Pregnancy is an amazing time for couples worldwide. As you and your spouse prepare to bring new life into the world with more anticipation, as the event of labor comes closer. Pregnancy is a complex topic. It should not be taken lightly. A twin pregnancy can be even more complicated. Twin pregnancies bring about differences in the fetus development. Couples need to sit down and share the differences so they can be emotionally and physically, to know what to expect. Twin pregnancy offers an extreme amount of variance while comparing every week against the other. While one week can be peaceful, another can be quite eventful. Here’s the week-by-week breakdown for women expecting twins.
The First Trimester of Twin pregnancy
Table of Contents
This covers the first 3 months or 13 weeks of a pregnancy. This first trimester is when early pregnancy symptoms can be so difficult, that women expecting twins may become wary. On account of high levels of hCG or human chorionic gonadotropin hormone. Along with more severe pregnancy symptoms, the onset can also be earlier. For those ladies with a history of conceiving non-identical or fraternal twins or twins run in the family, the possibility of twin pregnancy should be explored in the first trimester itself. The uterus lifts and rises out of the pelvis much earlier with 2 babies than one.
So, if you are trying to keep a twin pregnancy confidential, it can be difficult right from the start. It is around the fifth or sixth week that women suspect pregnancy. But with twins, the symptoms are so specific that women may end up confirming their pregnancy even earlier. A positive home pregnancy test indicator that is quicker than usual could hint at a twin pregnancy. If the test is carried out during the early stages of conception or urine passed later in the day, and the confirmation of pregnancy is still quick, it could mean you are carrying twins. Early morning urine has the highest hCG concentration which is why it is an ideal specimen for pregnancy testing.
Twins can also be seen on an ultrasound by the sixth week of pregnancy. During the first trimester, a rapidly expanding uterus is a sure sign of twins. Being larger than usual for dates makes a difference. Additionally, women expecting twins may also experience weight gain. Apart from this, tender breasts, frequent urination, extreme fatigue, and intense vomiting and nausea come into play. There are also appetite fluctuations coupled with extreme hunger and sensitivity to certain smells and foods.
Nonidentical or fraternal twins are the most common type. These are DZ or dizygotic twins. This holds that there are two zygotes, as two babies are each formed from an individual, single fertilized egg respectively. By the third week of pregnancy, each fertilized egg forms into hundreds of cells in a ball called the blastocyst. Also, the newly formed embryo burrows into the uterine lining to be nourished and developed further.
Identical twins or monozygotic twins, on the other hand, are rarer and develop from the same fertilized egg. The egg splits into two babies and the babies even share the same placenta and look alike exactly post their birth.
This is when the pregnancy commences. For fraternal twins, two fertilized zygotes/eggs are burrowed in the uterine lining. Each of these has their own placenta and umbilical cord. These can be two males, two females or one male and one female. In the case of MZ or identical twins, a single fertilized egg or zygote splits into two identical girls or boys. The identical twins are burrowed into the uterine lining and share the same placenta, amniotic sac, but their specific umbilical cord is different.
Nervous System Develops
At this stage of the pregnancy, the neural tube of your child forms. It turns into the brain, the spinal cord, and the nervous system later.
Circulatory System is Born
Small and tiny blood vessels begin to form, circulating nutrients between the mother and the child. The tiny heart of your child beats. Major organs begin to form such as the intestines and the tiny buds which develop into arms and legs also grow. There are tiny depressions where the nose, mouth, and ears are set to appear.
5 to 8 Weeks
Post the first 4 weeks of pregnancy, certain symptoms appear. Typically, women find out they are pregnant in this stage. There are multiple symptoms indicating pregnancy. New and different symptoms develop. The most common one is an increase in eating portions and your appetite. This is on account of the energy needed for developing the fetus. The body craves glucose at this time. With the need for the development of two fetuses instead of one, the need for energy doubles, raising the need for cravings even more. You will need an additional 600 calories, so it is important to eat right for the well-being of your baby.
Tiredness and Frequent Urination
Getting tired is another symptom of being pregnant with twins. Not getting enough nutrients for the body results in bursts of exhaustion despite not excessive physical exertion. This can cause a lot of weariness and fatigue. Frequent urination is another symptom of a twin pregnancy in the next 4 weeks or second month of pregnancy. This is on account of an increase in water intake of women during their pregnancy. The uterus also exerts more pressure on the bladder, causing the urge to go to become more common.
