Pregnancy with twins: what you need to know and how pregnancy with twins proceeds

Physiological signs of twin pregnancy

Experienced mothers can determine the number of developing babies at the earliest stages, but there are few of them now. Therefore, it is good to know certain signs indicating multiple pregnancy:

As a result of a pregnancy test, the second line appears very brightly, which indicates a high concentration of gonadotropic hormone in the urine.
Rapid weight gain is the first sign of twin development. In a woman carrying one baby, in the first 12 weeks the weight increases by only 2-3 kg, while during a multiple pregnancy this figure increases at least twice.
Rapid growth of the abdomen. Active growth during a singleton pregnancy is observed in the 5-6th month, while a woman carrying twins already has a fairly large belly in the fourth month.
Severe toxicosis accompanies a pregnant woman with twins until late pregnancy. In addition to nausea and vomiting, severe dizziness is observed, which prevents the woman from getting out of bed normally and leading her usual lifestyle.
When performing a blood test, a high level of gonadotropin is noted along with a lack of iron concentration. This is a common occurrence in the first trimester.
When visiting a gynecologist, the doctor may feel two baby heads or hear two heartbeats. After the 10th week, an ultrasound can be performed, which will accurately determine the number of gestational fetuses. It is with an ultrasound that you can confirm the upcoming birth of twins. Second births are more favorable and have fewer complications than first births.

All these signs indicate early pregnancy, but do not forget about the individual characteristics of the body, due to which the first signs of a twin pregnancy may be misinterpreted.

“It’s more difficult with twins”

“I’m 32, and I have three wonderful daughters - the eldest is 6 years old and twins are 7 months old. After my first pregnancy, I quickly returned to my previous shape, there were no stretch marks or excess weight. With twins everything is more complicated. A huge belly that grew, itched and cracked with incredible force. And I didn’t smear it with anything, and I wore a bandage. Caesarean section at 36 weeks, babies were born weighing 2580 and 2465 grams. The result of a twin pregnancy is a huge diastasis and torn skin on the abdomen. After giving birth, the stomach did not go away at all, the overstretched muscles did not hold anything. I wore a bandage and did exercises. The belly has more or less tightened up and no longer looks like it was in the 6th month of pregnancy. I am planning an operation when the children are 1.5 years old. Exercises alone will not correct the situation, but I want my flat and beautiful belly back. I’m not ashamed of the scar from the CS, maybe later I’ll remove it with a laser, but stretch marks are terrible.”

Psychological signs of twin pregnancy

In addition to physiological changes in the body, you can notice strong psychological changes:

What happens to the babies and mother

The expectant mother notices that from time to time the twins begin to tremble rhythmically. This should not cause any fear because it is a normal hiccup. This is all completely normal.

Children can hiccup for a quarter of an hour at a time and several times a day. And some pregnant women do not notice their babies’ hiccups at all.

Fruit weight and development

This week of pregnancy, the twins are the same size as large melons. Their weight is approximately two kilograms and their length is about 44 centimeters. The approximate height and weight of babies are average. As children develop and the mother's body size changes, they can change both upward and downward.

Fetal parameters	Singleton pregnancy	Multiple pregnancy	Difference
Weight (g)	2248	2080	168
Height (cm)	45-47	43-45	2

Their skin is no longer transparent, but of a normal color. The lanugo (fine hairs that covered the skin) had almost disappeared. True, in some children they can persist right up to birth.

The lungs can also be called almost ripe. And therefore, if premature labor suddenly begins this week, the babies will most likely be able to breathe on their own, without the help of special equipment.

How can they lie

The position of the little ones inside the mother is gradually changing.

By the 34th week of pregnancy, twins usually turn their heads down to make it easier to pass through the birth canal. And since there is less and less space left in the stomach, babies do not spin. They can also occupy different positions - for example, both lie across, or both heads down or up, or even “jack”.

Mom's weight gain and uterine size

At this stage, the mother feels constant fatigue, and possibly slight pain.

Weight gain can be approximately 11-13 kg. The height of the fundus of the uterus is approximately 36-38 cm. It increases as babies grow in length.

It is considered normal if the indicator is approximately equal to the gestational age in terms of weeks (hence, how many weeks, so is the indicator in centimeters).

With multiple births, the picture is slightly different. Indicators may exceed the norm by 2 to 12 cm (compared to pregnancy with one child). This happens because babies lie and develop differently.

