Sorry, this article is only available in European Spanish. For convenience, the content is displayed below in another language. You can click on the link to change the active language.
When there is more than one:
Recommended read : What diet should I follow to have twins?
What do twin or multiple pregnancies mean for mothers?
Diagnosis of twin pregnancy
Most twin or multiple pregnancies are detected by ultrasound.
The first ultrasound is very important, as it allows you to know not only the number of fetuses but also whether they share the same placenta. In common language, babies who do not share the placenta (dichorionic) and twins who have only one placenta (monochorionic) are referred to as twins. Depending on whether you have twins or multiples, the type of monitoring will be different. In the case of twins, it should be stricter, with ultrasounds every two weeks.
A periodic ultrasound assessment of the anatomy and size of the fetuses is important to detect malformations or growth restrictions in the babies, which is more common in a twin pregnancy than in a single pregnancy. It is also essential to measure the cervix and assess the risk of premature birth. Additionally, some specific diseases only appear in certain types of twins, such as twin-to-twin transfusion syndrome in monochorionic twins, which can be successfully treated intrauterinely once correctly diagnosed.
What does a multiple pregnancy mean for you?
Multiple pregnancies require special attention, and taking care of yourself is the best way to care for your baby.
Nutrition and weight gain.
You should follow a healthy and balanced diet, increasing your intake of vegetables, fruits, and foods rich in vitamins, iron, and calcium while avoiding alcohol, tobacco, coffee, soft drinks, or products high in saturated fats.
However, although nutritional advice is generally the same as for a single pregnancy, if you are pregnant with twins, you will need to pay more attention to what you eat during these months. Following a diet during this type of pregnancy is more demanding as an increased nutrient intake is necessary since energy expenditure is 10% higher than in a single pregnancy. In caloric terms, pregnant women should not consume twice as many calories as during a single pregnancy. In fact, the increase is only 300 calories per day. In other words, if, during a single pregnancy, the recommended daily calories are between 2,200 and 2,500, they will be between 2,700 and 2,800, although this figure is adjusted based on the mother’s body mass index (BMI).
Finally, during pregnancies, it is more common to enrich the diet with vitamin, iron, and folic acid supplements, but always on the recommendation and under the supervision of your doctor.
Regarding weight gain, it is generally recommended that women who had a healthy weight before pregnancy gain between 15 and 20 kilograms, most of it during the first two trimesters to increase the “nutritional” capacity of the placenta and avoid premature births and the birth of underweight babies.
More frequent visits. A woman expecting more than one baby should consult her obstetrician-gynecologist more regularly. Your doctor will determine the frequency of visits, which will generally be monthly or biweekly depending on the characteristics of each twin pregnancy. You may need ultrasounds and other tests more frequently, especially as your pregnancy progresses.
Can you exercise in a twin pregnancy?
Moderate exercise helps control weight during pregnancy, prevents symptoms such as water retention or back pain, and helps women stay active. Therefore, in a twin pregnancy, sports such as dancing, swimming, or walking can be practiced whenever the doctor or gynecologist deems it advisable.
Twin pregnancy: high-risk pregnancy? What are the most common complications?
Medically, a twin pregnancy is considered a high-risk pregnancy, as complications can occur more frequently during pregnancy than in a single pregnancy, but this is not necessarily the case. Most women experience and enjoy a twin pregnancy without health issues.
Although most twins are born healthy, it is important to consider potential complications. For example:
- Premature birth. The more babies there are at the same time, the less likely your pregnancy is to reach term. If you show signs of premature labor, you may be prescribed injections of a medication to accelerate the baby’s lung development. In cases of prematurity, babies may experience complications such as breathing and digestive difficulties, vision problems, and infections. Bed rest is not generally recommended to prolong pregnancy, as it has not been shown to reduce illness or death in newborns, nor to prevent premature births. Twin pregnancies rarely reach the 40th week, with delivery usually occurring between weeks 36 and 38, and even earlier. This is why visits to the gynecologist are so frequent during the last trimester, to prevent complications and plan the best time for the birth of your babies.
- Gestational diabetes. This condition leads to high blood sugar that can affect the pregnancy and the health of your baby. It is more common in this type of pregnancy. The gynecologist and endocrinologist will teach you how to control your blood sugar levels. In most cases, a proper diet is sufficient, and insulin administration may be necessary if the diet is not enough.
- High blood pressure. If you have a multiple pregnancy, the risk of developing high blood pressure disorders during pregnancy, such as preeclampsia, is higher. Your doctor will explain how to manage it.
- Cesarean delivery. For twins or multiples, vaginal delivery is generally possible if the first baby is head down. Otherwise, a cesarean may be recommended. In some cases, complications after the vaginal delivery of the first baby may require a cesarean delivery for the second. For pregnancies with multiple babies, a cesarean is the recommended type of delivery.
- Feto-fetal transfusion. For twins who share a placenta, the blood vessels of the common placenta can cause one baby to receive too much blood and the other too little. This is a serious complication for both babies that can lead to significant complications and require fetal interventions during pregnancy. This type of twins will therefore be monitored with specialized checks every two weeks.
- Growth restriction. In twin pregnancies, the chances that at least one of the two babies grows at the lowest end of normal are increased. In any case, when you have two babies, they can never grow as if there were only one, and their growth must therefore be monitored more closely for each of them.
The most important thing: rest and do not neglect your emotional health
During twin pregnancies, women must rest properly, take care of their mood, and avoid stress. It is normal for the expectant mother to be particularly anxious about her health and that of her children, or to feel more uncertain about childbirth and raising her children.
Fortunately, there are currently many multiple births, and professionals are increasingly prepared to assist with them. You can consult your doctor about the specifics of twin pregnancy, ask for advice, or request to be put in touch with other women who have experienced this.
Do not be afraid to express your feelings to your partner and those around you to relieve your worries. And, if you need it, do not hesitate to contact an expert to help you channel your emotions during these months of happy waiting.
And… after childbirth? Caring for multiple babies
Multiple healthy babies have the same needs as other newborns. However, you may need more rest and support than you think, especially if the babies are born prematurely or need special medical care after birth. You are also at a higher risk of postpartum depression. If you experience symptoms of postpartum depression, do not hesitate to talk to your doctor.
If you are considering breastfeeding your twins, seek specialized help so they can inform you of everything that is necessary. At first, it is best to breastfeed the children individually to fully dedicate yourself to each of them and practice. When you feel more confident, you may be able to breastfeed both at the same time.
Take the time to enjoy your babies; ask your friends, loved ones, and others for help when you need it.
For more information, you can check the following links:
- Madrid Association for Multiple Births: AMAPAMU: amapamu.org
- Spanish Association of Primary Care Pediatrics: http://www.somosmultiples.es
- Multiple Birth Associations: http://www.mellimama.com
- First Association of Twins and Multiples in Spain: GEMESPA: http://www.bebesymas.com
- National Association for Multiple Births: ANPAMU: http://wordpress.com
- Association of Twins and Multiple Births: TAMBA: www.tamba.org.uk
Dr. Cristina Casanova Pedraz
Specialist in obstetrics and gynecology. University Hospital of Torrejón. Madrid. Master’s in fetal medicine from the Fetal Medicine Foundation. PhD in the official postgraduate program in health sciences and biomedicine. University of Valencia / Spain. Collaborating professor at Francisco de Vitoria University in Madrid.
To maximize your chances, check out this diet to have twins!