Pregnant with twins? 15 questions you should ask your doctor

When we discover that we are pregnant, a million emotions flood our mind, from surprise to joy, and of course, also fears and many doubts due to this new stage that we are about to begin. After knowing that we are waiting for a baby, there are many things that we should know and take into account, and that are usually the same for all pregnant women.

However, there are special occasions, such as in multiple pregnancies, in which we must have other types of care or that will require proceeding differently from a simple pregnancy. We share you 15 questions you should ask your doctor if you are pregnant with twins.

What type of twins are?

Usually, when we talk about a pregnancy in which two babies come, we mean a twin or twin pregnancy. But nevertheless, There are two types: monozygotic twins (commonly called "twins") and dizygotic twins (twins). The main difference is that in the first fertilization has taken place in the same ovule by the same sperm, while in the second, it occurs when two ovules are fertilized by different sperm.

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Should I look for a specialist in multiple pregnancies?

Gynecologists are prepared to handle both single and multiple pregnancies, but if you have the option of going with a multiple pregnancy specialist, go ahead. In special cases, such as very advanced ages or in women with a history of high-risk or complicated pregnancies, perhaps it would be convenient to find one.

Are all twin pregnancies considered a risk pregnancy?

Not necessarily, This is something that will depend on the mother's medical history and the conditions in which the pregnancy develops. Usually, unlike a simple pregnancy, medical check-ups are more frequent at the beginning of the third trimester due to the risk of premature delivery, but can be started earlier under certain conditions, for example, in case babies share the placenta ( such as monochorionic or monoamniotic twins), where revisions should be carried out more frequently from the second trimester.

What kind of risks or complications exist in a twin pregnancy?

A multiple pregnancy is associated with an increased risk of experiencing certain complications during pregnancy, but this does not mean that they will happen. It is simply important to know them, to be informed.

The most common complications in a twin pregnancy They are:

  • Premature delivery The average duration of a twin pregnancy is 36 weeks, but approximately 30% of multiple births occur before week 37.
  • Low birth weight In twin pregnancies more than half of babies have low birth weight.
  • Delayed intrauterine growth. In the case of twins, it is more likely that there are alterations in the nutrients they obtain from the placenta, so an imbalance can occur that causes the growth of one of the babies (or both) to be restricted so that its size is not in accordance with the weeks of gestation.

Also, there are more common complications that the mother may suffer in the pregnancy of twins, such as preeclampsia, anemia or postpartum hemorrhage, as well as other complications during childbirth, such as umbilical cord compression, tangled or braided cords, or placental complications.

How much weight should I gain?

The amount of kilos that is recommended to increase during pregnancy will depend mainly on several health factors of the mother, such as height, body type and weight before pregnancy.

Based on the information on the website of the Centers for Disease Control and Prevention (CDC), this is the amount of kilos each woman should increase in a twin pregnancy, according to her BMI:

  • If your BMI is less than 18.5, you should increase from 22 to 28 kilos.
  • If your BMI is between 18.5 and 24.9 (the normal or healthy range), you should increase from 16 to 24 kilos.
  • If your BMI is between 25.0 and 29.9, you should increase between 14 and 22 kilos.
  • If your BMI exceeds 30.0, you must increase between 11 and 19 kilos.

Do I need to eat more because I expect two babies instead of one?

Don't listen to that old myth about pregnancy that says you should now eat for two (imagine with twins: for three!). During pregnancy it is important to take care not to gain excess weight, because this could increase the chances of suffering from preeclampsia, gestational diabetes and having a cesarean delivery.

You should consult this with your doctor, because It will be he who gives you the most appropriate indications according to your own needs, and thus avoid getting too fat in pregnancy and spend the kilos.

Do I need to make any changes to my daily routine?

Being waiting for more than one baby represents a greater physical effort for the mother, so you probably notice the symptoms and discomforts of a pregnancy sooner and with greater intensity. And although this may be more tiring, it does not necessarily mean that you should make drastic changes in your routine or that you should reduce the pace of your activities.

As long as you feel comfortable and your doctor verifies that your pregnancy passes normally, you can continue with your activities, although maybe you feel you need to lower your daily rhythm a little To make it quieter.

Can I do exercise?

