Expecting twins? You may be feeling a myriad of emotions, from elated to overwhelmed to anxious to going into overdrive mom-mode. Whatever your case may be, the absolute best way to start caring for your twins is to take care of yourself about 9 months prior to those bundles giving you their first loving gaze.
And this isn’t a cake walk for the faint of heart. Twin pregnancy is hard. Your body will endure more than you ever thought possible. So will your mind. People will say bizarre things and impede on your privacy in ways you didn’t know possible. You’ll get questions and remarks on fertility, sleep, your neighbor’s aunt’s cousin’s twins, birthing stories, budget advice and daycare questions. The scales will tip at numbers you thought you’d never see. Singleton moms will make blissfully clueless remarks in an attempt to relate. You’ll be told you look “due any day” by complete strangers with months remaining. It’s a crazy ride that’s just getting started and will undoubtedly be the most important high risk – high reward scenario of your lifetime. But trust me on this, it is absolutely worth it. Take it all in stride! Read below for a realistic, practical, need-to-know guide on expectations, advice, insight and precautions for you when expecting two.
First Trimester and throughout:
1. Talk to your doctor.
Yes, Google can be your friend, but perhaps not when it comes to twin pregnancy. You’ll quickly become well-versed on the terminology, symptoms, risks, and what you may be prone to based on your journey of conceiving twins or your family history. You know yourself best. Trust your gut. If something seems awry, ask questions and don’t ignore symptoms. Over-researching on your own will lead to an overwhelmed mama met with opinion and personal commentary overload. Save yourself the stress, and talk to your doctor about what type of twins you’re carrying, family history, risk factors, a game plan going forward and get ready to clock in plenty of extra time at your OB office!
2. Be supplement savvy.
Be sure taking your prenatal vitamin is part of your daily routine, along with extra folic acid. The recommended daily dose of folic acid is 1 milligram per day (vs. 0.4 mg for a singleton pregnancy). Your physician or midwife may add additional supplements along the way.
3. Snack smart.
It’s important you start incrementally increasing your calorie intake but also use this as a strategy to ward off the hell that is nausea during a twin pregnancy. Do what works for you! This could be 5 small meals a day or a couple main meals with snacks in between. A good general rule is to add about 300 calories per day per baby (so yes, roughly 600 quality calories for twin mamas) to your diet – think yogurt, cereal, nuts, fruit, veggies and cheese! Keep some options in your nightstand, purse and car!
4. Brace yourself for nausea and vomiting.
With twin pregnancy, nausea is more an issue of “when” versus “if.” Higher levels of HCG are to thank for this, and it is no joke. Nausea can last all day, coming and going in waves, with essentially anything or nothing bringing it on. Keep in mind, your body is doing amazing work, and the nausea will resolve itself eventually. There are very few guaranteed ways to avoid nausea altogether, so gear up for a game of trial and error to discover what works for you during this miserable timeframe. Sea sick bands, ginger gum, maternity teas, candies, incremental snacking, and some prescription medications can help with this. For me, it was a mix of all of the above coupled with time. That first morning or day of no puking after weeks is like a holiday and needs to be celebrated.
5. Stay hydrated.
Yes, we know, easier said than done, especially during bouts of nausea and vomiting, but it’s essential to stay well hydrated and up your water intake during a twin pregnancy to avoid discomforts like constipation or hemorrhoids and also serious complications later like preterm labor. A good starting point is to drink at least 10 8-oz glasses of water per day or 2 Liters of water plus a couple extra glasses (depending on how you want to view it.) Don’t like water? Explore with some healthy, fun concoctions of your own!
6. Keep moving.
While it may be the absolute last thing you want to do, light exercise can be very beneficial for an expectant mama. Just remember, go easy on yourself! Your body is making two babies so you’re already a bodybuilder ;). But sticking to a routine you had prior to pregnancy like walking, swimming, yoga, cycling or light strength training (with doctor’s okay) can have wonderful health benefits during and after pregnancy.
Second Trimester and beyond
7. Stock up on antacids.
Feeling the burn? Heartburn is more common in twin pregnancies, so stock up on Tums as-needed and Zantac or Omeprazole to take morning or evening. Trust us, you’ll be glad you did. Don’t forget to stash these little life savers in your purse, nightstand or car console.
8. Watch the scale climb.
Are you healthy? Are the babies healthy? Then do not fret. Everything grows when expecting twins. Everything. So keep this perspective in mind and don’t get too caught up in the numbers on the scale. In general, if you start at a normal weight when conceiving, you should expect to gain roughly 35-55 pounds when expecting twins. This number will vary depending on certain factors, and the expectation is that you’ll gain less if your BMI started out higher.
