What to Know About Swelling in Twin Pregnancy

As you progress along in your twin pregnancy, you may begin to worry about symptoms like swelling. Read up on what you should know about swelling in twin pregnancy plus what other twin moms experienced!

So you’ve made it through the first trimester of twin pregnancy, maybe even your second trimester, and now you’re beginning to really feel all the discomforts. 

The bigger belly. The unbelievably restless sleep. 

And perhaps, you’ve even begun to notice some swelling–either in your feet, your ankles, your face, or elsewhere. 

We want you to feel as prepared as possible for the expected and unexpected in your pregnancy with twins, so keep reading to learn why swelling happens in twin pregnancy, when it’s concerning, and insights from other twin moms who’ve been there.

Why you may experience swelling in your twin pregnancy

Swelling during pregnancy is unfortunately par-for-the-course for most women. In fact, up to 70% of pregnant women experience swelling (aka edema) at some stage of their pregnancy. 

So why the swelling? 

There are a few factors. One of the main ones is that the total amount of water throughout your body increases by 6 – 8 liters. And for twin pregnancies, the fluid retention is even greater due to the additional fetus. That’s a ton of extra fluid! 

A lot of this fluid is re-routed to your lower extremities due to having to make its way to your uterus. Prior to pregnancy, only about 3% of your total blood volume travels to the uterus. But by the time you reach 37 weeks, 16% of your total blood volume is making its way there. 

All this extra fluid–while it can cause pesky pregnancy swelling–is mostly beneficial though. The additional fluids help to soften your body so that it can expand as your uterus grows with the fetus, and it also helps your joints and tissues prepare to open for delivery. 

When to call the doctor about your twin pregnancy swelling

As you’ve seen, some swelling is simply a normal part of pregnancy–especially with twins. 

But in some cases, rapid or increased swelling can be a sign of preeclampsia (which is 2 to 3 times more prevalent in twin pregnancies than singleton pregnancies). 

So, if you experience any of the following symptoms with your swelling, call or see your healthcare provider right away:

• Your swelling seems to rapidly increase (in your face, feet, or hands)
• You have changes in your vision (like blurriness or flashes)
• You get a bad headache that won’t seem to go away
• Severe heartburn or a pain below your ribs
• Vomiting, nausea, or a general feeling of being unwell

What other moms experienced with swelling in their twin pregnancy…

We recently asked our community:

How bad was your swelling in your twin pregnancy and when did it start?

And here’s what twin parents shared:

“I was stupidly lucky and didn’t swell until the very end. But I was also drinking 150 – 200 oz of water each day.” 

“My swelling was worst a couple days after delivery actually.”

“At 4 months my legs were swelling if I walked too much.”

“32 weeks it started, then by 34 weeks my blood pressure started to rise.”

“Pretty bad (not the worst I’ve seen) and started consistently around 30 weeks I think.”

“Started mid-2nd trimester, but my feet became so big around 30 weeks. It hurt to walk.”

“Terrible! Started around week 22 for me.”

One mom’s twin pregnancy swelling saga

For most of my pregnancy with the twins, I feel like I had a normal amount of swelling. My face looked a teeny bit puffier than before I was pregnant, and once I made it over 22 weeks or so, my feet and legs started to look a little more swollen as well. The second half of my pregnancy was during the winter months, so I remember when I tried wearing my cute knee-high boots, I eventually was unable to zip them because my legs were just getting too big. 

The final few days before my delivery though (which was 34 weeks, 5 days), the swelling definitely worsened, especially in my feet. I honestly think I was on my feet too much during those final weeks and days. My final day at work (as a teacher) was on Thursday, so I remember I spent most of that last day on my feet trying to clear out my classroom since I wouldn’t be returning until the following school year. 

Then over the weekend, we had hosted a few friends for the Super Bowl. Of course, I couldn’t just sit my butt down and instead was up and at it playing host and baking (oh, how I regret not resting more). 

Two days before my planned c-section, I ended up heading to the hospital with my mom while my husband was at work. Not only were my feet super puffy, but I was always having intense itching on my hands and feet and my vision was doing weird things (like seeing bright flashes). 

Once at the hospital, the doctors determined that I was exhibiting preeclampsia, and we had to do an emergency c-section as soon as my husband could make it. Even after delivery, it took a few days for the swelling and crazy fluid retention to go down. Even one of my nurses was surprised at how much fluid was coming out through the catheter. (Yikes!)

Looking back, I really wish I had been more vigilant with the increased swelling and rested my body way more than I did at 34 weeks pregnant with twins. 

This isn’t meant to scare you. Of course, a degree of swelling in twin pregnancy (or any pregnancy) can be normal. But if you’re reading this during your twin pregnancy, take my advice: listen to your body and pay close attention to all your symptoms. With two little ones in there, it’s always better to play it safe and err on the side of rest and caution. 

~ A twin mom with 3.5-year-old boy-girl twins

What do to for swelling in twin pregnancy?

While swelling during your pregnancy may be nothing to be too concerned about in most cases, it’s still rather uncomfortable.

Here are some ways you can try to reduce your swelling and manage the discomfort:

• Try not to stand for too long. 
• If it’s hot, try to stay indoors if possible.
• Elevate your feet. 
• Wear thick-soled shoes that are supportive and comfortable. 
• Consider wearing stockings or compression socks. 
• Stay away from tight clothing.
• Use a cold compress where the swelling feels uncomfortable. 
• Stay hydrated (this can help flush out excess fluids).
• Try to lower the amount of sodium you consume.

All content on this website, including medical opinions and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

Want to feel more prepared for the ins and outs of twin pregnancy health? Check out these articles too:

• What Are Complications of Twin Pregnancy?
• Preeclampsia With Twins: What to Know from Twin Moms Who’ve Been There
• The Glucose Test and Gestational Diabetes With Twins
• Pregnancy Weight Gain With Twins: What to Expect

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