If the doctor suggests undergoing additional examination, you must agree.

Feelings and well-being of a pregnant woman

Due to the fact that intestinal motility is impaired, a woman may feel pain in the stomach and suffer from constipation. And because the uterus is now pressing on the bladder, the pregnant woman has the urge to urinate more often than usual.

If after the expectant mother has eaten she feels a little nauseous, the portions of food should be reduced.

Movements

The 34th week of pregnancy with twins is characterized by calming down and slowing down the movements of the babies. Still - there is less and less space. But still, they do not stop their “swimming”.

Sometimes they can even have too much fun. You can calm them down by simply gently stroking their belly.

Harbingers of childbirth

The expectant mother increasingly feels that her stomach is pulling. This is due to Braxton Hicks contractions, or training contractions. They begin in the area of the fundus of the uterus, and then seem to “flow” down. Thanks to this training, she prepares for real childbirth. But since in this case the cervix does not open, the woman does not feel pain. Contractions are not rhythmic, so don't worry.

By the end of the 34th week, pressing sensations in the lower abdomen may appear. This is due to the fact that the uterus has dropped and the babies are preparing to exit through the birth canal. The head of one of them is fixed near the entrance to the pelvis. Thanks to the lowering of the abdomen, the expectant mother feels that she can breathe a little easier. During this same period, the plug may come off.

The course of pregnancy with twins

During pregnancy, a woman’s body undergoes a strong hormonal surge; in addition, the overall load on the musculoskeletal system, cardiovascular and other systems also increases. During pregnancy with twins, this load increases several times, since the mother’s body must provide sufficient nutrition and excretion of metabolic products not only for her body, but also for her two growing babies.

During a multiple pregnancy, there are many difficulties that need to be foreseen in advance in order to preserve it. Due to the high pressure on the cervix during pregnancy, premature birth of twins, rupture of amniotic fluid, development of preeclampsia, severe toxicosis and other complications are often observed.

In the last 3-4 weeks, the woman is in the hospital, which allows doctors to regularly monitor her condition and the development of the babies, monitor the progress of the pregnancy and timely carry out the necessary measures to preserve the fetuses or an unexpected birth.

How and where do pot-bellied mothers live before giving birth to twins?

I gave birth to my long-awaited and premature twins at 32 years old at 7.5 months or 34.2 weeks. I was admitted to the hospital a month and a half before giving birth due to severe swelling and constantly increasing pressure - from 140/110 and above. “This is not good!” said my obstetrician-gynecologist at the next examination and, out of harm’s way, wrote me a “VIP pass” to a hospital bed out of turn. It was not a burden for me to lie in the prenatal department, since my husband was constantly on duty, and I did not make friends in a city that was unfamiliar to me even then.

I drove a taxi within an hour to the emergency room with a suitcase on wheels . But it turns out that such suitcases are not allowed through the local checkpoint. Fortunately, the nurses gave me some kind of large plastic bag and I, with my belly and my bag on top, plopped on the tiled floor to my room. The nurse and I walked through dark, cold corridors , hobbled like ducks past the maternity ward, the screams of the women from which made the blood run cold, and reached a cold, very cold ward.

It was October , and the room was at the end , and also with two balconies on each side. It was very cold. How afraid I was of catching a cold then! I took care of myself as best I could. It’s good that on his last visit, my husband took me shopping and bought me an enormous, warm robe that reached to the floor. Then it was very useful to me. When we were taken out in the morning to donate blood from a finger prick, all the girls sat practically bare-bottomed on cold benches, and I sat on a warm robe. Everyone had big bellies and their dressing gowns rode up almost above the navel. Keep this in mind when you go to the hospital for the birth of your twins.

Okay, let's get to the point. Every day all women in labor were weighed . Those who showed strong daily weight gain were forced to run a kilometer. Just kidding, they left it to measure the pressure . For those whose blood pressure was very high, they first tried to “treat” them with Dopegyt or Nefedipine. If the results were zero, then the unfortunate people were placed in intensive care under round-the-clock drips . Out of the entire department, there were about five of us with swelling. We were like laboratory mice being experimented on)))

Imagine such a device on a pregnant woman!

