Pregnant with Twins? What Are the Symptoms?

by Virginia B. Hargrove

Twin Pregnancy SymptomsSome women go through the first weeks of their pregnancy without a signal sign that they're pregnant.

Then there are up to 70 percent of women who notice early clues that a baby or even babies are on the way.

How do you know if you're pregnant with twins? You can expect to have the same symptoms as with a singleton pregnancy, however, the signs and symptoms of twins happen earlier and can be more intense.

When You're More Likely to Have Twins

Since 1980, twin births have increased 70 percent. In 2009, three of every one hundred babies born in the United States were multiples. These factors can increase the chances that you'll get pregnant with twins:

  • Fertility treatment: Assisted reproductive technologies and fertility-stimulating drugs both increase the likelihood of conceiving twins.
  • Age: Women over 30 are more likely to have twins.
  • Family history: If your family has twins, you're more likely to have them. Dad's history isn't a factor.
  • Weight and size: Taller or heavier women have more twins.
  • Ethnic background: African American women and American Indian women are more likely to have twins than caucasian women. Asian women are less likely.
  • Getting pregnant while breastfeeding Some studies have shown that your changes of conceiving more than one baby rises if you're tandem nursing.

Signs and Symptoms of a Multiple Pregnancy

Your grandparents might have been surprised by a twin birth, but you'll probably learn about the double bundle of joy during a routine first or second trimester ultrasound.

Even before your ultrasound, these factors can alert you and your caregivers that more than one baby is on the way.

Ultrasound Confirmation

Jill was expecting her first baby. She headed in for a routine ultrasound in her early second trimester. She'd been joking about having twins for years.

When the technician said, "Here's baby A and here is baby B..." Jill thought she was kidding. She whipped her eyes to the screen and there they were -- two tiny bodies and two tiny heartbeats.

Seeing is believing. For many women, the first hint of twins comes at that ultrasound appointment.

Two Heart Beats

Toward the end of the first trimester, your baby's heartbeat can be detected with a Doppler system. An experienced doctor or midwife might be able to detect more than one heartbeat.

If the heartbeats appear to be coming from different locations and have different rates, your provider will probably schedule an ultrasound to confirm twins.

Elevated hCG Levels and Abnormal Test Results

Women carrying multiples of have higher levels of hCG. Since other factors can cause elevated levels, you won't know for sure if you're having twins, yet.

During the early second trimester, your midwife or doctor will offer an alphafetoprotein screening. If your screening test comes back positive, you might not have an issue. The test measures a protein made by the fetal liver. If two babies contribute this protein, the test often reports a high reading, but both babies are okay, more than likely. However, always go with what your healthcare provider discusses with you.

Morning Sickness Times Two

Some multiple moms experience more nausea than moms carrying one baby -- others don't. If you're feeling extra icky sooner you could be baking a double batch. Midwife Cynthia Flynn says that she has noticed when moms report extreme queasiness in early pregnancy, they discover there's more than one baby on the way.

Uterus Larger Than Expected for Your Due Date

If your midwife or doctor notes that your uterus measures large for your stage of pregnancy, twins might be the reason. They'll suggest an ultrasound to confirm multiples and rule out other reasons.

Extra Weight Gain

Just as measuring larger can alert a provider that you're carrying twins, extra weight gain can be another clue. Moms of twins gain about 10 more pounds on an average than moms of singletons.

Frequent and Early Fetal Movement

Some moms carrying multiples notice their babies' movement earlier than moms with one. Since there are several factors that influence how soon you'll feel your baby move, feeling early flutters doesn't necessarily guarantee multiples. If you are experiencing early movement, it can be one more sign that your baby's holding hands with a sibling.

Extra Fatigue

Many moms-to-be feel tired during early pregnancy. If your first trimester feels like one long hangover, you might be more than one baby waiting for the placenta to get its act together.


Have you been dreaming of twins? Do you have a mother's intuition that you're carrying more than one baby. Don't discount your feelings. Many moms just know it's twins and they're right!

Do you have twins on the way? What was your first hint that "baby" turned out to be "babies"?


girlisrad's picture

Submitted by girlisrad on

HAaa.. I thought all my pregnancies were twins! I was SO huge, so fast!!!!!! And I dreamed about twins every time too! I think that was the fear talking!