During pregnancy it is recommended to stay active and exercise, as it has been proven that this can help at the time of delivery and reduce the occurrence of certain complications. But nevertheless, In the case of a twin pregnancy, you should consult your doctorWell, according to your medical history and the conditions in which your pregnancy develops, it will be he who told you what kind of exercises you can or cannot do.

Should I have any special care?

As we have said, you probably do not need to take any special care unless your doctor tells you to, but because in a twin pregnancy the discomforts are usually more intense, you may need more rest, due to all the energy your body is consuming by gestating two babies at the same time.

Should I get a vaccine?

It is recommended that at the time of becoming pregnant the woman is already immunized against rubella, whose vaccine also includes protection against mumps and measles, and if it has not yet passed, also against chickenpox.

Once pregnant, and knowing that you have all the necessary vaccines to prevent infections that can cause damage to your baby, there are two immunizations especially indicated during pregnancy: the flu vaccine and whooping cough vaccine.

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How will I feel the movements of my babies?

As with the symptoms or discomforts of pregnancy, the movements of babies in a twin pregnancy appear before a single pregnancy. When we wait for a baby, we usually begin to feel their movements between the 18th and 20th week, but in a twin pregnancy, they can feel from two weeks before.

These movements can be felt in different areas of the belly, and it is very common for mothers to identify which of the twins it has been, since they usually stay in the same place. Unlike a simple pregnancy, in a twin pregnancy the movements of babies can be more painful because there is less space inside the uterus.

What week should my babies be born?

Unlike those in which only one baby is expected and the ideal is to reach 40 weeks, in a multiple pregnancy the duration is shorter. Usually, in the case of a twin pregnancy where everything goes well the average duration is 37 weeks, a very ideal duration to give birth to twins, according to studies.

What type of delivery will I have?

Previously it was thought that twin or multiple births should always be by caesarean section, but studies in recent years have shown that a multiple pregnancy does not have to end in caesarean section.

In the case of twins, for example, a vaginal delivery is safer for them than a caesarean section, because at birth vaginally, the risk of natal morbidity was much lower for both babies.

Another study in twin pregnancies found that Caesarean section really does not provide any benefit compared to vaginal delivery, and that does not represent a significant increase or decrease in the risk of fetal or neonatal death compared to vaginal delivery.

Therefore, if the pregnancy passes normally, without complications and if the first baby is fitted (that is, with the head down and ready to be born), a vaginal delivery will be the best option. Caesarean section should be performed only in case of an emergency or if a complication occurs.

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How long is a multiple birth?

Though the phases of childbirth are the same in single and multiple pregnancies, the duration of a birth varies greatly from one woman to another and from one pregnancy to another, regardless of whether a baby or more is expected.

The fact of being a multiple pregnancy does not mean that the delivery in general will be longerHowever, the phase of expulsion will be more extensive and will take twice, because it is two babies born.

In the case of a vaginal delivery, the interval between the birth of the first and second babies is usually less than one hour. In case of further delay, the doctor must make a decision and depending on the situation of mother and baby, a C-section will be performed.

On very particular occasions and under certain circumstances, deferred birth may occur, that is, that babies are born on different days. This can happen naturally, when contractions stop after the birth of the first baby (which is very, very rare but has happened), or, for medical reasons, such as improving the prognosis of the second baby in case of a birth premature.

In all cases, the risks and benefits should be analyzed by medical staff, who will make the best decision for mother and children.

Can I breastfeed both babies at the same time?

Of course! The fact that they are two babies does not mean that you will not be able to do it, since your body is ready to feed them both and in addition, it is the most advisable because your babies will weigh less at birth, since they are born before being a multiple pregnancy.

There are several techniques and positions to breastfeed at the same time and you can even make your own twin breastfeeding cushion, but if you prefer, you can breastfeed one at a time without problems.

And if you have any questions or complications, Do not hesitate to contact a lactation consultant, which will provide you with the necessary support to carry it out successfully and with advice for your particular case.

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The most important thing during your pregnancy is to have a doctor you trust and that makes you feel safe. Don't be afraid to ask these and all the questions you consider necessary about pregnancy and childbirth, so that you are better informed and can calmly enjoy your twin pregnancy.

Photos | iStock

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