It is during this phase of 5-8 weeks that classic morning sickness or nausea begins to develop. Women feel very sick in the morning and even other times during the day. Amount of resources needed by the body become more. As twin pregnancies are even more challenging, nausea may even be more advanced. So, during this phase of twin pregnancy, it is important to consult your doctor to ensure a smooth and easy pregnancy and quick progression across the stages. Certain complications can be avoided through medical supervision. Nausea and aversion to smells may occur. Women should try for smaller and frequent meals to keep energy levels up and avert nausea.
A twin pregnancy also causes heartburn right at the start. This is because the uterus is larger than usual. Antacids can help with heartburn symptoms for most ladies. Rather than stretching out after meals, it is better to sit straight or take a short walk to aid in the digestion of the food. Constipation should be avoided by increasing water and fiber intake.
Nosebleeds, Shortness of Breath and Mucus
Many women experience stuffiness of the nose or even nose-bleeds during pregnancy. This is on account of the fact that there is an increase in the supply of blood to the mucus. Increase in the blood can make mucous membranes in the nose swollen and secrete additional mucus. Many women may also experience shortness of breath and there could also be an increased heart rate due to the increased blood supply and low blood pressure.
This is a common symptom of early pregnancy, Breast swelling and tenderness rise in women expecting twins. There is also a darkening of the areola which is the circle around the breast’s nipple. You need proper support for your breasts by wearing supportive innerwear during a twin pregnancy.
By 4-6 weeks, twin babies show up on the ultrasound as 2 little gestational sacs. Amniotic fluid and embryo are inside the whole time. Babies develop rapidly as the week’s progress. During the period between 5-8 weeks, the baby’s bladder, brain, liver spine, kidneys, reproductive tracts, extremities, and cardiovascular system develop. The first time the twins will be seen on an ultrasound, they are about 2-3 mm long. By the 7th or 8th week, they are double that size. Cardiac activity is seen by the ultrasound but a scan is not possible until the twelfth to sixteenth week.
First Visit to the Doctor
At the time of the first visit to the doctor, the pregnancy will be confirmed. Additionally, questions and concerns about the pregnancy need to be tackled. Some of the tests that may be carried out during a twin pregnancy are the detection of blood pressure, testing vital signs, physical exam of areas of the heart, breasts, abs, lungs, and pelvis. There will also be a family history or medical history questionnaire session. Your gynecologist may also test urine and blood samples.
At this stage, the twins may develop two chambers in the heart. Their hearts beat at about 150 beats per minute. The ears, teeth, brain, and liver are formed and continue to develop into complex organs. The skin on the outside is very translucent as the twins’ toes and fingers begin to separate. The eyelids form over the eyes.
Weeks 9-12 (Third Month)
Intensification of Symptoms
The next phase of 8-12 weeks sees the intensification of earlier symptoms of pregnancy. The reason for this is simple. The symptom proliferation is on account of the organs of the babies that are developing at this stage, and need more energy to form. This doubles the impact when it is a twin pregnancy.
While energy levels slump, cravings tend to increase. There are also changes in the appetite. The cravings or aversions to certain types of foods and smell rise. Researchers hold that the cravings are associated with getting nutrients you actually lack. While some women crave salt and sodium, others like spinach for the extra iron.
Anemia is present in the rare case that the mother’s blood cells are diverted to take care of the child. A mild form of anemia is not rare while carrying twins. This is because the blood supply of the body increases dramatically to support growing babies and red-cell production lowers.
One positive effect of the pregnancy is an increase in the natural glow of the skin and improvement of the skin tone. Having their children gives women a natural glow. Changes in the complexion result in a pregnancy flow. Increase in blood pressure creates a radiant look. However, it also makes the skin sensitive to skin care products. Taking care of the skin during pregnancy is important. Bleeding gums is a complaint that takes place throughout the pregnancy. Increased blood supply causes the swelling of the gums. Bleeding should not be a cause for concern though. It is essential to be gentle while flossing and brushing.
