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How do I Know if I’m Having Twins?
Many people learn about their multiples at an early ultrasound. Others find a rapid rate of growth in their uterus causing them to suspect twins. If this is your second child, however, you may not want to be so quick to assume you’re having twins. It is common for your stomach to grow faster during a second pregnancy compared to your first pregnancy.

Sometimes multiple heart beats can be heard, leading your practitioner to believe that there is more than one bundle of joy in your uterus. Other times, during your prenatal tests, the doctor may find abnormally high levels of hCG since multiple babies will increase the levels of these hormones. The more babies you are having, the faster the rate of rise in hCG. In single births, hCG should almost double every 48 hours. Only a very small number of twin pregnancies remain undetected until birth.

Preparing for
Multiple Pregnancies
When you are having a multiple pregnancy, it is necessary to increase your nutritional intake even more than you would with a single pregnancy. In general, you need to increase the amount of protein that you eat. Protein is the building block of every cell in your body and your babies’ bodies. It will help you build a good placenta and a strong amniotic sac. A healthy diet will also help fight against infection.

As for your health care provider, you will want to find a midwife or doctor who has experience with multiple births. You don’t want someone who will panic at every corner. While the amount of care you receive will generally be the same as a single pregnancy, you will probably see your practitioner more frequently towards the end of your pregnancy. You may also have more testing than most women during pregnancy, but not always.

Healthy Pregnancy
Here are some tips to help you have a healthy pregnancy:

• Proper Nutrition: Low birth weight is one of the most common problems with a multiple birth. However, following
  a healthy diet can help lower your babies’ risk of this complication. Thus, when eating for three or more, be sure to consume about 300 additional calories along with one additional protein serving, one additional calcium serving and one additional whole grains serving.
• Extra Care: Expert medical monitoring can help reduce many of the risks associated with
  multiple pregnancies. By adhering to your appointment schedule — which will be more frequent — you can ensure that you are getting the best care possible.
• Increased Weight Gain: Due to the extra baby and the extra baby by-products, your practitioner will most likely advise a carefully monitored weight gain of at least 35 to 45 pounds.
• Proper Rest: Since your body will be working twice as hard, it will need twice as much rest. Ensure that you take regular breaks from your daily actvities. Getting at least eight hours of sleep will also ensure that your body is properly rested. Yor doctor may prescribe taking an early leave from work, getting help with the housework and even bed rest at home.

Complications of Twins and
Multiple Pregnancies
There can be a higher risk of complications with twins than with single births. Along with the regular monitoring of fetal growth and normal complications of pregnancy, like high blood pressure, you will also be monitored for complications specific to
multiple births, such as intrauterine growth retardation and twin-to-twin transfusions.

Giving Birth to Your Twins
In years past, cesarean was the common way for delivering
multiple births. However, vaginal birth is usually very safe for multiples, who frequently need the stimulation and rise in hormones levels associated with labor. Whether or not you will have a vaginal birth will depend on many factors, including the position of the babies and how the babies tolerate labor.

If your babies are in a position where neither can move, they are said to be locked. These babies will have to be born via cesarean. Breech babies really depend on the size of the baby and the skill of the practitioner. Usually if one of the babies is head down, a vaginal birth will be attempted. If the second baby is breeched or transverse, an internal or external versiom may be attempted to help out with the birthing process.

Recommended Link
Do you have an interesting, funny or amazing story to tell about your twin or
multiple pregnancy? Visit Pregnancy Stories to share your experience, and perhaps a few pearls of wisdom, with other expectant moms.

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2. Doppler Heartbeat Count

Using absolutely harmless sound waves, a Doppler system amplifies fetal heart sounds, usually distinguishable at some late point in the first trimester. An experienced physician or midwife can even detect more than one heartbeat, indicating a multiple pregnancy. However, those sounds can be misleading; what appears to be a second heartbeat may actually be background noise or, rarely, the mother’s own heartbeat.

3. Elevated HcG Levels

For various reasons, doctors may monitor HcG (human chorionic gonadotropin) levels. HcG is a hormone detectable in a pregnant women’s blood or urine about 10 days post-conception; it increases at a rapid rate, peaking about 10 weeks into the pregnancy. Twins may produce elevated levels of HcG. However, the standard HcG level for twins also falls within the normal range for singletons.

4. Abnormal AFP Test Results

AFP (Alphafetoprotein) screening is a blood test performed on pregnant mothers sometime during the second trimester. Also known as maternal serum screening or triple marker screen, it is usually used to identify increased risks of certain birth defects. A twin pregnancy can produce an usually high – or “positive – result.

5. Measuring Large for Gestational Age

Throughout the pregnancy, your doctor or midwife may measure the height of the uterine fundus (from the top of the pubic bone to the top of the uterus) as a way of indicating gestational age. Your twin or multiple pregnancy may causes the mother’s uterus to expand beyond the range of a single pregnancy. However, other factors may also increase the measurements and need to be taken into account.

6. Weight Gain

Just as a multiple pregnancy may cause mothers to measure large, it may also result in an increased weight gain. How much weight women gain can vary depending on her height, body type and how much she weighed before the pregnancy. Increased or rapid weight gain more than likely reflects eating choices rather than twins; generally, mothers of twins only gain around 10 lbs. more than singleton mothers.

7. Excessive Morning Sickness

About 50% of pregnant women experience some amount of vomiting or nausea that is associated with their pregnancy. Moms of multiples certainly aren’t exempt, but neither are they doomed to a double dose. Only about 15% of respondents in a poll on this site actually reported enhanced morning sickness symptoms as an indicator of their multiple pregnancies. Experiences vary widely – so some do, some don’t.

8. Early/Frequent Fetal Movement

Feeling a baby — or babies — move inside your womb is one of the most thrilling aspects of your pregnancy. Although many moms of multiples do experience more frequent or earlier fetal movement, there is some considerable disagreement among medical professionals on the subject. For many women, recognizable feelings of movement occur earlier in subsequent pregnancies, whether there is one baby or more.

9. Extreme Fatigue

This is one of the most commonly reported complaint during pregnancy with multiples. Sleepiness, lethargy and exhaustion during the first trimester can be enhanced because your body is working overtime to nurture more than one baby. In some cases, the fatigue can be attributed to other factors such work, stress, poor nutrition or having other children, but it can also be an indication of multiples.

10. History/Hunches

While the other items in this list refer to some kind of visible evidence – meaning: exaggerated symptoms, abnormal test results, etc. – we can’t disregard the power of a mother’s intuition. A family history of multiples, or a powerful hunch can be convincing indicators. Follow up with your doctor about these feelings to find out more.