Having Multiples? Take Extra Care in the First Trimester

Prenatal care is important for any pregnancy. But it’s even more crucial if you’re carrying twins or other multiples. You’ll need to take care of your body and work closely with your healthcare provider. This can help your chances of having a successful, full-term pregnancy.

Starting prenatal care

Once you know that you're pregnant with multiples, ask your healthcare provider ask about his or her experience with multiple births. Together, you’ll set a schedule of checkups. Plan ahead so that you don't miss any of these visits. You may need to take time off from work.

Your healthcare provider can help you narrow in on your due date. But keep in mind that twins and other multiples are more likely to arrive earlier than single babies. To lower your risk for preterm labor and other issues, take these actions in your first trimester:

  • Stop smoking. Smoking increases the risk of miscarriage. It also raises the risk that your babies will be born small for gestational age (SGA). Ask your healthcare provider for help.

  • Don’t drink alcohol or take drugs. Alcohol and drugs cause miscarriages and birth defects. They can also cause intellectual disability and low birth weight. If you need help to stop, talk to your healthcare provider.

  • Talk with your healthcare provider about your nutrition.  Moms who are pregnant with multiples normally need to eat more and gain more weight.

Testing for the type of multiples

If your twins formed from a single fertilized egg that split into two, your children will be identical twins. This means that they will be the same sex. They’ll also have the same blood type, hair color, and eye color. If your twins formed from two separate fertilized eggs, they’ll be fraternal twins.

They may or may not be the same sex.

If you’re having triplets or more, your babies can be identical or fraternal. Or they can be a combination of both.

You’ll have an ultrasound during the first trimester to check if your babies are identical or fraternal. Your healthcare provider will check if there are one or more placentas. He or she will also make sure that each baby has its own amniotic sac. Identical babies have a greater risk for birth defects. Plus, pregnancies with identicals are at greater risk for problems if the babies share a placenta.

Showing earlier

Almost every part of your body is affected by a multiple pregnancy. Your uterus and cervix will start to change right away. Because you’re carrying more than one baby, you may look pregnant in the first trimester. You’ll likely have some common signs of early pregnancy. Every pregnancy is unique and you may not have all the symptoms. If this isn’t your first pregnancy, you may have symptoms at different times than in past pregnancies.

Online Medical Reviewer: Bowers, Nancy, RN, BSN, MPHFoley, Maryann, RN, BSN

Date Last Reviewed: 4/12/2016

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