Large Belly & Stretch Marks
The biggest change brought about by the rapidly developing twin fetuses is that the babies take up a lot of space in the stomach cavity. This increases the maternal bump and makes the belly bigger. The fat also begins to stretch out the skin, leading to stretch marks at a later date. To avoid stretch marks, choose vitamin E creams.
The embryonic period gets over after week 12 and the structure of the embryo is complete. Developing twin fetuses are still growing. Kidneys, extremities, and intestines of the twins grow at a phenomenal rate. At week 8, the babies are 4 cm long each and weigh around 1 gram. By week 12, their length has doubled to about 9 cm and weight is around 20 grams.
Advanced symptoms can occur such as intensification of morning sickness and nausea.
The babies become over 2.1 inches in length. Livers begin to function and the kidneys produce urine. Babies take in amniotic fluid through the mouth and the kidneys and then change it to urine. This process helps in development. As brains continue to develop and form, the nervous system can produce reflexes in muscles, but no kicks may be experienced yet. The eyes move to the front of the face and the ears move to the sides.
Symptoms in The First Trimester
There are different types of symptoms such as breast tenderness, shortness of breath, constipation, fatigue, constant urination, decrease or increase in saliva, increased heart rate, leakage from nipples, nose stuffiness, morning sickness, changes in libido, bleeding gums.
The doctor on your first antenatal visit collects important information going over information regarding pregnancy. One may start the routine with prenatal visits. If there are any questions regarding pregnancy, these should be asked as well. An ultrasound may be conducted to check the well being of the babies. Certain tests are optional and one can discuss the cons and pros with consultants.
Check on the visits regarding weight gain or loss, blood pressure, respiratory rate, pulse, heart and lungs, breast exam, external uterine palpitation, measuring the height of the uterus, assess the heartbeat of the fetus, check urine screens for sugar, blood, and any bacteria.
This is the middle most trimester which lasts from the close of week 13 to week 27. This is considered the most enjoyable of the three trimesters for a simple reason. The pregnancy fatigue and morning sickness have settled down, but the uterus size is reasonably comfortable. Mobility is reasonable and walking as well as sitting is not an issue. Many women who are pregnant with twins find themselves feeling energetic and optimistic for the first time because the symptoms settle down. During the second trimester, a sense of attachment with the child grows. The early weeks are over and with these, so is the risk of a miscarriage. This is the time when one reaches the second trimester and feels ready to be a mother. By this time, at least one ultrasound is complete and the babies can be seen on the screen. Fetal movements are seen and felt constantly and the need to become organized and think about the impact and implications of having your children should form a part of the mind.
Morning Sickness Diminishes
In most twin pregnancies, the morning sickness or nausea either diminishes or may be completely gone. Enjoy a hearty appetite and fulfill your hunger cravings. But you also need to follow the nourishing diet set by medical practitioners so that your babies get the best nourishment. If there are extreme cravings, these must be discussed with the doctor. Additional supplements or vitamins can work wonders.
Thick, white creamy vaginal discharge may be released. But discharge that is not white in color or associated with other symptoms should immediately be reported to the doctor.
You may not get as much sleep as you used to. Sleep can be disturbed by the need to urinate, increased instance of dreaming, heartburn while resting or other reasons. You need to try and find a comfortable position and try to get the maximum rest. It is hard to carry a twin pregnancy and you need to be fair to the body, letting it rest more often.
Many women may experience increasing chances of a headache. But in the event of severe or frequent pain, report the same to your doctor. Don’t take pain relievers without the doctor’s consent. Instead, try a relaxing bath, calming music and eat as well as drink often. Resting in a darkened room or using a soothing compress over the eyes is also beneficial. Hormone production can also trigger migraine headaches. Different environmental, hormonal, food and lifestyle triggers can lead to migraines. Stay away from air pollution, fumes, bright lights, smoke, aspartame, alcohol, chocolate, caffeine, dairy products, fatty foods, additives like monosodium glutamate and nuts as well as physical exertion. Depression, anxiety, and stress also trigger migraines.
Swelling of Feet and Breast
At this point, maternity clothes are your best bet. Choose maternity pants and bras to offer optimal support. Swelling of the feet can also occur. Extra-abdominal weight has the impact of increasing the spine’s curve. Wearing athletic shoes and flat footwear as well as propping up the feet can decrease discomfort.
