Multiple Pregnancy

Multiple Pregnancy

Multiple pregnancies carry their own risk, depending on the number of babies and would be classified under a High Risk Pregnancy. Multiple pregnancies have a tendency to go into labour early. Generally most pregnancies will progress like a normal pregnancy, but there will be certain things that your doctor will keep an eye out for and may ask for further tests, which she will discuss with you if needed. 

Expecting Twins or Triplets

If you’re pregnant with more than one baby, it’s called a multiple birth.There are two twins and three triplets. Multiple pregnancies are becoming more prevalent as more women use reproductive treatments and have children later in life. With a multiple pregnancy, you are more likely to experience difficulties such as early birth, hypertension, and fetal growth restriction.

What is a multiple pregnancy?

A multiple pregnancy occurs when you are carrying more than one baby at the same time. Twins are two infants that you are carrying. Triplets are three babies born during the same pregnancy. It is also possible to carry more than three kids at once (high-order multiples). A multiple pregnancy usually carries higher hazards than a singleton pregnancy (carrying only one kid).

How do multiple pregnancies happen?

A multiple pregnancy can occur in one of two ways:

  • Before implanting in the uterine lining, one fertilized egg (ovum) divides.

  • At the same period, two or more distinct eggs are fertilized by different sperm.

These two kinds of multiple pregnancy produce identical or fraternal siblings. The distinction between identical and fraternal babies stems from the manner in which multiple pregnancy occurs.

When a single egg is fertilized and then splits, identical twins or triplets result. These newly separated embryos are all the same. Children who are identical multiples will have the same appearance and gender.

Fraternal multiples are formed when separate eggs are fertilized by different sperm. Because there are distinct eggs and sperm, the genetic material is different. These children will not be identical and may be of different sexes.

If you have triplets or more, your infants could be identical, fraternal, or a mix of the two. This can occur if your body produces several eggs and more than one of them is fertilized. 

When there are both identical and fraternal multiples, more than one egg was fertilized, and at least one of those eggs split after fertilization.

Are identical twins or triplets always the same sex?

Identical twins or triplets are always the same sex because they share genetic material. A baby's sex is determined by the sperm cell that fertilizes the egg at conception. There are two types of sperm cells: those with an X chromosome and those with a Y chromosome. An X chromosome is present in the mother's egg. If an X-chromosome-carrying sperm cell fertilizes an egg, the result is a XX (female) combination. If the sperm cell has a Y chromosome, the result is an XY pairing (man).

Identical multiples begin as a single egg and subsequently divide, therefore the chromosomal combination present at fertilization determines the sex of all multiples.

What increases the chance of a multiple pregnancy?

A number of factors can enhance the likelihood of a multiple birth. You may be more likely to become pregnant with more than one child if you:

  • Are older (women in their 30s are more likely to have multiples since the body begins to release multiple eggs at once as they get older).
  • Are you a twin or do you have twins in your family?
  • Are on fertility medications.
  • If you are taller or heavier than average, you may be at a higher risk of multiple pregnancy.

Genetics is another risk factor for multiple pregnancy. If you are a multiple or if multiples run in your family, you are more likely to have a multiple pregnancy. This inherited feature is often passed down through the maternal (mother's) line of descent.

Another factor for multiple births is the use of reproductive medications. Because techniques like in vitro fertilisation (IVF) generally involve putting more than one fertilised egg into your uterus, treatments for infertility can raise your risk of a multiple pregnancy. To maximise the chances of success, your provider will normally transfer more than one egg at a time

How common are multiple births?

Multiple births have become more common in recent years because more people are using fertility drugs and procedures, such as IVF, to help conceive a baby.

What are the signs of a multiple pregnancy?

An ultrasound checkup with your healthcare practitioner is the only way to find out whether you're pregnant with more than one kid during your pregnancy. During this test, your provider will examine photos of the inside of your uterus to determine how many kids are there.

Symptoms may be more severe during a multiple pregnancy than during a single pregnancy. These are some examples:

  • Severe nausea and vomiting (morning sickness).
  • Rapid weight gain in the first trimester of pregnancy.
  • Sore or very tender breasts.
  • High human chorionic gonadotrophin (hCG) levels — this hormone is made during pregnancy and is what a pregnancy test picks up.
  • High amounts of the protein alpha-fetoprotein in your blood.
  • If more than one heartbeat is found during a fetal Doppler scan, your provider may suspect multiples in addition to an ultrasound.

What complications are linked to multiple births?

Possible complications include:

Premature labor and birth: The most common complication of multiple births is premature labor. If you’re pregnant for multiples, you are more likely to go into premature labor (before 37 weeks) than a woman carrying only one baby. The goal for many moms of multiples is to complete 37 weeks. This is considered term in a twin pregnancy and reaching this week of gestation increases the chance the babies will be born healthy and at a good weight. Babies that are born prematurely are at risk of another complication of multiple births — low birth weight.

Preeclampsia or gestational hypertension (high blood pressure): High blood pressure is called hypertension. During pregnancy, your healthcare provider will watch your blood pressure carefully to make sure you don’t develop gestational hypertension (high blood pressure during pregnancy). This can lead to a dangerous condition called preeclampsia. Complications related to high blood pressure happen at twice the rate in women carrying multiples compared to women pregnant with only one baby. This complication also tends to happen earlier in pregnancy and be more severe in multiple pregnancies than single pregnancies.

Gestational diabetes: You can develop diabetes during pregnancy. This happens because of the increased amount of hormones from the placenta. The size of the placenta can also be a factor in this condition. If you have two placentas, there’s an increased resistance to insulin.

Placenta abruption: This condition happens when the placenta detaches (separates) from the wall of your uterus before delivery. This is an emergency situation. Placenta abruption is more common in women who are carrying multiples.

Fetal growth restriction: This condition can also be called intrauterine growth restriction (IUGR) or small for gestational age (SGA). This condition happens when one or more of your babies is not growing at the proper rate. This condition might cause the babies to be born prematurely or at a low birth-weight. Nearly half of pregnancies with more than one baby have this problem.

Am I more likely to have a C-section delivery if I’m carrying multiples?

A caesarean section is a surgical technique that allows a baby to be delivered through an incision (cut) in the abdomen. This method of delivery may be utilized for a variety of reasons, but it is most commonly used in multiple births. If you are expecting numerous children, your chances of having a C-section are higher than if you were expecting just one. Even in single births, however, a C-section may be the safest option for delivery.

The newborns are frequently not in the proper posture for birth – head down. A C-section can also occur if you have a pregnancy condition that makes vaginal birth unsafe for you or your babies. 

Your healthcare practitioner will follow you in the weeks leading up to your due date and will advise you on the optimal method of delivery.

Can I be active and exercise during a multiple pregnancy?

Exercise and movement are essential components of each pregnancy. You can exercise during a multiple pregnancy in most circumstances. Low-impact workouts are an excellent way to stay fit and healthy throughout pregnancy. Some low-impact exercises to try while pregnant with multiples include:

  • Swimming.
  • Walking.
  • Prenatal yoga.

Even though exercise is beneficial during pregnancy, you should consult with your doctor about the appropriate activities for you. Some more rigorous activities may not be appropriate during a multiple pregnancy, such as:


Aerobics that involve jumping.

It's also crucial to remember that if you have any difficulties, your workout plan may need to adjust over time.