painful a twin pregnancy can be. Around 32 weeks, your belly will measure about the size of a full-term singleton pregnancy and you’ll start to wonder how you’re possibly going to make it all the way to 38 weeks! Just hang in there and take it one day at a time.

When you’re pregnant with twins, expect the unexpected. Educate yourself on the warning signs of preterm labor, the warning signs of preeclampsia, and read up as much as you can on what to do to prepare. Our expecting twins class (offered in NYC, Chicago, Houston, and online) is a great way to learn all you need to know to prepare for your twin delivery and bringing home your babies (we also offer an online breastfeeding twins class!)

Many twin pregnancies are considered high risk, but not all (some are considered “medium risk” if all is going well). Your doctor will advise if you need to see a high-risk doctor, often found in the Maternal Fetal Medicine unit of your best local hospital.

Twins occur at random, by reproductive technology, or by conditions that are genetic, such as hyper-ovulation. Learn more here.

• Higher-than-normal levels of hCG in your twin pregnancy week by week may indicate that you’re pregnant with multiples, but you’ll need to wait until your ultrasound for 100% certainty.
• Common early pregnancy symptoms of fatigue, frequent urination, breast tenderness, and food cravings are extra EXTRA — your symptoms are WAY more severe than what is normal for a singleton pregnancy
• Due to elevated levels of pregnancy hormone hCG, women carrying multiples may have more nausea and vomiting than those carrying only one baby
• Your faster-than-normal growing belly may tip you off. But if you’ve never been pregnant before you don’t have anything to compare it to.
• If you have any of the following conditions you may have greater risk of twin pregnancy: Family history of fraternal twins, fertility treatments like in vitro fertilization (IVF), mother is of advanced maternal age (over 35 years old), BMI over 30, above average maternal height, or you’ve had previous pregnancies

The mother would be the parent that carries the gene for twins. The gene versions that increase the chance of hyperovulation can be passed down through the mother’s side of the family. Hyperovulation would cause fraternal twins, as multiple eggs are being fertilized at once.

The ideal time for twins to be born is at 37-38 weeks. It’s important that the pregnancy doesn’t go past 38 weeks to avoid added risks to the babies and mother, such as a ruptured uterus. About 60% of twins are born before 37 weeks, while single babies are born around 40 weeks.