Identifying and Managing Twin Pregnancies

Realising you're pregnant with twins might come as an unexpected twist. Whether you’re filled with joy, overwhelmed with questions, or feeling both at once, you're not alone. This article is here to offer clarity and reassurance, explaining how twin pregnancies happen, how they may affect you, and what you can expect along the way. Gaining a clear understanding of the basics can increase your confidence and help you feel better prepared for what lies ahead.

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Discovering you're pregnant with twins often comes with joy, unexpected emotions, and a million things running through your mind. It's natural to feel both excited and uncertain, as your journey will be a little different from a typical pregnancy. Whether your twins came as a total surprise or through planned treatment, understanding what’s happening can ease the overwhelm. This guide will help you navigate the basics of twin pregnancy with clarity, compassion, and the confidence to take each step as it comes.



What It Means to Be Pregnant with Twins

When you’re pregnant with twins, you’re growing two babies in your uterus at the same time. This has become more common in recent years, especially due to fertility treatments and people starting families a bit later in life.
There are two main types of twins:

  • Identical (monozygotic) twins: Results from the division of a single fertilised ovum into two separate embryos during early development. They end up being the same sex because they share the same DNA.
  • Non-identical (dizygotic) twins: Occur when two separate eggs are fertilised by two different sperm. They’re as genetically similar as any other siblings and may be the same sex or different.


How Do You Know If You're Carrying Twins?

You might start thinking, “Hmm, could there be more than one in there?” if:

  • Your baby bump seems bigger than what’s typical for how far along you are
  • Twins run in your family
  • You’ve had fertility treatment
  • Your pregnancy symptoms feel more intense or show up earlier

Usually, the first real confirmation comes at your 12-week ultrasound scan. At this scan, your healthcare provider will assess several factors and check for:

  • The number of babies
  • One way doctors check if twins might be identical is by seeing if they share a placenta. It’s a helpful clue, but not the only one, and you're in good hands either way.


What Causes Twins?

The truth is, no one knows exactly what causes identical twins; they happen completely by chance, and the odds are about 1 in 250.

But several factors can increase your chances of having non-identical twins:

  • Family history on the mother’s side: If twins are common in your mom’s family, it’s more likely that you might have twins as well.
  • Age: Women over 35 are actually more likely to release more than one egg during ovulation, which means there's a higher chance of having twins.
  • Fertility treatments: These can result in more than one embryo being implanted, increasing the likelihood of a twin pregnancy.

Twins are Identical or Not? Here’s How You Know?

It’s not always easy to see if someone’s having twins, especially before they’re born. But doctors look for some special signs that can help them figure it out.

  • DNA test after birth: This is the most accurate way to confirm if your babies are identical.
  • The placenta: If you get your first ultrasound before 14 weeks, your doctor can usually check if your twins are sharing one placenta. If they do, it’s a strong sign they’re identical, and knowing early can bring some peace of mind.
  • The babies’ sex: If one baby is a boy and the other is a girl, they are not the same twins. If both babies are boys or both are girls, they might be the same (identical) or different (fraternal).


What to Expect During a Twin Pregnancy

Let’s be honest, carrying twins can be more physically demanding than a singleton pregnancy. Your body is working extra hard, and you’ll likely feel that.

Here’s what you might notice:

  • Faster weight gain: You’re nourishing two babies, so you may gain more weight earlier on.
  • More appointments: Enhanced prenatal monitoring is often recommended to identify complications at the earliest stage, ensuring prompt and appropriate care.
  • Increased symptoms: Some people experience more fatigue, back pain, or conditions like anaemia and gestational diabetes.


Will You Need a Caesarean Birth?

Not always. Lots of people carrying twins can still give birth vaginally especially if both babies are facing down.

However, a caesarean might be recommended if:

  • A cesarean delivery may be necessary if one or both fetuses are in a breech or transverse position.
  • If your body or your babies seem like they’re under stress, like pain, weird movements, or changes in heartbeat, it might mean something’s not right and needs attention.

Twin pregnancy is a unique experience, one filled with double the love, but also double the questions. It’s perfectly normal not to have all the answers right away. What really counts is that you feel informed, supported, and taken care of while getting ready for your little ones. Go with your gut, stay close to your medical team, and know it’s totally okay to feel all sorts of emotions right now. You’re not alone in this, and you’ve got everything it takes to do this beautifully.

FAQs on Identifying and Managing Twin Pregnancies


  1. Can I breastfeed twins?
    Yes, absolutely. It might take some practice and support, but many parents breastfeed twins, whether one at a time or together.
  2. Will I need more scans than a singleton pregnancy?
    Yes! When there are two babies, doctors look more often to make sure both are growing strong inside.
  3. Is bed rest common during a twin pregnancy?
    Not always. Bed rest isn’t routinely recommended anymore, but in some high-risk cases, your doctor might suggest reducing physical activity.
Disclaimer: Medically approved by Dr Rajeshwari Pawar, Consultant - Obstetrician and Gynaecologist, Cloudnine Group of Hospitals, Pune