Twin Pregnancy: Symptoms, Types & What to Expect

Finding out you’re expecting is a big moment in itself, but when you discover it’s twins, the initial reaction is a mix of surprise, excitement, and numerous questions. It’s not just “twice the joy,” as some people say, but it can also mean a different experience than a single pregnancy.

From how your body feels in the first few weeks to how your doctor monitors your progress, having twins comes with its own set of changes, and understanding what’s normal (and what’s not) can make the whole experience a lot less overwhelming.

What Is a Twin Pregnancy?

A twin pregnancy is defined as the simultaneous development of two babies in the uterus. This development can occur in two ways: one where a fertilised egg splits to form two embryos, or two eggs are fertilised separately by two different sperm.

Twin pregnancies have been on the increase over the years. In fact, in India, the rates have risen from 0.9% in 1992-93 to 1.5% in 2019-21, or 15 in every 1,000 births. Several factors are responsible for this increase, including heredity, delayed pregnancies, and fertility treatments.

While many aspects remain the same, a twin pregnancy requires additional care to keep both the mother and babies healthy.

Early Signs and Symptoms of Twin Pregnancy

In the first few weeks, the symptoms of a twin pregnancy are somewhat the same as those of a single pregnancy, although they may be more severe.

The first sign of a twin pregnancy is intensified pregnancy symptoms. You may experience severe morning sickness, which occurs due to the high levels of pregnancy hormone, hCG. In addition, extreme tiredness or fatigue is common despite getting enough sleep.

Another noticeable symptom is rapid weight gain or faster abdominal growth. Although every pregnancy is unique, women who are expecting twins will start to “show” sooner than those expecting single babies.

Other symptoms reported by women expecting twins include:

• Increased breast tenderness
• Higher levels of hunger
• More frequent urination
• Elevated levels of hCG in early tests

However, it’s worth noting that the above symptoms are not definitive. The only way to be sure of having twins is to undergo a medical examination.

How is a Twin Pregnancy Confirmed?

In most cases, a twin pregnancy is confirmed after conducting an ultrasound scan, which is normally carried out during the first trimester of the pregnancy. In some cases, if there is a high concentration of hCG hormone in the blood, it could be an indication of a twin pregnancy, although this is not a confirmed test.

During the scan, your doctor can confirm the following:

• If the twins are sharing a placenta
• If the twins are in separate sacs
• The development of the twins

Types of Twin Pregnancy (Identical vs Fraternal)

The following are the two primary types of twin pregnancy:

• Identical Twins (Monozygotic)

Identical twins develop from a single fertilised egg that separates and forms two embryos. These babies share the same DNA, meaning they will always be the same sex and often look alike. Depending on the timing of the division, they may share a placenta or have their own placentas.

• Fraternal Twins (Dizygotic)

Fraternal twins are formed when two separate eggs are fertilised by two different sperm. These twins are as genetically similar as regular siblings and can be of the same or opposite sexes.

Fraternal twins are more common than identical twins and are often influenced by genetic and environmental factors.

What Causes Twin Pregnancy, and Can You Increase Your Chances?

Twin pregnancy can happen naturally, but there are ways to increase the odds.

One of the primary contributing factors is family history, particularly from the mother’s side. If twins run in your family, then your odds may be higher.

Other contributing factors are as follows:

• Women over 30 have a higher chance of releasing multiple eggs at ovulation
• Having had multiple pregnancies
• Fertility treatment, like IVF
• Being tall or well-nourished may increase your chances slightly

It’s always important to be sensitive to this topic, as there’s no way to conceive twins intentionally without medical supervision.

How Prenatal Care Differs in a Twin Pregnancy

Prenatal care for a twin pregnancy is more closely monitored than in a singleton pregnancy. This is because, in this case, the body has to support the development of two babies.

What you should expect:

• More frequent check-ups to monitor development and growth
• Additional ultrasounds to monitor development
• Dietary changes, which will require more calories and iron in the diet
• Monitoring for possible complications, such as preterm labour and hypertension (high blood pressure)

Doctors pay special attention to conditions like gestational diabetes and anaemia, both of which are more common in twin pregnancies.

Also, rest and self-care become more important. Listening to your body and following advice from your doctor can really make a big difference in ensuring a healthy pregnancy.

Also Read: Foods to Eat When You are Pregnant

How are Twins Delivered?

The mode of delivery for twins in the womb varies depending on various factors, including the position of the babies, complications, and the progression of the pregnancy.

A caesarean section (C-Section) delivery is likely if:

• The babies are in a breech position
• There is evidence of fetal distress
• The pregnancy is classified as high-risk

In cases where the babies are both positioned head-down, the possibility of a vaginal birth increases. However, your doctor will be in the best position to advise you as your due date approaches.