Twin Pregnancy - Everything You Need To Know

As with all pregnancies, you can help alleviate any fears by ensuring that you and your partner are educated and informed. I’ve included some of the key points and main differences about twin pregnancy vs singleton pregnancy below.

Remember, if you understand what is happening to your body and why, it will help to remove the fear. Check out our Ultimate Online Birth Course to find out everything you need to know in preparation for birth.

How do twin pregnancies occur?

There are two main types of twins – fraternal and identical.

Fraternal twins:

Fraternal twin pregnancies occur when two separate sperm fertilise two separate eggs. This means that the two embryos are just as unique as any other siblings. The only thing they share more in common than any other sibling is the uterus at the same time! This is the type of twin pregnancy that can run in families; some women are more likely to release two eggs at the same time.

Identical twins:

Identical twin pregnancies occur when a fertilized egg splits in half and creates two genetically identical embryos. Depending on when this split occurs, the embryos may get their own gestational sac and placenta. If they split later, the two embryos may share a sac and in some cases a placenta. Identical twin pregnancies happen completely by chance. You can’t inherit a gene that makes you more likely to have identical twins.

Factors that can influence and increase your chances of having a twin pregnancy:

– If you are over 45 your chance of having twins increases to 17%.

– Undergoing fertility treatment whereby medication is used to stimulate the ovaries. Therefore, increasing the chances of two eggs being released. Women who undergo IVF also have a higher chance of twins as generally more than one embryo is placed in the uterus.

– Women with a higher than average BMR (Basal Metabolic Rate) have a higher chance of twin pregnancies. Although, ironically can have a harder time falling pregnant in the first instance.

– Another interesting statistic – women who are in the top 25th percentile for height are more likely to have twins. Nature thinking there is a bit more room for two perhaps?

How do you know if you’re carrying twins?

There is no way to know for absolute certain that you’re carrying twins until an ultrasound confirms that there are two babies in there!

However, there are several signs and symptoms many Mumma’s of twins experience that may indicate more than one bubba in those early weeks. If you’ve just found out you’re pregnant and want to know if there are any early signs to look out for that you’re carrying twins in the first few weeks – read on!

Common pregnancy symptoms can often appear earlier or are more pronounced in a twin pregnancy. This is because your body is not only growing one baby but two. This means double the energy used, double the space used (hello to a bigger bump sooner!). And often times, higher levels of pregnancy hormones.

Common twin pregnancy symptoms include:

Extreme morning sickness

Morning sickness is really common, especially in the first 12 or so weeks. However, those pregnant with twins often report feeling abnormally queasy and unwell.

Food intolerances

It’s also common to go off certain foods that you ordinarily like when you’re pregnant but especially so in twin pregnancies. Foods that Mums often report going off include; meat, fish, coffee and green veggies

Really tender boobs

A very common pregnancy symptom, but more pronounced in twin pregnancies

More fatigue than normal

Again, really common in pregnancy but may be more than a singleton pregnancy.

Showing earlier than usual

For obvious reasons, you’re growing two babies and in some cases two placentas.

Higher resting heart rate

It’s very common for your resting heart rate to rise during pregnancy but it’s even more common in twin pregnancies.

High levels of HGC

This is the hormone that is tested for in pregnancy tests and in most (but not all cases) women who are pregnant with twins will have higher than normal levels of this hormone.

Do twin pregnancies involve more risk than single pregnancies?

Because there is more than one baby, there are more variables. So, inevitably there is a higher degree of risk associated with twin pregnancies.

There are greater risks to the mother such as having a higher chance of the following pregnancy health related issues:

– High blood pressure
– Gestational diabetes
– Preeclampsia
– Gastrointestinal issues such as constipation
– Higher chance of requiring a C-section
– Early labour symptoms leading to bed rest
– Post-partum depression and anxiety

There are also some additional risks for babies such as:

– Premature Birth
– Miscarriage

Things you can do to minimise risks:

Once you find out you are having twins, there are things you can do to help ensure you minimise your risks. Regular, quality prenatal care is important in addition to;


You are growing not one but two humans! This requires an enormous amount of energy so if there is any way you can work in additional breaks and naps into your day – do it!