We gave urine according to Nechiporenko , we kept a diary on “how much was drunk - how much was drained,” we collected a daily urine test in a three-liter jar and got up to measure blood pressure every 4 hours – both night and day. Once, for a day, I was put on a device for measuring blood pressure, which automatically inflates the cuff every 20 minutes. This is called 24-hour blood pressure monitoring, or ABPM . Surprisingly, I slept well that night, despite the squeaking sound that the machine makes before inflating the cuff. Thanks to two motherwort tablets ! There is one caveat when wearing this miracle device - as soon as you hear a squeak, you must freeze in any position. As in the game “The sea is agitated once...”) Otherwise, the result will be distorted.

I remember how at the next squeak, I took out a pen, which rolled under the bed. I had to freeze on all fours . Well, at least I made the girls in the ward laugh! Everyone walked tense - they were afraid of childbirth. For many they were repeated. As a rule, those who had their first birth were not afraid. And the “repeat” ones already knew what awaited them and were very afraid.

The tests that I took over the course of a month and a half described my situation as deplorable. Therefore, they did not let me go home, and in order for my birth of twins to go more or less safely , I had to try to complete the pregnancy as long as possible. Every day I added a coin to my children’s health fund. I understood this and rejoiced at every day that ended well.

But, one not-so-great morning, the scales showed an increase of 1.5 kilograms per day . I couldn’t eat that much, and I didn’t have much food in me. I also drank a little water, but the swelling increased sharply . The pressure also rose. They gave me a Nefedipine , from which I smoothly settled in the corridor on the wall half an hour after taking it. They didn’t risk giving it to me anymore; they limited themselves to Dopegit .

On the second day the situation continued. Again, 1.5 kilograms and blood pressure 150 over 110. Doctors from all over the department began to visit me frequently. Every three hours I was examined by new people in scrubs. We listened to the stomach through a tube, pressed our fingers on our feet and watched how quickly the white mark from the finger disappeared. I guessed that intensive care and the birth of twins were just around the corner. In the evening, in the ward, I finished writing a couple of articles for the client, and the girls and I sat down to drink tea. I allowed myself a piece of bread with cheese and sausage and a mug of tea. In the morning the scales showed an increase of two kilograms !?! WTF?!

15 minutes after weighing myself and measuring my blood pressure, my doctor came running to me with huge eyes and started scolding me from the doorway for swelling. What could I do in such a situation?! Yes, I was ashamed of the piece of sausage last night, but I didn’t drink water last night. In general, without thinking twice, she sent me to intensive care . And a new stage in my hospital life began.

Caesarean section during twin pregnancy

How the birth of twins goes is of concern to many women facing multiple pregnancies. Since it is impossible to predict how your body and your children will behave, you would like to at least get acquainted with the possible options for the development of childbirth, complications and subsequent care for newborns.

Pregnancy most often ends with a planned cesarean section. If indicated, cervical suturing may be required. This will extend the pregnancy by several weeks in order to carry the babies to term and prevent premature dilatation of the cervix.

Caesarean section ensures the birth of healthy babies without birth injuries that can occur during natural childbirth. The expectant mother needs to seriously consider the issue of childbirth and consult with a doctor who can suggest the best option.

Signs of multiple pregnancy:

- doubtful

Presumable signs of a multiple pregnancy are similar in their manifestations to a single pregnancy, only the symptoms are expressed, as a rule, even brighter and more intense:

Nausea. Nausea is especially severe in the morning. This symptom may also be accompanied by vomiting. Expectant mothers feel especially nauseous after eating their morning meal.
Gastrointestinal disorders. At 4-6 weeks of pregnancy until 8-12 weeks, the mother experiences digestive discomfort and stool irregularity.

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Natural birth of twins

Independent birth of twins is possible only in the case of a normal pregnancy, the absence of any pathologies and infections in the body, and also in the presence of qualified doctors. The most important factor when choosing a natural birth or cesarean section is the position of the fetuses, since after the birth of the first child, the second often turns incorrectly and gets its legs stuck in the birth canal.

In some cases, during a natural birth it becomes necessary to perform an unplanned cesarean section. The pregnant woman should be warned in advance about the possibility of such a development of events. The doctor should tell you why this can happen and reassure the woman, since the operation is performed to minimize possible risks and complications for both the babies and the mother.