During weeks 12-16, an increase or decrease in salivary secretions may be noted. Alongside this, there could be anemia, food cravings, rising heart rate, nipple discharge, constipation, nasal stuffiness, breast tenderness, bleeding of the gums, shortness of breath, heartburn, sun sensitivity, and fatigue or stretch marks may result. Changes in libidinal urges may also be noted.
Doctors can assess different factors of pregnancy at the checkup. Check concerns and questions. An ultrasound may be carried out to evaluate the condition of the baby. Caregivers offer the AFP test to check for pathologies and carry out routine testing.
At 12 weeks, the embryo is now called a fetus. At 12 weeks, each of the developing babies weighs around 20 gm. At the start of week 13, each of the twins displays reflexive motions. By week 16, the twins will weigh 120 gm each. They also reach the length of about 4 inches. By the sixteenth week, developing babies can swallow and the kidneys start to operate. Production of urine by the fetus further leads to amniotic fluid. The babies also show control over the environment.
The twelfth week is the point in a twin pregnancy when the body shows signs that there are two human beings inside your body, growing rapidly. Developing organs in the bodies of the babies are fully developed and take nutrients as well as energy from the body.
This is a rapid period of development, with the twins being almost 4 inches in length each. Their bodies grow faster than their heads and legs grow faster than the arms. The little twins now weigh 100 gm or two-tenths of a single pound. The lungs move as if one is breathing. Female twins produce eggs in the ovaries. It is around this time that the spinal cord becomes encased with the myelin sheath to offer protection. The bones are soft and rubbery with cartilage. This bends at the joints and fingernails also form.
The nervous systems of the twins begin to develop further. Nerve fibers start to connect and twins start developing a sense of taste, touch, vision, hearing, and smell. Babies get to know the smell right at birth. The babies reach 10 inches from head to toe. With twins, it can get a bit crowded in the stomach. During this time, the twins also develop a thick skin coating that protects their head called vernix caseosa. This protects the babies immersed in the amniotic fluid and boosts their immunity, protecting them from infections which may be passed at birth.
It is at this juncture of the pregnancy that there isn’t a physical change. The monotony of the pregnancy starts wearing down the mother psychologically and support may be needed from the husband or other family members so mothers can remain positive and make the right choice regarding their children’s and their own health.
Round Ligament Pain
This is one of the easiest parts of the pregnancy, where morning sickness abates and the appetite is simply wonderful. But a new symptom emerges as a result. Round ligament pain feels like a sharp pain like sensation on one side of the stomach. It is generally between the navel and the hip. The pain is brought on by movement but can occur from nowhere also. It is a normal pregnancy pain, but if the pain is extended see the doctor immediately.
This is the halfway point of pregnancy. Babies continue to grow at a rapid rate. By week 20, each baby is a minimum of 7.5 inches in length. Fetal movements are felt at this stage. Babies also produce their own amniotic fluid, something which the placenta was doing earlier. At this stage, the membrane between the two babies is thin but can be checked on the ultrasound. While babies cannot see or hear at that moment, researchers believe they become aware of each other. The fetus develops and movements become coordinated. The babies need to grow, as their lungs and brains mature. Movements become more coordinated as a result. This is the full-fledged point where babies can be felt kicking, running at full capacity and growing in the stomach. The babies also gain a sense of auditory awareness with developing ears and sense vibrations from the mother’s movement as well as vibrations within the body too.
At this stage, the skin of the mother may undergo discoloration, there are more severe stretch marks and swollen or fattened body parts. Mothers can become discouraged and need support at this time. Staying motivated and healthy is very important.
The twins gain more characteristics that make them resemble each other and offer 100% identical look. An important milestone is that the babies become independent and their bodies become more developed, gaining features such as layers of fat and their distinctive fingerprints.
Edema is possible during a twin pregnancy. The extra fluid accumulation can even result in the carpal tunnel syndrome. Numbness or tingling can be sensed in parts of the fingers and palms caused by excessive bone and nerve compression. If this is experienced, try to drink lots of water.
Higher Body Temperature
Higher body temperature is one factor felt by everyone else in the room. The resting metabolic rate rises during pregnancy and causes a person to feel overheated. It does not link with fever in any way. Drink extra fluids to replace lost fluids experienced as a result of sweating.
