Asma Khalil

Having Twins?

So you’ve just been told you’re having twins?! Don’t panic; it’s likely that your pregnancy will go fine and in 6 or 7 months’ time, you’ll have two beautiful healthy babies! But it’s true; when you’re having twins, there are some extra things you need to be aware of.

With twins you can double everything! So, for example, morning sickness in the first 12 weeks is more common. And the two babies take twice as much iron from you, so it’s easy to become anaemic. For that reason it’s a good idea to take a pregnancy supplement (all of which have some iron and some folic acid, plus some other bits and pieces thrown in) throughout the whole pregnancy.

Heartburn is common in pregnancy; you’re more likely to suffer with it when you have twins – twice the hormone levels and more squashing of your stomach as the babies grow! It’s perfectly safe to take an antacid such as Gaviscon at any stage of pregnancy.

Constipation is more common so be sure to drink plenty and have plenty of fruit and fibre in your diet. And, if necessary, certain types of laxative (such as Lactulose) are safe to take.

Apart from those general aches or pains, there are a few more important issues to be aware of. It’s a little more common to find that one of the twins’ growth is slowing down (known as ‘growth restriction’). When there’s only one baby in there, your doctor or midwife can have a pretty good idea if the baby’s growing normally or not just by feeling your stomach (which they do at every antenatal visit). But of course when there are two babies in there, it’s impossible for the doctor or midwife to feel whether both babies are growing normally. So you will be offered scans of the babies every 4 weeks to check on their growth and wellbeing.

High blood pressure (known as ‘pre-eclampsia) and diabetes of pregnancy (gestational diabetes) are also more common with twins, but your doctor and midwife will automatically keep an eye out for these (as they do for all pregnant women) and these conditions can be managed of they happen.

It’s important to know whether your twins share an afterbirth (placenta) or each has its own. This can usually be worked out at your early pregnancy scans, and usually by 12 weeks. Twins that share a placenta (known as monochorionic twins) can develop the complication of ‘twin to twin transfusion syndrome’, or TTTS). This is where one twin takes more from the placenta than the other, and in the end becomes surrounded by much more water (amniotic fluid) than the other. This type of twins will therefore be monitored even more closely throughout the pregnancy, often having scans every 2 weeks to check for TTTS. And for the same reason they will be delivered earlier – usually around 36 weeks (that is, 4 weeks before the due date). Twins where each has its own placenta (known as ‘dichorionic’) do not get TTTS and are usually delivered around 37 weeks (3 weeks before the due date).

Going into early natural labour (premature labour) is more common with all types of twins. The average is around 37 weeks but it can sometimes happen earlier. So be prepared for the possibility that your babies might have to spend some time in the baby unit. But remember that most babies that spend time in the baby unit will be absolutely fine by the time they leave the hospital.

But, at the end of the day, while it’s important to know about these issues and not to be too upset if they happen, it’s most likely that you and your babies will have a straightforward and uncomplicated pregnancy and birth. And try to get some sleep!