9. Go shopping.
Now is the time to stock up on maternity basics like some comfy t-shirts and go-to jeans. Once you put on those maternity pants, you’ll never want to go back! Don’t fight it. Start with the basics, and assess what you need as it comes! It’s so tempting to stock up right away, but start with the essentials because you might grow at a faster or slower rate than expected. And remember, your maternity clothes will only be as comfortable as your undergarments. Finding the right bra is a crucial, albeit annoying task. And treat yourself to some comfy panties too!
10. Get ready for check-up central.
While a twin pregnancy automatically classifies you as “high-risk” and therefore check ups are more frequent anyway, the mainstay of testing can fall between the 20-30 week mark of twin pregnancy. It is also the time to start paying close attention to some symptoms that could indicate underlying issues. Again, don’t panic, risks are higher with twin pregnancy, but the statistics are still in your favor that you might not develop anything serious at all! Talk to your doctor about any concerns you have. Here’s a brief rundown of what to be on the lookout for:
Week 20 – A thorough anatomy scan ultrasound. Unless you opted for genetic testing earlier on, this is where doctors will assess growth of your precious little ones, address potential concerns and reveal gender!
Week 26-28 – Gestational diabetes testing. You’ll get a 1-hour glucose tolerance test, and if you pass, you’re good to go! If you fail (which many people do), your provider will order a 3-hour fasting Glucose Tolerance Test which can diagnose Gestational Diabetes. Women pregnant with twins are twice as likely to develop gestational diabetes, and it can normally be adequately controlled with diet and lifestyle modifications. It also typically resolves after giving birth, so do not let this be a major cause of stress!
Week 26-28 – Hemoglobin (iron) levels – Yes, you’re more likely to become anemic when carrying twins, which can be resolved with an iron supplement or increasing your intake of iron-rich foods, like dark leafy greens, red meat or fortified cereals.
Week 26-30 – Vaccines, like TDAP, are generally offered at this point to the mama to help protect babies from problems like whooping cough. Talk to your provider about your options.
Also, this timeframe through the end of pregnancy tends to signal other potentially serious issues as well, such as Pregnancy-induced hypertension (high blood pressure, occurring at 3-4 times the rate of singleton pregnancies), Preeclampsia (high blood pressure and protein in the urine, occurring at twice the rate of singleton pregnancies), and Cholestasis (a liver condition causing intense itching with no rash, especially on the palms of your hand or soles of your feet – do not ignore these symptoms). Your OB will regularly check your blood pressure and urine to be on the lookout for potential issues, but if something seems off, do not ignore the symptoms, as they could have serious effects for both you and the babies.
Additional issues that are less serious but annoying nonetheless can also pop up during this timeframe, including itching skin, stretch marks, PUPPP rash, carpal tunnel syndrome, and achy joints, not to mention constipation, frequent urination, UTIs, and trouble sleeping. Are we having fun yet?!
Congratulations, being pregnant with twins means you have a greater likelihood of developing any of these issues. But do not panic, most can be diagnosed and treated during pregnancy or will resolve after the babies are born. Be sure to talk to your doctor if you think a symptom you’re experiencing could be something serious.
11. Buy a Belly Band.
… and wear it religiously. This will drastically help lower back pain and take some pressure off your pelvic region. Support tank tops are a good idea too. Your stability muscles are getting a crazy workout and will be happy to have some extra support.
12. Conquer the world.
It’s time to take advantage of the “sweet spot” – you know, where you’re not too sick, too tired or too big yet! Trust us, in a twin pregnancy, it can be short-lived! Nesting in those last few weeks is a dreamy notion reserved for mothers of singletons, so get your planning done NOW. The key to surviving those first crazy, blurry, wonderful, exhausting months with infant twins is to plan ahead. We’ve tried to make this as easy on you as possible based on our own experiences and have created our version of to-do lists – TWO DUE CHECKLISTS. Follow these checklists to make sure your hospital bag, nursery, diaper bag, laundry room, pantry and freezer are all stocked up on essentials. If you’re able to, line up extra help for after the babies’ arrival. Clean. Line up a pediatrician. Get a pedicure and a prenatal massage. Familiarize yourself with your breast pump (or order one) if you plan to breastfeed. Go on dates. Now is your time to try to enjoy your pregnancy and plan for what’s to come! You got this!
