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Having Twins

The news that you are having twins can be happy, exciting, wonderful, and nerve-wracking all at once. The idea of carrying more than one baby can make some pregnant women nervous, especially if they are not informed about the facts of being pregnant with twins. Being knowledgeable about your upcoming birth will help to prepare you and may help with what is to come. Many women who are pregnant with twins have questions. This page should answer some of them by covering the basic information that you need to know about having twins.



During the process of conception, a single egg is released by the ovaries to wait for fertilization in the fallopian tubes. If sperm are released into a woman’s vagina, they will travel through the cervix, uterus into the fallopian tubes. This is where sperm joins with an egg to fertilize it. This fertilized egg then travels down into the uterus, where it embeds itself into the uterine wall and begins to grow. Twins can occur in these early stages of fertilization. Two different types of twins can form:

  • Fraternal Twins: This type of twin set is the most common. This occurs when two different eggs are both fertilized by two different sperm and implant themselves into the uterine wall at the same time. Fraternal twins will both have a different amniotic sac and placenta. Since these eggs were fertilized by two different sperm, it is very unlikely that the children will end up looking the same. Fraternal twins can be both of the same sex or one male and one female.
  • Identical Twins: Identical twins are extremely rare. They form when the single fertilized egg splits in early pregnancy and develops into two fetuses. The twins may share the same placenta but usually have separate amniotic sacs. Since identical twins come from the same sperm and egg, they will look exactly alike. They are always the same sex, have the same physical features, and have the same blood type.



Twins are almost always detected during a routine ultrasound exam, which allows the doctor to see pictures of the growing baby. Your doctor may be able to tell if they are identical or fraternal through the ultrasound. Sometimes, they may be found earlier, especially if your uterus grows much faster and larger than normal.



If you are going to have twins, you will need special prenatal care. You may need to see your doctor more frequently, as well as needing to have more tests taken to make sure that you and your babies are healthy. You also may need to take special classes about birthing that will help you prepare for the birth of your twins. Other things you may need to do include adjusting:

  • Nutrition: It is important to understand that you will inevitably gain more weight if you are pregnant with twins than just one baby. If you are of average weight, plan on eating healthy foods that amount to about 2,700 calories a day. You should expect to gain around one pound per week, and a little over a pound during the later months, with an all-around weight gain of 35-45 pounds. If you are overweight, you may need to eat less to gain less. If you are underweight, you may need to eat more to gain more.
  • Vitamins: Your doctor may advise you to take special vitamin supplements that will help you have a healthier pregnancy. He or she may recommend taking iron supplements because anemia is common among women who are pregnant with twins. You should also take folic acid supplements.
  • Rest: Twins carry much more weight and cause more stretching of the uterus. As a result, you may feel very uncomfortable at times. You should rest frequently and drink plenty of water. You may even need to take short breaks from work in order to stay healthy.



There are several risks of complications that are greatly increased by having twins. These include:

  • Growth Problems: Oftentimes, twins will be born smaller than most babies. This is because two babies are growing and need twice as many nutrients. Oftentimes, the condition of twin-twin transfusion syndrome (TTS) can develop in identical twins. TTS happens when one twin passes blood and nutrients to the other through their shared placenta, causing the blood-giving twin to be much smaller. The receiving twin will be much larger and sometimes has too many nutrients. TTS can cause preterm birth or even death.
  • Preeclampsia: This is a condition when the mother has extremely high blood pressure, resulting in protein being introduced into the urine. High blood pressure is harmful because it restricts blood flow to babies, causing them to get less oxygen and nutrients. It can also harm the kidneys, liver, heart, and brain of the mother. Seizures may occur in rare cases. If a woman’s blood pressure becomes too high, the babies may need to be delivered early.
  • Preterm Labor: This is a condition in which labor begins anytime before the 37th week of pregnancy, sometimes resulting in preterm birth. Preterm birth can be very dangerous for babies, as it causes problems with eating and breathing. The earlier the birth, the more problems the baby will have; extremely preterm babies may have physical and mental problems that oftentimes are permanent. If you have preterm labor, your doctor may give you steroid injections which will help the baby’s lungs develop. If preterm labor is caught early enough, it can even be held off for several days.
  • Fetal Loss: Sometimes, one of the babies can die, usually in early pregnancy. If this is the case, it usually does not affect the other baby and causes only minor bleeding. However, if one twin dies later in the pregnancy, it can be very problematic for the other baby, as well as emotionally traumatizing.


Your doctor will make sure to monitor your twin’s pregnancy very carefully to make sure that there are no problems. This will include taking blood tests, regular ultrasounds, heart rate checks, and physical activity checks.



How you will birth your babies depends on their position, health, and weight. Sometimes, twins are able to be born vaginally. If the first twin is in the head-down position, it can usually be born vaginally, and the same with the second twin in head down position. If the second twin is not in the head-down position, it is still sometimes possible to deliver the baby vaginally. However, if the baby is large or in a difficult position, it may be delivered with a cesarean section. Usually, vaginal labor with twins can be very slow, but the twins are usually born within a few minutes of each other. If a cesarean birth is needed, your doctor will give you anesthesia for the pain and will make an incision in your abdomen and uterus and lift both babies out.



How you will need to care for your twins depends on their health at birth and whether or not they were born on time or early. Usually, you will be able to care for them like any other single pregnancy. However, the presence of two newborn babies can be very stressful for women. Two crying babies and twice as many diaper changes can be overwhelming and difficult. If you feel this way, it is important to talk to your doctor and friends about these feelings.

It is possible to breastfeed both babies at once. Since both of your breasts will produce milk, it will increase to meet the needs of both of your babies. If you are breastfeeding twins, it is important to drink plenty of fluids and eat healthily. Taking vitamins is also important at this time.



Having twins can be both an exciting and anxious time for a woman. However, in order to be ready, it is important to become informed about your upcoming new babies. Make sure to take care of yourself and learn the warning signs of problems. If you are having twins, talk to your doctor and friends about what you can do to take care of them and about the new additions to your life.