Could I be pregnant with twins or more?
Many women wonder in the early stages of pregnancy if they could be carrying twins or more. If there has been a previous pregnancy, it's common to compare pregnancies, and if abdominal size or weight gain seems to be more than in a previous pregnancy, the thoughts of twins can really made a heart pound! However, in the case of a subsequent pregnancy, it's important to remember that the abdomen may pop out faster because the uterus and ligaments have been stretched by the previous pregnancy(ies).
In our survey, 54% of our moms did not suspect they were pregnant with multiples, while 46% did. For those who did suspect, these were their first symptoms, with the most common listed first:
- Belly size - abdomen popped out quickly, was larger than expected and measured large for gestational dates at doctor appointments. They usually needed maternity clothes or larger clothing between eight and 12 weeks.
- Morning sickness - often more extreme than in a singleton pregnancy and often started earlier than in a singleton pregnancy.
- Fatigue - exhaustion hit sooner than in a singleton pregnancy and lasted longer
Other symptoms mentioned by our survey moms were:
- Larger/faster weight gain (for those who lost weight due to morning sickness, the weight gain didn't apply but the belly still popped out sooner)
- More fetal movement than in singleton pregnancy
- Strong aches during ovulation (releasing more than one follicle)
- Got up 3 to 4 times a night to use the bathroom
- Heartburn was worse than with a singleton pregnancy
- Retained more water than with singleton pregnancy
Let's not forget the sixth sense. Lots of women have a hunch they're carrying twins or more, but only 2% of our survey respondents "just knew" they were pregnant with more than one baby without having any other symptoms.
Multiples are definitely suspected after infertility treatment. A high hCG level may start the suspicions rolling quite early in the pregnancy, as well as becoming very sick with ovarian hyperstimulation syndrome.
Our survey respondents who had a prior singleton pregnancy mentioned that in their multiples' pregnancy:
- Their bellies grew faster than in their prior pregnancy
- The first trimester fatigue was much greater
- Morning sickness was worse
- They felt increased or differing patterns of fetal movement
Most moms suspected multiples around 6 - 9 weeks, although some didn't suspect until early in the second trimester (12-16 weeks), and a few were very intuitive with hints as early as 4 weeks. And, let's not forget that 54% of our moms didn't suspect at all until the diagnosis was made (usually by 20 weeks).
Please keep in mind that you may be expecting twins and have few, if any, of these symptoms. Moms pregnant with more than two will most likely experience the majority of these symptoms.
How and when are multiples diagnosed?
Multiples are usually diagnosed via ultrasound which may be scheduled for a variety of reasons. The majority of our survey respondents were scheduled for routine ultrasound exams because they were considered a standard of care by their particular careprovider. A few were scheduled because of rapidly rising HCG levels, infertility treatments were used to conceive, the doctor heard more than one heartbeat, mom was measuring large for dates, the results of the alpha-fetoprotein test were high, or due to other suspicions of multiples. Also, some were scheduled to investigate bleeding episodes or rule out ectopic pregnancies.
Occasionally, an ultrasound (or rather the technician performing the ultrasound) will miss a fetus. S/he may be hiding behind his/her twin. An ultrasound performed later in the pregnancy may pick up the hiding baby.
One percent of our moms discovered their twin pregnancies in the delivery room! It doesn't happen often, but it does happen. The overwhelming majority had their multiples diagnosed in the first trimester.
Identical or Fraternal?
If two eggs are released from the ovary (or one egg from each ovary) and are fertilized by two separate sperm, fraternal twins (dizygotic) have been conceived. Fraternal twins can be the same sex or boy/girl, and will look as much alike or as different as any siblings. If one egg is fertilized and later divides in two, identical (monozygotic) twins will develop (or divides into three, identical triplets will develop, etc).
Identical multiples have the same chromosomal makeup so will be the same gender, and have the same hair and eye color, blood type, etc. Only one-third of all twins are identical.
In the case of triplets or quadruplets, etc., any combination is possible. Three (or four or more) eggs can be fertilized creating fraternal triplets, etc. One fertilized egg can split into identical twins with another fertilized egg making it a triplet pregnancy (two identical babies and one fraternal). Or one egg can split into three creating identical triplets, etc.
In our survey, exactly one third of our parents had identical twins and two-thirds had fraternals. Click here to read our article on the Odds of Having Multiples.
Click here for "How will I feel about having multiples?"
Our Multiples' FAQ:
Section I - Suspecting and Diagnosing Multiples
Section II - Preparing for Multiples
Section III - Pregnancy & Childbirth
Section IV - NICU
Section V - Going Home/Postpartum
Section VI - As They Grow
Section VII - Resources
Section VIII - Miscellaneous/Special Tips & Inspiration