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How will my prenatal care differ if I'm carrying more than one baby?
Even if you're young and in perfect health, your pregnancy will be considered "high-risk." A multiple pregnancy increases your chance of a premature birth – delivery before 37 weeks – as well as other complications. Good prenatal care can help protect you and your babies throughout the pregnancy.
You'll need more frequent prenatal visits than you would with a singleton. As a general guideline, expect to see your practitioner once a month for the first 24 weeks, every other week until 32 weeks, and then weekly (or more often) after that.
What kind of practitioner should I choose?
Most women choose a health practitioner before they discover they're carrying multiples. If you're not already seeing an obstetrician, you should make an appointment with one as soon as you learn you're carrying twins.
At some point, you may need to see a perinatologist as well. Also known as a maternal-fetal medicine specialist (MFM), a perinatologist is an obstetrician who specializes in high-risk pregnancies. Some perinatologists do not deliver babies themselves but work in conjunction with obstetricians.
If you're carrying triplets or more, or if you have any serious medical conditions or pregnancy complications, you'll need to see a perinatologist right away.
What prenatal tests will I need if I'm having multiples?
If you're carrying multiples, you'll get the same prenatal tests that women carrying single babies do – you'll just have them earlier or more often.
For example, while mothers of singletons may have just one or two ultrasounds, you may have five or more. You probably already had an ultrasound sometime in your first trimester to find out how many babies you were carrying.
Then, starting at around 18 weeks, you can expect to have an ultrasound about once a month until you reach term. Sometime after mid-pregnancy, your practitioner may want to perform a vaginal exam and ultrasound to check for signs of premature labor.
Your practitioner will check your blood for iron-deficiency anemia more frequently than if you were carrying one baby. Your iron stores are used up more quickly when you're carrying multiples, putting you at higher risk for this condition than women with singletons.
Women carrying multiples are also more likely to develop gestational diabetes. As a result, you'll need to take the glucose screening test earlier than most women. (Most pregnant women take the test between 24 and 28 weeks.)
Because you're at an increased risk of preterm labor and delivery, you may be watched closely for signs of preterm labor. If you have any, your doctor may admit you to the hospital to check your cervix for dilation and length. You may also have a test for fetal fibronectin to help rule out premature labor. (Fetal fibronectin is a protein in vaginal secretions that can be a signal that your body is getting ready to give birth.)
After about 32 weeks, you may have a nonstress test or a biophysical profile to assess your babies' well-being. A nonstress test is an exam that measures the heartbeats and movements of your babies and checks for contractions that could be a sign of premature labor. A biophysical profile includes a nonstress test along with a detailed ultrasound that looks at your babies' body movements, breathing movements, and the amount of amniotic fluid that surrounds them.
For information on testing multiples for Down syndrome and other birth defects, see our piece on prenatal genetic testing when you're pregnant with multiples.
Follow one woman through her pregnancy with twins and watch her give birth.