Signs and Symptoms of Multiple Pregnancy

Am I having twins? (or more?!?)

pregnant belly with twin flowers
Could It Be Twins?. MorePixels / Getty Images

Do women who are pregnant with twins, triplets or more exhibit special "symptoms"? Yes ... and no. Just as individual women experience a wide range of symptoms with a singleton pregnancy, so the conditions vary with multiples. 

It's true that the morning sickness, exhaustion, and weight gain can be intensified in proportion to the number of babies -- twice as sick, three times as tired, or four times as many pounds!

But, some lucky moms experience only mild discomfort, so mild that they never even suspect they are carrying multiples.

What are some of the signs of a multiple pregnancy?

Although it differs from woman to woman, some of the more common indications are:

* Weight Gain

Early weight gain of up to ten pounds in the first trimester can result due to increased blood volume and uterine size. By the end of the second trimester, most mothers of twins have gained fifteen to twenty-five pounds, whereas singleton pregnancies usually produce gains of ten to twenty pounds.

* Measuring large for gestational age

Increased uterus size can be a strong indicator of multiple pregnancy. However, most women measure larger and show earlier with subsequent pregnancies, so don't be alarmed if you can't fit into your jeans after six weeks of pregnancy with your second child even if you didn't wear maternity clothes until twenty weeks with your first baby.

* Severe morning sickness symptoms, including nausea and vomiting

Some moms of multiples do report that their symptoms were increased with twins, as opposed to their singleton pregnancies. Melissa, a mom of fraternal twins, remembers "I did have morning sickness with the twins, and did not have any at all with my two older sons.

I lost 5 pounds during the first trimester." Nevertheless, she didn't learn she was carrying twins until three hours before delivery!

On the other hand, a mom of triplets reports, "I can't say that I noticed any big difference between my daughter and the triplets. I was actually sicker with my daughter than now with the 3."

Still unsure of your odds of conceiving twins? This quiz can help!

* Feeling fetal movement early in the pregnancy

There is some disagreement among medical professionals as to whether a woman carrying twins is more likely to feel movement earlier. But many moms do claim that those early flutters and flips were their first clue that they might be having more than one. Kim is a mom of two sets of twins, as well as a singleton. She says, "When I was pregnant with my boys, I knew I was having more than one baby.

I had already had *one* baby and there was no way I was having just one. It was either two or an octopus!"

However, Jae experienced the opposite in her twin pregnancy. "As far as movement goes though, if I didn't know was having twins, I wouldn't have a clue. Because my daughter was a crazy baby in utero! She kicked and bounced and jumped around all the time. These two little guys so far, are no match for her! And I'm 21 weeks now!"

* Abnormally high results from an alphfetoprotein (AFP) test

For many mothers who do not experience any other extraordinary symptoms, this is the first thing that raises suspicions for them -- and their physicians. The AFP test measures a protein secreted by the fetal liver. More than one baby increases the amount of this protein in the mother's blood, and will produce a "high" result. Because a high result can also suggest abnormalities with a single baby, a doctor will usually schedule an ultrasound for further determination of the situation.

* Unusually extreme fatigue, not attributable to other factors

Nurturing one baby drains a body's energy, but carrying around two, three or more is positively exhausting! It's easy to dismiss the increased fatigue. If you've never had a baby before, you might be surprised by your lack of energy, but not realize it is out of the ordinary.

If you have had previous singleton pregnancies, you might attribute the tiredness to being older or maintaining the responsibilities of family and work.

But fatigue is probably the most common complaint of mothers of multiples. A mom recalls that during pregnancy with her fraternal girls, "The biggest thing was the tiredness. Without fail, I could not keep myself awake past 3 PM. It hit me whilst I was driving one day. I managed to stay awake til I got home but as soon as I had turned the car off, I fell asleep (we were parked in the driveway) and stayed that way until my son, who was also sleeping in the car, woke me an hour later!

I have all of the above! Could it be multiples?

Check out our list of the Top Ten Signs of Twins/Multiples. If you suspect you are having multiples -- due to the enhanced symptoms described here, or other "gut" feelings -- talk to your medical provider. The only way to know for sure if you are carrying more than one baby is a thorough ultrasound performed by a trained professional in the second trimester.

Listening for dual heartbeats is tricky even for the most experienced obstetricians, even with Doppler technology. And an early sonogram isn't conclusive either.

I have the pictures to prove it! My seven-week sonogram showed one perfect bean-sized bubble. (My identical girls have always been skilled at playing hide-and-seek!)

Are you having multiples? Share your symptoms.
Think you could be having twins? Take this quiz and check out your chances.


”Signs & Symptoms of Multiple Pregnancy." American Pregnancy Association. Accessed October 16, 2015.

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