Maybe you’ve always dreamed of having two babies to love on and snuggle with skin-to-skin—or maybe the thought of two colicky babies has you scared straight. The chances that you’re having twins is greater than it ever was—twin pregnancies have been on the rise since 1980, peaking in 2014 at about 3 percent of all babies born. So maybe you are carrying twins. How do you know? What are the signs of a twin pregnancy? That’s what we’re going to cover in this post.
Read on to find out:
- Signs of a twin pregnancy
- How to confirm a twin pregnancy
- Plus, the truth about hidden twins
Science-Backed Signs of Twin Pregnancy
Besides an ultrasound, there are very few things that definitively signal a twin pregnancy. They are:
Alpha-fetoprotein (AFP) is a protein that’s produced by the liver and yolk sac of a developing baby during pregnancy. This protein then travels into mama’s blood. During the second trimester, a test measures the amount of AFP that the fetus releases from its liver (into mom’s blood). This test is used to screen for chromosomal abnormalities or birth defects such as Down syndrome.
However, a high level of AFP may mean there are simply two babies excreting it! One study found that women carrying twins had AFP tests that were twice as high as women carrying singletons.
At your prenatal appointment, the midwife or doctor will want to check for a heartbeat, starting at around 10 to 12 weeks. Sometimes a second heartbeat can be heard. However, sometimes you can be carrying twins and still not be able to hear two heartbeats with the doppler (even when you’re looking for two!).
Other Possible Signs of Twin Pregnancy
In addition to the more common early pregnancy signs, women who are pregnant with multiples may have the following twin pregnancy symptoms:
In general, a twin pregnancy causes mama’s body to produce more hCG, the hormone the body secretes during pregnancy.
In studies, moms with twin pregnancies produce more hCG and for longer periods of time than a singleton pregnancy.
Keep in mind, though, that hCG production varies widely from woman to woman so high levels should not be used as a definitive measure of whether mama is carrying twins. Some women with singleton pregnancies produce an unusually high amount of hCG, and some women carrying multiples produce an unusually low level of hCG.
Since many mamas do report higher hCG levels with twin pregnancies, other early signs of pregnancy are exacerbated in a twin pregnancy. Here, some common complaints in mamas carrying multiples:
Extreme morning sickness
Because of the bigger increase in several pregnancy hormones, morning sickness can be especially bad during a twin pregnancy. In studies, twin pregnancies are a risk factor for the most severe form of morning sickness, hyperemesis gravidarum. But, not all moms pregnant with twins will experience severe morning sickness! Some may not feel queasy at all. Every mom and pregnancy is different.
If the nausea does hit, here’s what to do:
- Eat a healthy balanced diet: Sometimes easier said than done, but a mix of protein, fat, and complex carbs at each meal will not only nourish you and baby but help regulate blood sugar (one potential cause of morning sickness).
- Support the liver: The liver is responsible for processing hormones and other toxins and is often overburden in first trimester of pregnancy. Milk thistle or dandelion root teas are excellent, as are safe digestive bitters, fermented foods like raw apple cider vinegar, and lemon water.
- Boost digestion: Age old remedies of both ginger and peppermint are helpful for stomach upset and nausea. Try these ginger chews or tea and these real peppermints and/or tea.
- Beware of the empty stomach: As soon as you wake up, eat something with protein and complex carbs. Some moms even keep whole grain crackers by their bedside. This can reduce nausea caused by sluggish bile or low blood sugar.
If you want to dive deep with many more strategies for combating morning sickness, check out our dedicated post on morning sickness remedies.
Similarly to the extreme morning sickness, some mamas with a twin pregnancy notice an especially strong aversion to certain foods. Blame this (again!) on the hormonal fluctuations you’re experiencing.
Common culprits include:
- Green leafy veggies
- Coffee (When pregnant, be sure to stick to 200 mg of caffeine or less per day!)
Some evidence suggests that changes in taste perception during pregnancy is to blame.
Another theory suggests that food aversions are protective for the developing baby but also mentions that aversions are likely more complicated than that.
In any case, it may be best to listen to those aversions and stay away from those foods for now. Try to eat the healthy, mild tasting foods you can tolerate like broth, bananas, avocados, oats and smoothies and don’t stress about it. These aversions usually pass within a few weeks and you can get your fill of nutrient-dense foods later.
Any pregnant woman is going to be tired, but many mamas with a twin pregnancy report feeling utterly exhausted. The sharp rise in progesterone to support the gestation of two babies, combined with a higher basal metabolic rate (the rate at which the body uses energy), can cause the debilitating fatigue. Plus, the first trimester is the most critical for developing the baby’s foundational body systems (and you’re doing this for two babies!)
When you’re feeling wiped out, here’s what to do:
- If you’re working, take naps during your lunch break.
- Go to bed early every night (before 9 p.m.!).
- Practice deep breathing if you’re unable to sleep.
- A healthy diet and good prenatal can boost energy levels.
- Some moms find foods high in B vitamins like nutritional yeast flakes or bee pollen help.
- Drink plenty of water. Believe it or not, dehydration is a HUGE cause of fatigue.
- Finally, walk 20 minutes a day. While it may seem like torture, it can really boost your energy! (And it’s good for your babies’ IQs.)
