Being pregnant with twins can be daunting, but it’s important to remember that most twin pregnancies proceed without major complications.

Twin pregnancy symptoms

Most of the symptoms associated with twin pregnancies are a result of the added weight the mother has to carry. Of course, they are all symptoms that mothers of singletons can experience too, it’s just that they often start earlier in twin pregnancies. They include:

1. As the babies grow there is more pressure on other organs which can lead to indigestion, breathlessness and needing the loo more often.
2. Some women suffer back pain as a result of the added weight
3. Others struggle to find comfortable sleeping positions.

Twin pregnancy complications

More serious complications include:

1. Build up of excess amniotic fluid (polyhdramnios). If this occurs you’ll be carefully monitored to determine if any action is needed such as an amniocentesis to drain off some of the fluid or extra bed rest.
2. The risk of pre-eclampsia also rises in twin pregnancies so your blood pressure will be regularly monitored. If it gets too high and is a risk to you and your babies the twins will be delivered early.
3. Premature labour is the main risk and it is much less likely that the pregnancy will get to 40 weeks. Figures vary but studies suggest just over half of all women expecting twins give birth before 37 weeks.
4. Twin to twin syndrome (TTTS) is rare but can occur in identical twins when they share an outer membrane — the chorion — and so blood from the placenta is shared by passing from one twin to the other. It happens in about 10% of monochorionic twin pregnancies. The risk is one twin will get too much blood while the other doesn’t get enough so one twin grows faster than the other.

The expert view

Jeanne Tarrant, team manager for the Royal College of Midwives, says: “Complications in twin pregnancies include the onset of early labour and mothers run the risk of high blood pressure. It’s most likely they will go into labour quite early on so it’s unlikely the pregnancy will go to 40 weeks. Symptoms in pregnancy are mainly due to the greater weight being carried so mothers may feel a little bit more tired because the growing twin pregnancy has twice the demands on the mother’s body. They are more likely to be breathless as they get bigger because as the twins grow there is less room in there for the lungs.

It’s common to get a lot of swelling in the legs because of the weight of the babies. Mothers often complain of not feeling rested after a night’s sleep because it is difficult to get comfy in bed so we suggest lots of pillow support.

“They’ll probably have more regular visits to the hospital; they are more likely to have consultant-led care than someone carrying a single baby, so they’ll see obstetricians more frequently. Mothers of twins are more likely to have a caesarean section but it depends how the babies are lying. If they are both head down near the due date or delivery then the chance of a successful vaginal birth is great but if the first baby is not head down then there’s a greater chance of a c-section.”

A mum’s view

Lara Barrett, mother to Sam and Ewan, says: “I felt exhausted for the first trimester. I worked all the way up until they were born because they came early. I felt fine in the pregnancy apart from my legs which really swelled up from quite early on.

"I was monitored for twin to twin transfer syndrome which can happen with identical twins. I didn’t have it but I did develop pre-eclampsia. At 32 weeks I went for a scan and they were worried about my blood pressure going up and so they kept me in hospital and were testing me regularly. It’s a balancing act between bringing the twins out early and the risk of high blood pressure. It got to the point in the night when they said they had to deliver the babies. They were in special care for a night and weighed 4.5 and 5lbs.”