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Pregnancy and birth with multiple babies


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Pregnancy with multiple babies means that a woman is pregnant with more than one baby at a time. This can happen in a few ways: twins, triplets, quadruplets or more. Twins are most common. 

The pregnancy and birth process with multiple babies is different than what it is with one baby. 

Fraternal twins happen when more than one egg releases and sperm fertilizes each egg. When this happens, it causes more than one embryo to implant and grow in the uterus (womb). 

Identical twins happen when the sperm fertilizes a single egg and it splits. This results in identical embryos that implant and grow in the uterus. 



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  • Fertility drugs that induce ovulation (when a woman's egg leaves the ovary) often cause more than one egg to release. In vitro fertilization (IVF) can also lead to multiple births if more than one embryo transfers to the uterus. 

    Age is another common cause for multiple births. Women older than age 35 are more likely to release multiple eggs during their menstrual cycle than younger women. It also can be spontaneous. 

  • Usually, women who are pregnant with multiple babies gain more weight than women who are pregnant with a single baby. In some cases, your doctor may suggest eating an extra 300 calories a day for each baby.

    Before making any lifestyle changes, talk with your doctor to find out what's best for you. 

  • You should talk with your doctor before you exercise while pregnant. Overall, exercise is important for your health. Exercise is generally safe while pregnant as long as you don't do strenuous exercise.

    Instead, try low-impact exercises such as swimming, prenatal yoga and walking. If your doctor clears you for exercise, try to complete 30 minutes of exercise a day. If you do have any problems during your pregnancy, stop exercising right away and talk with your doctor. 

  • When you’re pregnant with multiple babies, your chances for certain complications are higher. You will have more frequent prenatal care visits with your ob/gyn. 

    After your first trimester, you may be required to have ultrasound exams every four to six weeks. If your care team notices a problem, you may need special tests such as nonstress tests, biophysical profiles and frequent ultrasounds. 

  • Preterm birth is the most common complication of multiple births. Babies born before 37 weeks have an increased chance of short-term and long-term health problems. These problems include trouble breathing, eating, staying warm and behavioral concerns.  

    These types of problems may not be clear right away and can appear later in childhood or even adulthood. Babies born before 32 weeks have a much lower chance of surviving or often have severe health problems, even with the best care. 

    Multiple babies born preterm have a greater chance of developing serious complications that can lead to cerebral palsy. Children born with problems related to preterm may need lifelong medical care.

  • Your doctor can confirm, but in most cases, you will need to have a cesarean to deliver multiple babies. In some cases, you can deliver twins vaginally.

    Factors impacting delivery include: 

    • Your health
    • The number of babies
    • Position (where the babies are in the uterus) 
    • The weight and health of each baby
    • How labor is progressing
    • If your doctor and health care team have handled multiple births before
  • Absolutely, but it may take some practice. Your milk supply will automatically go up to the right amount, so your babies get the proper nutrition.

    You’ll need to make sure you’re eating healthy foods and drinking plenty of fluids. Talk to your doctor about seeing a lactation specialist, so they can help you begin the process and answer any questions you may have. 

  • Yes, delivering more than one baby at a time can raise your chances of postpartum depression. If you feel intense sadness, anxiety or despair that stop you from doing daily tasks, you may have postpartum depression. 

    Contact your doctor right away and they can help you with a care plan for your postpartum depression.