Everything You Need to Know About a Twin Pregnancy

Types of Twin Pregnancy

• Fraternal twins: These twins form when two separate eggs are fertilised by two different sperm. Each baby grows in its own amniotic sac with its own placenta, receiving nutrients and oxygen separately. Fraternal twins can be the same sex or different sexes and won’t look identical.
• Identical twins: These occur when one fertilised egg splits into two embryos early in pregnancy. Identical twins share the same genetic material, so they look alike and are the same sex. They may share a placenta or have separate ones.
• Mixed multiples: In pregnancies with three or more babies, there can be a mix of identical and fraternal twins.
• Conjoined twins: In very rare cases, identical twins do not fully separate and are born physically connected.

What to Expect in a Twin Pregnancy

First Trimester (Weeks 1 to 13)

Your Symptoms

• Implantation bleeding: Light spotting may occur about two weeks after fertilisation as the eggs attach to the uterine lining.
• Tender breasts: Your breasts may feel sore or swollen due to higher levels of the hormone hCG (produced in greater amounts with twins).
• Frequent urination: Your body has more blood to process, leading to more trips to the bathroom.
• Fatigue: Higher hormone levels can make you feel more tired than usual. Try to rest whenever possible.
• Nausea and vomiting: Morning sickness may begin about a month after fertilisation and can be more intense with twins.

Twins’ Development

• Early growth: By 4 weeks, each baby is a tiny cluster of cells that implants into the uterine lining. Placentas begin forming to nourish them.
• Heartbeats and organs: Around 6 to 8 weeks, their hearts start beating, and major organs like the brain, spinal cord, lungs, and genitals begin to form.
• Limbs: By 8 weeks, tiny arms and legs start to form.
• Facial features and more: By 12 weeks, fingers, toes, and fingernails appear. Their faces become more defined with eyelids, a nose, and an upper lip. Tooth buds form, and they start producing urine.

Second Trimester (Weeks 14 to 27)

Your Symptoms

• Weight gain: If your pre-pregnancy weight was healthy, expect to gain 15 to 20 kg over your twin pregnancy.
• Lower back pain: A growing belly shifts your centre of gravity, which can cause backaches.
• Difficulty sleeping: Your growing belly might make it hard to find a comfy sleep position. Try sleeping on your side with a pillow between your knees.
• Stretch marks and itchy skin: Hormonal changes and stretching skin can lead to itchiness or stretch marks. Keep your skin hydrated with water and gentle moisturisers.
• Dizziness: Increased blood volume can make you feel lightheaded.
• Quickening: Around 18 to 22 weeks, you’ll start feeling your babies’ movements, known as quickening.

Twins’ Development

• Sex organs: Their sex organs form by 14 to 17 weeks.
• Eye movement: Around 16 weeks, their eyes can move behind closed lids. Their eyebrows and eyelashes also start to grow.
• Hearing and movement: By 18 weeks, they may start hearing sounds.
• Protective layers: Their skin gets coated with vernix (a waxy substance) and lanugo (fine hair) to protect them from amniotic fluid.
• Fingerprints and lungs: By 23 to 27 weeks, their fingerprints form. Their lungs start to produce surfactant (a substance to prepare them for breathing).

Third Trimester (Weeks 28 to 40)

Your Symptoms

• Hip and pelvic pain: The extra weight can cause discomfort in your hips and pelvis.
• Braxton hicks contractions: You might feel practice contractions that don’t dilate the cervix. Unlike true labour, these are irregular and may stop when you change positions.
• Haemorrhoids: Increased blood flow and uterine pressure can cause painful veins around the rectum. A high-fibre diet and warm baths can help.
• Leg swelling: Fluid retention might cause swelling in your legs or feet.
• Fatigue: Carrying twins takes a lot of energy. Rest often, nap when possible, and try light exercise to stay active.
• Snoring: Hormonal changes might lead to snoring.
• Difficulty moving: As your belly grows, simple movements may feel harder. Take things slowly and rest when you need to.

Twins’ Development

• Eye opening: By 28 weeks, your babies may open their eyes and sense light. They also spend more time in REM sleep.
• Shedding lanugo: Around 32 weeks, the fine hair that covered their bodies begins to shed.
• Brain and bones: Their brains now regulate body temperature, and their bones harden. Though their skulls remain soft for delivery.
• Vital organs: Between 33 and 36 weeks, their lungs and circulatory systems are nearly ready for life outside the womb.
• Positioning: By 37 to 40 weeks, they may move into a head-down position for vaginal delivery. Although it's possible that some twins may be breech.

Risks and Complications of a Twin Pregnancy

• Premature birth: Over 50 per cent of twins are born before 37 weeks. This may require extra hospital time for breathing or feeding support.
• Gestational diabetes: Carrying twins increases the risk of high blood sugar during pregnancy.
• High blood pressure and preeclampsia: These conditions are more common with twins. Symptoms like swelling, headaches, or vision changes need immediate attention.
• Twin-to-twin transfusion syndrome (TTS): In some identical twin pregnancies where the babies share a placenta, one twin may receive more blood than the other.
• C-section delivery: Vaginal delivery may be possible if the first twin is head-down, but C-sections are more common.

FAQs on Here's What to Expect When You're Expecting Twins

1. Do I need to eat a lot more when carrying twins?
   You’ll need more nutrients and calories but it’s about balanced meals not just eating double.
2. Is bed rest necessary in twin pregnancies?
   No, bed rest is not recommended for uncomplicated twin pregnancies. Your doctor mayNo, bed rest is not recommended for uncomplicated twin pregnancies. Your doctor may only suggest rest in specific medical situations. only suggest rest in specific medical situations.