By: Shelly Vaziri Flais, MD, FAAP
Congratulations! The fact that you are carrying more than one baby places you in a special category in the eyes of obstetricians.
Is a twin pregancy considered high risk?
Many call twin pregnancy a
high-risk pregnancy, but don’t be scared by this categorization. High risk does not automatically translate into your pregnancy having problems. Rather, high risk can be translated as, "We will need to follow this pregnancy more closely." Also in the high-risk category are mothers with diabetes, those with a history of preterm labor with prior pregnancies, or those who have other major health issues themselves.
The majority of twin pregnancies progress smoothly, and the odds of a healthy pregnancy increase if you take better care of yourself.
Proper nutrition when carrying twins
The most important step to care for your twin pregnancy is proper nutrition.
Take a prenatal vitamins with folic acid.
Ideally, pregnant mothers should take a prenatal vitamin with folic acid starting three months prior to conception. Folic acid has definitively been proven to reduce the chances of neural tube defects such as spina bifida.
If you haven’t started taking a prenatal vitamin daily yet, don’t fret about the missed time—but do start now. Take the vitamin with food to reduce nausea, and applaud yourself for taking an important step to keep your babies as healthy as possible.
Note: If you're pregnant with twins, you don’t need two prenatal vitamins a day—one is enough.
Eat the right foods and get enough calories.
Whereas single-born pregnancies require 300 extra calories a day, most experts agree that twin pregnancies need around 1,000 extra calories a day. Frequent and healthy snacks (think of snacks and mini-meals, with an emphasis on protein) can help you reach your caloric goals each day.
Morning sickness—or in most women's cases, all-day sickness—can be eased by eating small snacks frequently. Keeping a little something in your stomach at all times can help take the edge off of the nausea. Low-fat yogurt, fruit, smoothies, crackers and protein shakes are all good snack options.
Stay hydrated.
In addition to the extra calories, it is important to sip on water throughout the day. Keeping well hydrated may drive you crazy in later months when it seems like you’re running to the bathroom every 5 minutes; however, your babies’ extra blood flow and removal of wastes depends on it! It may help to drink more water earlier in the day and then stop after 8 p.m. so that you can sleep longer stretches at night between bathroom breaks.
Listen to your body
Proper nutrition and hydration are important for your twin pregnancy, as is listening to your body. Be sure to bring any new pregnancy symptoms you notice to your obstetrician’s attention.
Seemingly minor things could be a sign of something more serious, such as:
Preterm labor
Because twins have an increased chance of being born early (preterm), any symptoms or concerns must be addressed for the safety of your babies.
Bleeding or vaginal discharge, contractions that are becoming more frequent, pressure in the pelvis or lower back, or even diarrhea can all be signs of preterm labor. And while early bleeding in the first trimester could be the normal phenomenon of the twins implanting in the uterine wall, you should call your obstetrician if you experience bleeding at any point.
Preeclampsia
Twin pregnancy can also increase the chances of preeclampsia. With this pregnancy complication, the mother develops increased blood pressure, protein in the urine (detectable by urinalysis), and more swelling than is normal in pregnancy.
If you notice rapid weight gain, noticable swelling or headaches, alert your obstetrician so you can be examined as soon as possible. Depending on the severity of the situation, treatment may range from bed rest, to hospital-administered medications, to immediate delivery of the babies (the only "cure" for preeclampsia).
Remember
Try to focus on caring for yourself one day at a time and one week at a time. Eat well and pay attention to what your body and your twins are telling you. Every extra day that your babies spend inside the womb will strengthen them once delivery day arrives. The bigger your belly gets, the bigger your smile should be, since you’re creating two miracles!
More information
About Dr. Flais
 Shelly Vaziri Flais, MD, FAAP, is a board-certified practicing pediatrician and mother of 4 children. An assistant professor of clinical pediatrics with Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, she is the author of the American Academy of Pediatrics books,Nurturing Boys to Be Better Men: Gender Equality Starts at Home and Raising Twins. Dr. Flais is also editor-in-chief of Caring for Your School-Age Child, 3rd Edition, and a contributor for Sleep: What Every Parent Needs to Know. She has shared her reality-based parenting approach with national and local television, radio, online and print news outlets.
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