Many pregnant women experience pregnancy leg cramps. There is a sudden and extremely painful feeling. As one is carrying multiples, there is a greater risk of experiencing leg cramps. Whether one is suffering from calcium shortage or nutrient loss, it is essential to consult your gynecologist and take supplements.
There are all sorts of ongoing symptoms such as sun sensitivity, nose stuffiness, bleeding gums, constipation, leg cramps, round ligament pain, anemia, nipple discharge, pregnancy glow, and changes in sexual desire may occur. Sleep changes, fatigue, expanding uterus, and hearty appetite can also manifest. Additionally, there is spine curving, swelling feet, headaches, heartburn, stretch marks, vaginal discharge and fall in urination. For this month, baby care essentials need to be planned. Women also need to go for birth preparation classes, options, and plans. Child care and work arrangements should be in place. It is critical to study feeling and ask your doctor any questions you may have. Review the tests that have been performed and get specific instructions for dealing with issues.
While babies do not have eye color, their eyes are fully formed now. They have tiny eyebrows and eyelids. The endocrine system begins to mature and hormones are produced for regulating bodily functions. Lungs are still developing and breathing muscles can be moved in and out.
Second Trimester Ongoing Symptoms
The second trimester has a whole list of ongoing symptoms from changes in sexual desire to sun sensitivity. There’s fatigue, constipation, breathlessness, sleep changes, appetite increase, swelling feet, heartburn, vaginal discharge, and nasal stuffiness, Additionally the spine curves from added weight, there are bleeding gums, anemia, rising heart rate, pregnancy glow and a massive belly. Headaches and stretch marks may also occur. One good thing is that there is a decrease in urination.
During these months, birthing options need to be discussed and the gender of the babies must be ascertained. Work plans post-pregnancy also need to be carried out. If you travel during this period, be sure to discuss it with the doctor. Always check the results of screening tests with your doctors. At this stage, doctors track weight gain, pulse, respiratory rate, blood pressure, heart and lungs, breast exam, the height of the fetus, external uterine palpitation, urine screen for sugar, bacteria, and blood, pelvic exam and ultrasound assessment.
The third trimester covers weeks 28 to 40 of the pregnancy. This is the time when it comes obvious that a woman is pregnant with twins. The uterine size and belly growth are massive. A twin pregnancy takes over the mother’s abs and for being comfortable, women need to change the gait to accommodate changes in the center of balance. Fetal movements are strong and visible through the maternal ab wall. The muscular uterine wall thins so the babies limbs moving around are visible. For women who are smaller, this is more obvious than women with a larger frame and height. Swelling, exhaustion, fatigue and lack of general energy are common indications for mothers in their third trimester. Resting is critical in such a case.
At week 24, the babies become one and a half pounds in weight and 12 inches in length. Additionally, they develop fat under the skin and soft furry hair cover or lanugo too. Cheesy substance vernix caseosa forms a protective casing. The membrane separating the twins is elastic. But by the 28th week, the development and symptoms both advance.
Twins at this stage weigh around 2 pounds each and measure 15 inches in length. They also get fat deposit layers and bones begin to harden. The twins develop large amounts of brain tissue during this period. Their hearing is tuned in and they will respond to light. Reproductive organs also develop at this stage.
As babies come towards the close of the developmental cycle, mothers may experience early contractions. The twin babies may move also. The mother should track her contractions and report any issues that arise for medical professionals.
Aches and Pains
During the final stage, the pregnancy, especially with twins, now begins to feel like a challenge. The pains and aches of a heavy body weight take a serious toll on the mother. The knees may feel cramped and undergo a lot of pressure in the joints.
By week 28, the effects of pregnancy are felt. Feeling heavy and the weight of the pregnancy on the back and legs may be felt. The pressure of the growing belly can lead to backaches too. Relief may be experienced when babies change their position. Pelvic pressure may be felt at a later stage and the need to urinate more frequently may result.
In the period of these 4 weeks, the babies double their weight and by the 28th week, each baby will gain around 3 pounds and be around 15 inches in length. Fat develops under the skin and babies begin to accumulate pigment in the skin. Hair grows and facial features become more pronounced. It is during this period that the eyelids of the baby becoming unfused. The baby will be able to open and close their eyes. The babies may also kick more often at this time.
