If you've just found out that your future bundle of joy is going to be two bundles then you might be feeling that both congratulations and commiserations are in order. On the one hand there's the indubitable efficiency of producing two babies in the course of just nine months: only one lot of morning sickness, only one time of giving up those forbidden foods and suffering back-ache and, of course, a birth-one-get-one-free experience in the delivery room. On the other hand there's the prospect of having a tougher time than single-baby mums in those nine months of pregnancy, and that's before we even consider the ongoing challenges of caring for two babies.


Is a twin pregnancy harder and does it carry higher risks?
It's certainly true that a double pregnancy is more work for your body than one, and that there is an increased risk of developing pregnancy-related complications than with a single pregnancy. But just as with single pregnancies, being pregnant with twins isn't an illness, but a natural state that the body is designed to handle, so there's no need to be alarmed by the list of potential complications: Some pregnancy complications are more likely to occur with twin pregnancies, but not all, and you may sail through the pregnancy with little to distinguish yours from a normal, healthy, single pregnancy other than a bigger bump and a little extra weight.

It's wise to be aware of the potential discomforts and complications you might face, such as an increased likelihood of morning sickness, haemorrhoids and anaemia and higher risks of problems associated with high blood pressure, low fetal growth and premature labour (find out more here), but always remember that by far the majority of twin pregnancies result in the birth of healthy babies to healthy mums.

By and large there is no difference in treatment when you develop pregnancy complications in a twin pregnancy, rather the difference is in your prenatal care - you may undergo more tests than women expecting single babies, but this isn't necessarily the case. Once your doctor and midwife are aware that you are carrying twins they will tailor your antenatal care appropriately and keep a keen eye out for warning signs of complications.

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Should I behave differently when pregnant with twins?
Most of the advice given to single pregnancy mums is just as relevant to mums expecting twins, after all your bodies do change in the same way. But when you're making two babies it's all the more important that you follow the advice of your doctor or midwife in caring for your pregnancy and preparing for birth.

As with any other expectant mum, it is a good idea to familiarise yourself with the warning signs for pregnancy complications, particularly those which are more likely to occur with a twin pregnancy, so that you can seek help quickly if you do develop a complication or do go into labour prematurely. But try not to be anxious about potential problems as that will cause you and your babies unnecessary stress. Remember that the vast majority of women with twin pregnancies go on to deliver healthy babies and there's no reason to think that your pregnancy will be any different.

Diet and nutrition
The standard diet and nutrition advice given to expectant mums is all the more important for twin pregnancies but you need to take particular care of the following:

  • Calories - The usual joke about eating for two can become daunting when you think about eating for three, but of course you only need to eat for three in terms of quality, not quantity. In terms of calories you should only be eating about 600 more calories than usual per day, whereas a woman with a single pregnancy requires abour 300 extra calories

  • A balanced diet - Making sure you get a balanced diet is even more important for mums expecting twins. Try to ensure that your extra calories come from a diet high in protein, calcium, fruits, vegetables and whole grains and low in the empty calories of much snack and processed food

  • Pre-natal vitamins - Your need for all the usual pre-natal vitamins will be higher than with single pregnancies so be sure you're getting enough of the key vitamins and nutrients - such as calcium, iron and folic acid - through your diet and take a supplement if need be

  • Stay hydrated - Drinking lots of water is helpful in avoiding several pregnancy discomforts such as haemorrhoids, constipation and swelling. All pregnant women are advised to drink at least 2 litres of water per day, but women expecting twins are advised to drink a couple of glasses more than this

Keep an eye on your weight gain
When you're expecting twins it's usual that you will put on more weight than with a single pregnancy, about one-third as much again as the 10 - 12 kilos usually gained. However, as carrying too much weight around can increase your chance of certain pregnancy discomforts as well as that of premature labour, and as very rapid weight gain in the last trimester is one sign of developing pre-eclampsia, it makes sense to keep an eye out on your weight gain. We are not, of course, talking about monitoring the scales like a hawk and certainly not talking about dieting, simply try to be broadly aware of when you might be gaining excessive weight and make sure that you're getting a healthily balanced diet.

Rest and exercise

Women expecting twins are usually advised to get more rest by their doctors than in single pregnancies. Carrying twins can simply be more tiring than carrying a single baby, and a more cautious approach might be advised to lower the risks of developing pregnancy complications and premature labour. That said, there's no need to wrap yourself in cotton wool unless your doctor recommends it: gentle exercise, such as walking, swimming and yoga, is just as important to healthy twin pregnancies as it is to singletons. Just make sure that you take it easy and stay well within your comfort levels, particularly in the third trimester.

As you are carrying extra weight in a twin pregnancy there is more pressure on your pelvic floor, so all the more reason to be sure of doing your regular pelvic floor exercises.

Booking ante-natal classes early
Ante-natal courses tend to fill up early, so it can make sense to book your place as early as week 16 of your pregnancy. As your twins have a higher chance of making an early entry into the world it makes even more sense to register early to get a place on a course that you will have more chance of finishing rather than taking what's left at the last minute.


Early maternity leave

Carrying twins can be more tiring than carrying a single baby, particularly in the third trimester when your babies start to pile on weight and your bump grows rapidly. There's also that higher chance of premature labour or early delivery to bear in mind, so it makes sense to think carefully about when you want to stop work and consider finishing earlier than you would have done with a single pregnancy. If you are finding it tough to stay the course for as long as you originally planned then don't hesitate to talk to your doctor about your options.