Being pregnant with twins, triplets and other multiples

A multiple pregnancy (being pregnant with multiples) means you’re pregnant with more than one baby. If you’re pregnant with higher-order multiples, it means you’re pregnant with three or more babies.

Multiple pregnancy usually happens when more than one egg is fertilized by a man’s sperm. But it also can happen when one egg is fertilized and then splits into two or more embryos that grow into two or more babies.

Twins are called identical when one fertilized egg splits into two. Identical twins look almost exactly alike and share the exact same genes. Twins are fraternal when two separate eggs are fertilized by two separate sperm. Fraternal twins don’t share the same genes and are no more alike than any brothers and sisters from different pregnancies with the same mother and father.

Most babies are singleton babies. This means you’re pregnant with just one baby. But more women are getting pregnant with multiples now than in the past. This is mostly because more women are having babies later in life, and you’re more likely to have multiples if you’re older than 30. Also, more women are using fertility treatment to get pregnant. Fertility treatment is medical treatment to help women get pregnant.

How do you know if you’re pregnant with multiples?

You may be pregnant with multiples if:

  • Your breasts are very sore.
  • You’re very hungry or you gain weight quickly in the first trimester.
  • You feel movement in different parts of your belly at the same time.
  • You have severe morning sickness. Morning sickness is nausea (feeling sick to your stomach) and vomiting that happens in the first few months of pregnancy, usually in the first few months. It’s sometimes called nausea and vomiting of pregnancy or NVP.
  • Your health care provider hears more than one heartbeat or finds that your uterus (womb) is larger than usual. The uterus is the place inside you where your baby grows.
  • You have high levels of a hormone called human chorionic gonadotrophin (also called hCG) or a protein called alpha-fetoprotein in your blood. HCG is a hormone your body makes during pregnancy. Alpha-fetoprotein is a protein that a developing baby makes during pregnancy.

Your provider uses ultrasound to find out for sure if you’re pregnant with multiples. Ultrasound uses sound waves and a computer screen to show a picture of a baby in the womb.

What kind of prenatal care do you need if you’re pregnant with multiples?

If you’re pregnant with multiples, you may need extra medical care during pregnancy, labor and birth. You may need to go to extra prenatal care checkups so your provider can watch you and your babies for problems. You also may need more prenatal tests (like ultrasounds) to check on your growing babies throughout your pregnancy. This is because carrying multiples puts you at increased risk of developing pregnancy complications, including premature birth.

If you’ve had pregnancy complications in the past or if you have health conditions that put you at risk for pregnancy complications, your provider may refer you to a maternal-fetal medicine specialist. This is a doctor with education and training to take care of women who have high-risk pregnancies. High-risk means you’re more likely than most pregnant women to have problems with your pregnancy. If you’re referred to this kind of doctor, it doesn’t mean you’ll have problems during pregnancy. It just means they can check you and your babies closely to help prevent or treat any conditions that may happen.  

How are multiples born?

If you’re pregnant with multiples, you’re more likely to have a cesarean birth (also called c-section) than if you’re pregnant with one baby. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. Most triplets and higher-order multiples are born by c-section.

If you’re pregnant with twins, you may need a c-section if neither baby is in the head-down position or if you have other complications. You may be able to have a vaginal birth if:

  • Both babies are in the head-down position and you have no other complications
  • The lower twin is in the head-down position but the higher twin isn’t.

Vaginal birth is the way most babies are born. During vaginal birth, the uterus (womb) contracts to help push the baby out through the vagina.

Do you need to eat special foods if you’re pregnant with multiples?

No. But you do need more of certain nutrients, like folic acid, protein, iron and calcium. You can get the right amount of these nutrients by eating healthy foods and taking your prenatal vitamin every day. Prenatal vitamins are multivitamins made just for pregnant women. Compared to a regular multivitamin, they have more of some nutrients that you need during pregnancy. Your provider can prescribe a prenatal vitamin for you at your first prenatal care checkup. Even when you’re pregnant with multiples, you only need to take one prenatal vitamin each day.

To learn more about the health risks associated with being pregnant with multiples, you can read this article from the March of Dimes, or visit their homepage.

About the author:

March of Dimes is the leading nonprofit organization for pregnancy and baby health. For more than 75 years, moms and babies have benefited from March of Dimes research, education, vaccines, and breakthroughs. For the latest resources and health information, visit and

© 2017 March of Dimes Foundation
Originally posted 4.17

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