Eat well:

All that energy your body is using to grow two babies (and in many cases, two placentas) needs to be replaced so you need to ensure you’re eating adequate amounts to support your pregnancy. Easier said than done when you’re feeling more nauseous than normal, I know! Work with your healthcare provider to ensure you’re eating enough of the right foods because your body will have unique nutritional requirements during this time.

Try to stay active:

It’s important to try and remain as active as possible, going about your normal daily routines for as long as possible. Light to moderate physical activity is beneficial for you and your babies, so do what feels comfortable. As with any pregnancy, always check with your obstetrician and/or midwife to make sure what you’re doing is safe for you and your pregnancy.

Drink lots of water:

Being dehydrated can be a cause of premature labour, which is already more of a risk in twin pregnancies. Be sure to drink plenty of water throughout the day, although you may want to ease off in the last few hours before bed to avoid too many unnecessary trips to the bathroom during the night (which will probably happen anyway!).

Being pregnant with twins may be overwhelming, especially when you first find out. However, there is no need for undue worry or concern. While twin pregnancies can come with some additional risk and considerations, with the good prenatal care, education and preparation, you can greatly reduce many of these risks.

Are there any additional checks or testing required?

Generally, as there is more risk associated with twin pregnancies, you will have more tests. You will likely have more frequent scans than a singleton pregnancy, especially in the final few weeks. This is to monitor both the growth of the twins (checking to ensure that one is growing significantly faster than the other). Also, to check on their positioning which will affect your ability to give birth naturally.

Is normal vaginal birth still possible when having twins?

The short answer is yes, it is possible to have a vaginal birth when having twins. That being said, there are more variables so there is a higher chance that your healthcare provider may recommend a C-section.

There are many factors that will affect whether or not you are able to have a vaginal birth. These can include your health, whether or not you’ve had a C-section previously, the health of the babies and the position of the babies.

Keep in mind that up to one-third of twins are born vaginally, so just because you’re having twins it does not automatically mean you need to have a C-section. The best thing you can do is to be prepared for all the possibilities. Get educated about your options and be prepared that your birth might not always go to plan – just as with singleton pregnancies. Our online birth course includes full module that takes you behind the scenes of the full C-section process.

Do twins arrive earlier than singletons and are they smaller than ‘normal’ babies?

The average length of a twin pregnancy is 35 weeks as opposed to 39 weeks for singleton pregnancies. Less than half of twin pregnancies will last beyond 37 weeks.

For this reason, twins are often smaller than singleton bubs. Interestingly, twins are usually of average size up until about 30 or so weeks. After then they start to slow down compared to single babies, as they are competing for more for nutrients.

Twins are at a higher risk of being born prematurely for many reasons. These include a higher chance of spontaneous pre-term labour and complications that require the babies to be born earlier. Because twins are often born early or premature, they will be more likely to require special care meaning a longer hospital stay and extra monitoring. Your healthcare provider can discuss this further with you based on your unique situation.

Is breastfeeding possible with twins?


Just like any other pregnancy and baby, this is entirely dependent on each mother and each baby. However, if you plan on breastfeeding your twins know that it is possible – even if it does require a little extra coordination at f

There will be many factors involved in your twin breastfeeding journey such as when the babies are born, if they require tube feeding at first, whether you’re able to express, whether only one bub is able to feed or both and your supply. Keep in mind that when it comes to breastfeeding, supply = demand, so don’t worry whether you’ll be able to produce enough milk for two babies.

Breastfeeding twins may require additional patience, trial and error and support. Your health care provider can make local recommendations about lactation consultants in your local area if you need extra help. There is also a whole bonus Breastfeeding module in our Ultimate Online Birth Course which gives you the basics of breastfeeding so that you can feel prepared and re-watch whenever you need to.