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11 Things You Didn't Know About Twin Pregnancies

Experts share their advice for women who are pregnant with twins.
By
WebMD Feature
Reviewed by Louise Chang, MD

If you are expecting twins and don't know what to expect, you are not alone. Many women pregnant with twins have no idea what to expect, but that doesn't mean they -- and you -- can't learn. So here is some information to help you understand what's happening when you're expecting twins.

A twin pregnancy is a double blessing, but it can also carry greater risks than singleton pregnancies.

In the U.S, about three in every 100 pregnant women give birth to twins or triplets, according to the Mayo Clinic in Rochester, Minn.  And by many accounts, twin pregnancies are on the rise.

Be prepared. Familiarize yourself with the top 11 things you didn't know about your twin pregnancy from conception through delivery.

No. 1: You are more likely to become pregnant with twins naturally when you are in your 30s and 40s.

We all hear that the older we get, the harder it is to conceive, but advancing age may actually increase the likelihood of a twin pregnancy, says Abdulla Al-Khan, MD, the director and chief of maternal and fetal medicine and surgery at Hackensack University Medical Center in New Jersey. "Once you are 25 or into your 30s and 40s, ovulatory cycles are not regular anymore. If you are not regular and do ovulate, you could be ovulating two follicles at the same time." Voila! A twin pregnancy -- without assisted reproductive technologies.

No. 2: If you have two buns in the oven, you may need extra folic acid.

Women pregnant with twins may need more folic acid to help stave off birth defects, says Manju Monga, MD, the Berel Held Professor and the division director of maternal-fetal medicine at the University of Texas Health Sciences Center in Houston.

"We recommend 1 milligram of folic acid per day for twin pregnancies and 0.4 milligrams for singleton pregnancies," says Monga, who has twins.  Folic acid is known to reduce risk of neural tube birth defects such as spina bifida.

No.3: Women pregnant with twins clock in more time at the obstetrician.

Twin pregnancies require more monitoring than single pregnancies, Monga says. "We tend to do more frequent ultrasounds for growth in twin pregnancies, compared with one anatomy scan and one growth scan in a singleton pregnancy."

But along with additional testing comes risk. For example, the chance of miscarriage after amniocentesis is higher in twin pregnancies, Al-Khan says. "You are sticking the mother twice, so if the risk of miscarriage is one of 1,000 in singleton pregnancies, it would increase it to one in 500 for twins."

No. 4: Morning sickness may be worse with twin pregnancies.

"One of the things that is postulated as causing morning sickness is high levels of human chorionic gonadotropin, and we know that levels of this hormone are higher in twin pregnancies, so women carrying twins have a higher incidence of nausea and vomiting in the first trimester," says Al-Khan. The good news? Most morning sickness abates within 12 to 14 weeks of pregnancy -- even in twin pregnancies.

That's not all, Monga says. Moms pregnant with twins complain of more back pain, sleeping difficulties, and heartburn than moms who are carrying one child. Moms pregnant with twins also have a higher rate of maternal anemia and a higher rate of postpartum hemorrhage (bleeding) after delivery.

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