13. Ask about restrictions and plan ahead.
As my friend used to say, “Safety never takes a vacation.” Now is the time to ask about certain restrictions and different providers may advise differently! Following a certain week, your provider will likely not want you outside of a specific radius to your birthing hospital or at least a hospital with a NICU. Watch what you lift, and listen to your body when it gives you clear signs to take it easy. Also, if you have a job where you’re on your feet most of the day, you can receive certain permissions to have reduced hours or get your feet up, and many companies make accommodations with doctors’ approval for early leave prior to FMLA that will not affect your maternity benefits following the babies’ arrival.
Third Trimester to the big day!
14. Enjoy your Showers!
Because of the unpredictability of twins and general discomfort late into twin pregnancy, it’s best to schedule these on the early side! That way, you can enjoy your time spent with friends and family, and have plenty of time to put away, organize, clean, store and assemble all the adorable baby gifts you receive! People LOVE celebrating twins, so try to enjoy this special time! Just because you’re expecting two does not mean you need two of everything! For starters, you’ll need two car seats and cribs (and mattress pads and extra sheets), two bouncy seats or Rock ‘n Plays, a double stroller or double Snap ‘n Go, and two baby carriers. You’ll need plenty of onesies, sleepers, diapers and wipes. You’ll need coffee. With twins, it’s a delicate dance among practicality, functionality, convenience and budget! If you’re the type to write thank-you notes, print off our TWO DUE thank you note checklist to keep easy track of whose gifts you’ve acknowledged.
15. Take Classes
Whether you’re new to parenting or not, twins is a whole new ballgame. Do what makes you feel confident and prepared. We suggest taking an infant safety class and depending on your comfort level, a birthing class or multiples class. Check with your provider or local hospital, as these are often provided free of charge.
16. Schedule a brief hospital tour
Just do it. Know how to get there, what ramp to park in, what button to push on the elevator and who to ask for. No matter how prepared you think you are, nothing will throw you for a loop like your water breaking and you not being sure where to go!
17. Rest + Get your feet up
Your body will be aching for a break, and gravity this late in the game is a real factor on pressure and swelling. Get horizontal! Each day they’re inside is a gift, so do what you can to take care of yourself and not overdo it!
18. Prepare for your delivery and know your options!
What’s your birthing plan? We say this lightly, because we think it’s important to keep an open mind and heed the advice of your provider when it comes to twins. But know your options! Would you like to try a natural delivery? Based on the babies’ positions, are you scheduled for a cesarean section? C-sections are more common for twin deliveries and carry their own set of potential risks and benefits. Know that the healing process and recovery will vary based on how you deliver, so keep an open mind, stay calm, roll with last minute changes (the doctors and nurses have you and your babies’ best interests in mind) and try to plan accordingly.
19. Pack your hospital bag
This process can be equal parts exhilarating (you’re almost there!!) and terrifying (you’re almost there!!). At this point, baby brain is probably in full force, so don’t give it a second thought – here’s a nice little guide for what to pack for the hospital when expecting two, including pads, stool softeners, phone chargers, power snacks, comfy slippers, a soft robe, bralette (or some sort of comfortable seamless bra), a journal, a comfortable going-home outfit with a stretchy or seamless waistband and going-home outfits for the babes. It also includes a handy checklist like making sure your car seats are properly installed and have passed inspection, you don’t forget to take home those ugly-but-beautifully-comfortable-life-saving mesh panties from the hospital, and your refrigerator has something of substance in it for when you return home!
20. Take a moment.
Savor the last crazy pregnancy memory. Get excited – twin parenthood is the best adventure.
YOU DID IT. You’re almost there! You survived a hard pregnancy and double blessings, joy, laughter and love await you! It’s not easy, but it’s worth it, and know this: You can do it. You were made for this. Those babies are lucky to have you. Take a few more bump pics – you’ll look back and wonder how you were even standing upright! And jot down some thoughts. Don’t be discouraged if you immediately wonder what you’ve gotten yourself into, how you’re going to do it, and if you’re a ball of emotions following delivery. It’s a lot. And it’s hard. We’ve been there. And we’ll continue to be there for you! We wish you the absolute best as your adventure into twin parenthood begins! Don’t forget to check back with us when you come up for air, we’d love to hear your experiences and see pictures of those precious miracles!
love , hugs, encouragement and caffeine,
T I P S for T W I N S
What would your advice be for what to expect when expecting two? Did we miss anything? We know everyone’s experience is unique, and we’d love to hear from you!
