Embarking on the journey of a multiple pregnancy brings a wave of excitement, anticipation, and unique considerations. In this blog, we’re exploring what to expect when carrying multiples including potential complexities, challenges, and resources to guide expectant parents through their pregnancy.
What are the different types of multiple pregnancies and how do they occur?
Multiple pregnancies are any pregnancy with more than one fetus. If more than one egg is released during the menstrual cycle and a sperm fertilizes each egg, more than one embryo may implant and grow in the uterus, leading to fraternal twins or more. When a single fertilized egg splits, it results in multiple identical embryos, leading to identical twins or more.
The use of fertility drugs to induce ovulation causes more than one egg to be released from the ovaries and can result in twins, triplets, or more. IVF can also lead to a multiple pregnancy if more than one embryo is transferred. Additionally, women older than age 35 are more likely to release two or more eggs during a single menstrual cycle than younger women, meaning they are more likely to become pregnant with multiples.
What are the common challenges or differences a pregnant person might experience during a multiple pregnancy?
A person experiencing a multiple pregnancy will have a different experience compared to a singleton pregnancy. During a multiple pregnancy, a person will have more frequent prenatal care visits including visits with a high-risk obstetrician. We recommend calling a Maternal Fetal Medicine Physician. Starting in the second trimester, you may have ultrasounds every four weeks and potentially additional antenatal testing. Women carrying multiples are at increased risk of preeclampsia and gestational diabetes and will require increased visits/care if either of these conditions develops.
What are the potential complications or risks associated with carrying multiples, and how are they monitored or managed?
The most common complication of multiple pregnancy is preterm birth. More than half of all twins are born preterm and almost all triplets or higher are preterm.
Historically, bed rest has been associated with carrying multiples, but there is no conclusive medical evidence to support bed rest. Sometimes modified activity will be recommended, but it is suggested on a case-by-case basis.
How does the delivery process differ for a woman with multiples compared to a singleton pregnancy? What factors determine whether a woman carrying multiples might need a cesarean delivery?
The chance of cesarean birth is higher with multiples, but twins can often be delivered vaginally. The mode of delivery depends on the number of babies and the position, weight, and health of each baby. The mom’s health and how the labor is progressing are additional factors considered in the mode of delivery.
What support or resources are available for women experiencing a multiple pregnancy?
The following are resources available for women carrying multiples to help manage the unique challenges they may face:
- Massachusetts Moms of Multiples: a private Facebook group for moms to chat, support, and help one another
- Massachusetts Mothers of Twins Association: provides social, emotional, and educational support to parents of multiples.
- Multiples of America: supporting families through education, research, and membership in local clubs.
For additional resources, reach out to your provider.
Are there any misconceptions about pregnancy with multiples that you’d like to address or clarify?
If you have a pregnancy with multiples your provider will talk about Chorionicity and Amnionicity, so it is important to understand what these terms mean. Think of it as one question: Does each fetus have its own chorion (placenta) and amniotic sac?
- Dichorionic–diamniotic: Twins who have their own chorions and amniotic sacs
- Monochorionic–diamniotic: Twins who share a chorion but have separate amniotic sacs
- Monochorionic–monoamniotic: Twins who share one chorion and one amniotic sac
The chorionicity and amnionicity in a multiple pregnancy determine risk factors. For example, monochorionic twins have a higher risk of complications than twins that have their own separate placentas.
At Essex County OB/GYN we have the knowledge and skills necessary to help you navigate the complexities of a multiple pregnancy. From the joys to the challenges, our team is here to support you through every step of your journey. Contact us today to book an appointment!