pregnancy, Women's Health


Telling a couple that they are having twins is one the best things about my job. Watching their faces as the meaning of my words takes effect is priceless. With twin pregnancies on the rise due to increased use of fertility medication and older maternal ages, I get to tell the exciting news often. Currently 3.3% of births in the US are multiples.

Luckily in this age of ultrasound technology, women usually know fairly early in their pregnancy, so they can start planning right away. Here are some helpful hints for those who are going to be needing a double stroller:


1. Eat for 3. Twin pregnancies require an additional 600 calories a day. So a 5′ 5″ women who weighs 140 at the start of her pregnancy will need about 2500 calories a day. That doesn’t mean 2 extra Snickers bars. Focus on getting your 5-7 servings of fruits and vegetables a day. Also, eat lean proteins throughout the day to help prevent hypoglycemia. A prenatal vitamin with at least 1 mg of folic acid and an iron supplement is encouraged for all twin pregnancies. Weight gain is recommended to be 37-54 pounds for a mom with an normal BMI.

2. Don’t fret your belly size. In The Pregnancy Companion, we talk a lot about worrying over your belly size. ‘Helpful’ friends and neighbors tend to constantly comment on the size of your belly. One neighbor comments you are too large, later the same day a co-worker will think you are too small. It’s also hard to not compare yourself to other preggos who are at the same point in their pregnancy. The shape of your pregnant belly really depends on your body type and how many babies you have had. If this is your first pregnancy and you are tall with a long torso and firm abs, you may not show until after 20 weeks.  If you have a short torso and this is your third baby, you may be in maternity clothes before you get out of the first trimester. Your doctor will be monitoring your size carefully, so listen to her, and not your mother-in-law.

3. Stay active as long as you can. Gestational diabetes is caused by the placenta secreting an anti-insulin hormone, so with twins you have twice the placenta and therefore an increased risk. Twins do often mean bed rest later in pregnancy, but not always.  Stay active as long as you can to help keep up your muscle tone and reduce your risk of gestational diabetes. Stay in communication with your doctor about your amount of activity. Even if your pregnancy is complicated by partial bed rest, ask your provider if you can continue yoga and pilates to help reduce back pain and hopefully maintain  muscle tone.

4. Buy Tums in bulk. Most pregnancy symptoms are amplified in twin pregnancies. Heartburn tends to be one of the worst. Often women will go directly from their first trimester nausea to heart burn.  The hormones of pregnancy cause relaxation of the valve between the stomach and the esophagus. Add in that two babies are pushing your stomach up towards your esophagus instead of just 1, and you get a wonderful burning sensation in your chest complete with disgusting sour taste in your mouth. Tums are safe in pregnancy but you will often need stronger meds, so talk to your provider if Tums isn’t holding your symptoms.

5. Lay on your side. It’s usually recommended to start sleeping on your side after 20 weeks, but with twins 16 weeks is more realistic. The growing uterus can compress your blood vessels, reducing the blood return to your heart, and making you feel weak or dizzy. Swelling may also start earlier than normal. Stay active, reduce high-salt foods and invest in compression stockings early on.

6. Prepare early. 60% of twin deliver before 37 weeks, but luckily only 10% are born before 32 weeks, where the major complications of prematurity usually occur. Schedule your baby showers early and try to have your nursery ready by 30 weeks. Have a few preemie outfits on hand, but keep the tags on all clothes since you are not sure what size they will be when you bring them home.

7. Accept all help. I know people always say this, but with twins, this is REALLY true. Start a list of things you will need: dinners, laundry, diapers. When anyone asks what they can do to help, even if you don’t think they mean it, assign them a task.  If it’s someone you don’t really want coming to your house to scrub your tub, ask for diapers. If you can in anyway afford it, budget for a housekeeper during the first 2 months postpartum. I think this goes for all pregnancies, but for twins especially.

8. Find your support system. Whether it’s your MOPS group, Sunday school, family or neighbors, know who you can count on for help. Seek out other moms of multiples before delivery to find out tips. Meet Up, Google, Facebook are all at your fingertips to find groups of moms who know what you are going through.

9. Find good resources. Those who follow the blog know that I had a twin adoption fall through. During the months that we were preparing to parent twins I read multiple books. The best was Juggling Twins by Meghan Regan-Loomis. This book is absolutely hilarious and chock full of helpful hints, from pregnancy through the toddler years.

10. Don’t let twice the babies equal twice the worry. As soon as you find out you are having twins, most of you will immediately hit Google. This will fill your mind with all the complications that can happen in twin pregnancies. Twins are high risk. Your doctor will watch you closely to make sure the babies are growing well. She will watch for preterm labor and high blood pressure. Twin pregnancies have bumpy parts and miserable moments, but 90% of twin pregnancies do make it past 32 weeks, resulting in healthy happy babies.

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