Extreme breast tenderness
Pregnancy can make breasts incredibly sore and tender. This is another early pregnancy symptom that is often extreme when it’s a twin pregnancy and hormone levels are elevated. Your breasts are working overtime since they’ll have to support two babies rather than just one.
Here are some tips to reduce the pain of sore breasts:
- Ditch the tight, underwire bras for softer ones.
- Wear a cotton sleep bra to avoid the pain of moving in bed.
- Avoid running, bouncing or jarring your breasts until the sensitivity subsides.
- Consider making your breasts temporarily off limits to your partner.
Just like with a singleton pregnancy, carrying twins can cause increased urination due to rising levels of hCG. Since twin pregnancy hCG levels rise faster than those in singleton pregnancies, the increased need to go to the bathroom may be especially obvious.
Here are some ways to deal:
- Drink your fluids earlier in the day and stop 1-2 hours before bed.
- Try to avoid beverages that are diuretics. This could include tea, seltzer, and coffee. Stick with hydrating electrolyte drinks like coconut water, broth or plain filtered water.
- Empty your bladder fully by leaning forward with each pee. You can also wait a few seconds while on the toilet to be sure your bladder is completely empty.
Bigger belly than usual
Many women wonder, “when do you start showing with a twin pregnancy?” Well, it depends on so many factors but, in general, earlier than a singleton pregnancy!
Looking bigger than expected for gestational age is a possible sign of twin pregnancy, but keep in mind that many women show much earlier in subsequent pregnancies than their first.
Measuring the fundal height may be a more reliable identifier for possible twins.
Midwives and doctors measure the fundal height (the height of the uterus) starting at about 12 weeks of pregnancy to see that baby is growing normally. When the fundal height is larger than expected, it could mean that you’ve got twins! (Or, you have your conception or last period dates off.)
Higher resting heart rate
As we mentioned earlier, in pregnancy, the basal metabolic rate increases to provide nourishment for the baby. Similarly, the resting heart rate can increase too. A normal resting heart rate is around 70 beats per minute (bpm). During pregnancy that increases to 80 to 100 bpm. With a twin pregnancy, the heart rate can be even higher. After 100 bpm, tachycardia may be diagnosed. Tachycardia is often considered normal in pregnancy (so there’s no need to worry), but should be monitored by your midwife or doctor.
While you can’t necessarily stop your heart from racing, it may be beneficial to include stress reduction in your life.
Some ways to keep your system calm include:
- Not letting your body go into low blood sugar. Eat well-balanced meals and snacks at regular intervals.
- Practice deep breathing, visualization, and/or meditation. You can even just sit in a comfy chair and listen to some Enya!
- Avoid high stress environments like rock concerts, bumper-to-bumper traffic, walking along busy streets, etc.
- Use therapeutic herbs like chamomile or lavender in tea
- Diffuse their essential oils in a diffuser.
As always, talk with your doctor about what’s best for you.
When those hormone fluctuations kick in, mood swings might not be far behind. And like with other early signs of twin pregnancy, increased moodiness due to massive biological changes may be a sign that you’re expecting two bundles of joy!
When pregnancy moodiness hits, do this:
- Journal your feelings. You can write things that you sometimes wouldn’t say. Be free with your pen and “vent” all of your feelings without judgment.
- Get support from a trusted person (your partner, family members, or friends).
- Practice spirituality to keep a higher perspective and connect to peace. Whether that means go to church, join a Bible study, do meditation or practice yoga, find ways to connect to your spirit.
Also, keep in mind that intense feelings will go just as easily as they came (so don’t worry!).
Some mamas just know it’s a twin pregnancy! Whether it’s a nagging thought or a dream about having two babies, intuition is a real thing, especially in pregnancy. As the saying goes, trust your gut!
How Soon Can You Tell If You Are Pregnant With Twins?
Though all signs may point to yes, you’ll have to wait until you can confirm with an ultrasound after 6 weeks of pregnancy. (One study found that transvaginal sonograms earlier than 6 weeks gestation were unreliable in picking up two gestational sacs.)
Do know that finding out you have a twin pregnancy this early means you may end up with a twin loss. Researchers estimate that 21 to 30 percent of twins pregnancies result in vanishing twin syndrome. This happens when a twin pregnancy is confirmed at around 6 weeks (with an ultrasound), but the twin has “vanished” or been reabsorbed by the next scheduled appointment (around 12 weeks). Some women would rather not know until both twins are relatively safe, while others want to know even if the chances of losing one twin are high.
How Is a Twin Pregnancy Confirmed?
While there are many signs and symptoms of a twin pregnancy, there’s only one way to know for sure—an ultrasound. Some women choose to have one done early, while other women will choose to avoid ultrasounds until the 20-week scan. Still, other women, albeit rare, have no symptoms of twins and only find out at the birth!
Can There Be a Hidden Twin?
With an early ultrasound, it’s possible for there to be a hidden twin (one twin is hiding behind the other during the scanning), but it’s rare. By the 20-week ultrasound, no doubt about it, you would know for sure whether you were having twins or not!
How About You?
Do you think you’re having twins? What symptoms are you experiencing?