Possible Signs and Symptoms of a Twin Pregnancy

How many babies?

Whether you would love to have multiples or are terrified by the idea of carrying more than one baby at a time, it's very common for pregnant women to wonder if they could be having more than one baby. You may have a higher chance than you imagine- the rate of twin births, along with triplets, quadruplets, etc., is rising every year; currently more than 1 out of every 30 pregnancies contains more than one baby.

Here are some signs that could indicate multiples, along with the symptoms I experienced when I was expecting my twin daughters.

First Symptoms

Typically, two of the earliest pregnancy symptoms are morning sickness/nausea (which can last all day) and low energy/fatigue. While these can be common symptoms for any pregnancy, they are often more pronounced for women who are carrying twins. This is because the levels of HCG (human chorionic gonadotropin), the same hormone that gives you a positive on a home pregnancy test, are usually higher when there is more than one baby. Morning sickness and fatigue can also begin sooner into a twin pregnancy than a singleton pregnancy.

In my experience, the fatigue was much more extreme during my twin pregnancy than it was during my two single pregnancies. My morning sickness was about the same with my twins as it was with my first pregnancy but it started a lot sooner after conception.

Chances of Fraternal vs. Identical

Fraternal twins often run in families. They are caused by hyper ovulation, which means releasing more than one egg during a cycle. If you have fraternal twins in your biological family, you have a much higher chance of getting pregnant with twins. Taking fertility drugs and getting pregnant after the age of 35 also increase your chance of ovulating more than one egg, which means you could be having fraternal twins, triplets or more!

Identical twins are a completely random occurrence and less common than fraternal twins. Age, race and family history do not increase or decrease your chance of identical twins because they are technically a genetic malfunction caused by one egg splitting in half. My twins are identical, so although I had no reason to think I would be having twins, I got lucky!

Elevated HCG

It is possible to get a positive pregnancy test slightly sooner with twins than with one baby. Since the HCG levels are higher with multiples, they show up a little sooner. However, it is hard to determine exact levels by a home pregnancy test so getting blood work done by your doctor will get more accurate results. If the HCG seems higher than normal to a doctor, they will usually order an ultrasound which tell you for sure if there is more than one baby.

My doctor was concerned by my high HCG levels at my inital appointment and ordered an ultrasound, which was how I discovered for sure that I was having twins.

Other Clues

Since babies start out smaller than a grain of rice, even having quintuplets won't give you a gigantic belly overnight. The further along you get, however, the bigger you will become if you are expecting more than one baby. Measuring larger than usual for the gestational age is a major sign of a multiple pregnancy. Your doctor or midwife will probably be keeping track of these measurements and should notice a change in the size of your uterus as your pregnancy progresses.

Extreme heartburn and an overactive bladder are also symptoms that are more pronounced during a twin pregnancy. This is simply because two (or more!) babies take up more space inside your uterus than one. Also, as the babies grow bigger, the weight of two puts even more strain on your bladder than one would.

Sore leg, foot and back muscles and round ligament pain are also more common in multiple pregnancies. Again, the extra weight can be what is so hard on your body. In my experience, my heartburn and muscle pain was much worse during my twin pregnancy than in my singleton pregnancies.

Did you have any idea that you were expecting more than one baby?

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Gut Feelings

Many expecting parents say they knew they were having twins, even if no other symptoms were present. Intuition is a real thing and for whatever reason, many expecting mothers convinced that they are carrying twins or more turn out to be correct. Other parents say they feel that something is "off", or just sense that there will be a surprise or that something different is happening, even if they don't exactly picture themselves having twins. Sometimes other people can sense that a woman is carrying twins, even if she has no obvious signs.

However, many people are shocked when more than one baby appears on the ultrasound because they had no clue that there was more than one life inside them. This is one reason early ultrasounds are important whether you expect to be having one baby or more.

At the beginning of my first pregnancy I had many dreams that I was carrying twin girls. When I ended up with one boy I figured the dreams had no meaning and forgot all about them. Five years later, after discovering my third pregnancy, many friends and family members made jokes about there being two babies despite my having no family history of twins and not showing any more than with my other children. When I asked how they knew, many people said they simply had a feeling. I, however, did not expect to be having twins. The pregnancy didn't feel real to me at first and as soon as I discovered that I was carrying two babies it made sense.

Although all of these symptoms are signs that you could be having twins, triplets, or more, the only way to find out for sure (other than giving birth!) is to visit your doctor and have an ultrasound performed. While multiples are a wonderful blessing, the pregnancies can be riskier and it is very important to stay healthy and have proper medical care.

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