What can be seen on an ultrasound

A planned ultrasound examination is not provided at the 29th week of pregnancy, but the doctor may prescribe it for the following indications:

severe pain in the lower abdomen;
suspicion of pathology in one of the fetuses;
leakage of amniotic fluid;
discharge of blood from the vagina;
suspicion of pathology and shortening of the cervix;
if the size of the uterus does not correspond to the duration of pregnancy.

On ultrasound images you can see fully formed babies. Faces and external characteristics are clearly visible. Using Doppler ultrasound, blood flow in large vessels is assessed.

Features of twin births

The gestation period for a pregnancy with two fetuses is reduced from forty weeks to 35-37 weeks. This period is the most favorable for the course of labor. If labor begins before the 35th week, it is considered premature.

Giving birth to twins naturally can have unpredictable consequences, so it is necessary to approach this issue very responsibly. Parts of the fetal bodies or umbilical cord loops may fall out. Babies can get tangled in the umbilical cord or cling to each other. Also, even with the correct position during labor, the fetuses can suddenly change their position, thereby increasing difficulties.

The duration of labor can greatly increase, causing both mother and children to suffer. In especially severe cases, the fetus may become stuck in the birth canal, which then poses a great danger to their life.

Childbirth process

Even girls whose twin pregnancy progressed week by week clearly and without failures cannot be sure that they will give birth on a specific date.

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She almost always gives birth a month earlier, namely at 36 or maximum 37 weeks. The tactics of the birth process are simultaneously influenced by many factors.

Of great importance is, first of all, the presentation of the first baby, as well as the integrity of the girl’s amniotic sac, the volume of available amniotic fluid, the number of contractions and, of course, the age of the expectant mother, her general state of health.

Childbirth in the period up to 40 weeks is carried out mainly naturally, when both children have a cephalic presentation, the girl’s labor is characterized by regularity.

In other cases, almost always, if you look at a photo of a pregnant woman with twins with static data, doctors choose surgical intervention.

There is no need to worry about this fact, since, according to the available information from doctors, there is nothing dangerous in not giving birth on your own.

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In exceptional cases, this, on the contrary, allows you to give birth to a healthy child and the mother to save strength to care for him, starting from the first days of life.

Of course, when a girl finds out that she is pregnant with twins, she rejoices, but it is important to understand that in addition to such a gift of fate, it is also an incredible responsibility and serious work.

However, having gone through the path together from the conception of babies to their birth, parents find twice as many happy moments.

Umbilical hernia after pregnancy

Due to the large weight of babies, not only can the uterus become overstretched, but an umbilical hernia can also form. In this case, a stretching of the muscle ring occurs, which can only be eliminated surgically.

If there is no pain, doctors often leave the hernia and monitor it. But mothers who are constantly without help and often carry their children in their arms need to take care of their health, as complications and pinched muscles may develop in the future.

Also, if you have an umbilical hernia, it is not recommended to play sports, so as not to strain the already damaged muscles. It is important to remember that the birth of twins and the consequences after them largely depend on genetics and the individual characteristics of the body, so it is better if the doctor in a particular case determines the mother’s capabilities and prescribes appropriate treatment if necessary.

How a caesarean section is done: how twins are born

I was warned that the cesarean suture would not be a “smile”, but a longitudinal one . Because otherwise it will be difficult for doctors to get the twins out , and they could harm them. Of course I agreed. I was then told to sit on the couch and hunch over as much as possible to insert the catheter into my spine. Oh, how scared I was at that moment! I was afraid that they would give me the wrong injection and I would forever remain a non-ambulatory invalid. It's stupid, but that's how it is.

Still, I remembered that general anesthesia and the birth of twins are almost incompatible concepts. While one child is being delivered, the second will be suffocating in the mother’s tummy from anesthetic substances. So I silently followed the commands. I hunched over and felt the needle go right under the vertebra . Yes, it hurts . Then they told me carefully, in the same way - in the horse position, to lie down on the operating table and they themselves slowly straightened me into a lying position. They tied my legs, spread my arms to the sides on special supports and also tied them tightly.

A screen made of a disposable napkin was placed in front of me at chest level so that I would not look at the doctors’ manipulations. The operating table, by the way, looks like a rubber ironing board. It became warm, light and good - it was epidural anesthesia . I just lay there and was crazy. Even thoughts about the upcoming birth of twins receded into the background.

