Prenatal Care for Mothers Having Twins
About Women By Women
Congratulations! You're having twins! We look forward to helping you have a happy, healthy pregnancy and a safe delivery.
We give all our pregnant patients a copy of our Pregnancy Guidelines, which include information on nutrition, exercise, medications, and prenatal care, among other things. Several pieces of advice change when a woman is carrying twins, however, and this handout is designed to let you know how your pregnancy and prenatal care will be different. We also encourage you to explore other readings and resources developed specifically for women having twins (see attached list).
Here are some tips on what to expect during your pregnancy:
1. Your prenatal visits will be more frequent. Generally, you will have appointments every 4 weeks until 24 weeks, then every 2 weeks until 36 weeks, then weekly until delivery. Often times, we end up seeing you even more frequently than this. Internal exams are also done more frequently for women carrying twins to make sure that the cervix is not dilating too early under the extra pressure and weight of twins.
2. You will have frequent ultrasounds to monitor the growth and position of your babies. Typically, you will have an ultrasound every 4 weeks throughout your pregnancy. You may also have regular non-stress tests in the latter half of your pregnancy to monitor your babies' well-being.
3. You will need extra calories and nutrients to support your twin pregnancy, and you will gain extra weight. Women carrying twins need 6OO extra calories (over and above their usual intake) every day. In terms of nutrients especially Important in pregnancy, aim for:
· 1 mg of folic acid
· 80 grams of protein
· 60 to 100 mg of iron
· 1,500 mg of calcium
Your prenatal vitamin provides all of the folic acid and most of the iron. A simple way to ensure adequate protein intake is to include a protein source with every meal or snack. Dairy products are an excellent source of calcium. If you don't eat much dairy, talk with us about the many other ways to include calcium in your diet.
Although weight gain varies tremendously, most women carrying twins gain roughly 40 pounds.
4. You will need to reduce your activity level at some point during your pregnancy due to the extra weight and pelvic pressure of twins. Because every woman's body copes differently with the extra stress of a twin pregnancy, you'll need to periodically review your activity level with your doctor or nurse practitioner.
5. Women carrying twins are at greater risk for certain complications like preterm labor, pregnancy-induced high blood pressure, and anemia. All of these problems can be caught with careful monitoring (hence, your more frequent visits). We will also review with you the various symptoms and warnings signs you should watch for and report to us.
6. You are likely to deliver before your due date. Most twins are born between 35 and 37 weeks of gestation, as opposed to the usual 40 weeks. Fortunately, twins' lungs mature more rapidly than those of single babies, so delivering a few weeks early is usually not a problem. The average birth weight of a twin is roughly five and a half pounds.
7. You are slightly more likely to have a cesarean section. It all depends on the position of your babies at the time of delivery. If the presenting twin (the one moving into the birth canal first) is head down, a vaginal delivery is usually planned. If the presenting twin is breech or transverse (lying across your abdomen), a cesarean section is usually planned.
8. Taking care of newborn twins is a challenge! It helps to plan ahead for some help from family and/or friends when you arrive home from the hospital. If you plan on breastfeeding, a breastfeeding class or individual meeting with a lactation consultant before you deliver can be invaluable. Remember that we are always available to advise you by phone or in the office at any point after your delivery. We can also refer you to support services like lactation consultants, in-home newborn care services, and counselors specializing in adjustment to parenthood. Just ask!
Enjoy your special pregnancy!