Be aware of preterm labor symptoms like the Braxton Hicks contractions or contractions of the uterus at this stage much like menstrual cramps. Find the right care and limit physical activities. At this point, every two weeks the doctor will be visited. The doctor can guide you on important aspects of care. You will also be screened for B streptococcus and glucose tolerance test at this time Additionally, the caregiver will be checking weight gain and loss, pulse and respiratory rate, blood pressure. Also on the anvil will be an evaluation of uterine palpitations, the height of the fetus, fetal heartbeat, urine screens for bacteria, sugar and blood problems, and an ultrasound assessment.
Need for Rest
Women also experience a lot of changes. They are unable to carry out hard physical labor as a result. Most doctors recommend that women get rest and remain in bed for a long majority of the day and refrain from active work.
At this stage, the fatigue is pronounced. You need to listen to the body and rest when you can. Even when not sleeping, try to allow the body to rest and prop up the feet. Shortness of breath is worse at this stage. The uterus occupies a major part of the diaphragm. Sitting straight can help with the problem.
Another big problem is a backache. Pay attention to unusual aches in the back though, as this could be a sign of preterm labor. Nice warm soothing baths can help. Do not use hot water or sit in a Jacuzzi. In fact, avoid excessive sitting as this can lead to hemorrhoids. To avoid constipation, eat fiber and drink water for the best results.
When checking twin babies at this pregnancy stage, it seems they are alike. The two babies are now appearing with mature bone structures and are less cooped in the amniotic sac. By the close of the 32nd week, the babies weigh 4 pounds each. The babies may develop a lot of fat and all systems and organs are operational.
Twins begin to appear like newborns. They measure 16 inches in length and weigh around 3.7 pounds. Twins settle down in this time because there is no room to move around. Twins may or may not have lost their lanugo cover. The kidneys produce urine and the babies take in amniotic fluid. Their skin fills in with fat and they lose the wrinkled appearance. Their bones become solid, with the exception of the skull bones that remain soft because the head has to come out through the birth canal.
The most important part of the twin pregnancy is this final stretch for the mother. Babies are developing and mothers need to work had to remain healthy. The babies are gaining immunity and adjusting to the stage when they leave the womb. The baby gives back nutrients to the mother that are signaling her breasts to secrete milk.
It is at this stage that a decision about whether the birth will be a Cesarean section or vaginal comes into play. This is the month when multiple pregnancies are different. Babies that are smaller have a hard time regulating the temperature. However, babies are also helped to expand their lungs for their first breath through the use of a surfactant. The babies will be checked for their position and the subtle fetal movements will be felt. Braxton Kick’s contracts increase in frequency. However, if there are more than 4 contractions in an hour, you need to call the practitioner as this could be preterm labor.
This is the stage when labor will set in. It is a painful process but worth the effort, so you need to be physically and mentally prepared for it. The process of giving birth to twins is taxing. Massive persistence and courage are needed.
Twins may be slightly smaller than single full term babies. At this stage, twins gain 5.5-8 pounds. These are about 20 inches in length now. The skin sheds the covering called the vernix caseosa and prepares for the birth. Lungs need the final four weeks to complete maturing. Premature infants may need leg support.
Third Trimester Symptoms
The typical third-trimester symptoms range across bleeding gums, nasal stuffiness, leg cramps, overheating, edema, changes in appetite and sexual desire, shortness of breath, carpal tunnel syndrome, constipation, increased heart rate, sun sensitivity, nipple discharge, fetal movements, stretch marks and heartburn.
Prepare for the hospital birth and be ready to move out at the slightest sign of labor contractions. This is also the time to find out how babies are positioned and make the changes for the birth as per the position. Talk to your doctor about getting rest. The doctor may also recommend a pelvic examination to check for cervical dilation. Biophysical profiles may also be carried out to assess the condition of the babies. Weight, BP, pulse, respiratory rate, heartbeat, lung movement, uterus palpitation will also be checked. As always, the fetal heartbeat, urine screens, breast exam and ultrasound assessment will also be carried out when required.
Birth is a wonderful experience and the act of giving birth and bringing new life into this world is a miracle in itself. As a mother, you have to prepare yourself physically and emotionally, so you can stay healthy and motivated and take every care to ensure a healthy baby and an easy birth.