Then two doctors came who were supposed to operate on me, an anesthesiologist who was supposed to monitor the supply of anesthesia to the spine, and a bunch of other people in white coats. There were also nurses with mops. It turns out that when they cut the amniotic sac, amniotic fluid can drain onto the floor, which they need to quickly remove. Bleeding may also occur. In general, orderlies are always on hand.

The doctor who was about to operate on me asked me to move my legs . I moved, but I couldn’t feel my legs. But I felt my hands. They poked me on the stomach with a needle and asked if I could feel it. I answered positively. But despite this, the operation began immediately . My roommates warned me not to look at the lamps above the operating table, as they reflect everything they do to you. And I didn’t look, because I might have gotten completely sick. The creak of skin being cut was It wasn't painful, but it was scary.

That's pretty much how it all happened

When they pulled my first girl out of my belly, it felt like all my insides had been pulled out of me . Like a plunger . A minute later, they pulled out the second one. They both screamed. They were quickly wrapped in white sheets washed to gray and taken to the second floor, where the incubators stood. And then the “interesting” part began. The doctors took some kind of rag and began to stuff it inside my stomach. They used it to soak up any liquid that had entered the abdominal cavity. It was very painful, I whined and heard the command “Add anesthesia to her!” I don't remember anything else. I woke up when I was asked to crawl onto a gurney. It was three o'clock in the afternoon . The operation began at 9 am . As they later explained to me, I lost a lot of blood and immediately after the birth of my twins, I was transfused with donor blood.

Belly after giving birth to twins: how to get back into shape?

A common problem after childbirth is the appearance of stretch marks and sagging abdomen. A change in figure often has an adverse effect on the psychological state of a woman, who becomes very tired when caring for children. You can find various reviews on the Internet about the birth of twins. This is explained by the individuality of the female body and the characteristics of genetics.

Lack of free time and the opportunity to take care of your health can significantly worsen the picture and lead to the development of diseases. Getting back into shape with this regime is quite difficult, and even if the extra pounds disappear over time due to fatigue and an active lifestyle, it is much more difficult to cope with skin changes. Often only plastic surgery can correct the situation, which is not always possible.

What does the belly look like after twins: real photos of mothers

Multiple pregnancy is stressful for both the expectant mother and doctors. It is usually more difficult than waiting for one baby. And it takes longer to deal with the consequences.

Text: Natalya Evgenieva September 22, 2019

What should a woman look like after giving birth? Looking at the Instagram divas, it seems perfect. And those who cannot show off a flat stomach and slender hips a week after discharge are simply lazy and gluttons. However, why chase glossy mirages? This can only create nervousness, nothing more. There is a community on Instagram for mothers who can’t get used to their own bodies after giving birth. Here, by posting their photos anonymously, they can get what they need most - sympathy and support.

We chose three stories of mothers who gave birth to twins and were not shy about showing off their bodies. Which they can be proud of: they may be covered with stretch marks, but they managed, managed, carried and gave birth to healthy children.

Diastasis after childbirth

Diastasis is the separation of the vertical abdominal muscles. It is impossible to correct this problem without surgery, since the muscles need to be sutured. You can determine the presence of diastasis yourself. It looks like a hole above the navel; you can feel this hole while lying down.

If you have diastasis, you should consult a doctor, because it is impossible to solve the problem with exercises. This may lead to the development of complications. Natural birth of twins, like cesarean section, does not affect the appearance of diastasis. It is a consequence of severe muscle strain and occurs even in singleton pregnancies.

Can abdominal pain during pregnancy be caused by other reasons?

Yes maybe. Sometimes this can be caused by inflammation in the genitourinary system . You may experience pain when urinating and fever. To make sure you are doing well in this regard, you can do a urine test to check for infection.

Places where the muscles of the symphysis pubis pass

Another cause may be symphysitis . This is an inflammation of the muscles of the symphysis pubis. It is quite simple to distinguish this pain - it occurs when you move your leg to the side. I had exactly this kind of severe pain late in pregnancy when I rolled over in my sleep. I couldn't sleep from this nagging pain. It hurt where the legs connect to the body. And very strongly. It was not a sharp pain, but a pain that did not go away for a long time. Such unpleasant sensations also occurred while walking. We can say that the symphysite reminded of itself during the day and every time at night. After giving birth, everything went away by itself.

Other causes of abdominal pain during pregnancy include appendicitis .

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