It is very common for expectant mothers to think “is it, twins?” Nearly 4 percent of babies are now born in sets of two, three or more, with the majority of these multiple births being twins. As of 2023, the birth rate for twins was 32.6 per 1,000 live births.  

The most reliable way to know you are having twins is through ultrasound which is standard fare throughout pregnancy. But your body can send you hints that you are actually carrying more than one baby, here are some symptoms to look for: 

Early Weight gain and a bigger, earlier bump

On average, women who are carrying twins gain about 10 more pounds than those carrying a single baby. This extra weight can account for babies’ combined weights, extra tissue, fluid, and blood volume to support two babies. 

Increased Nausea or morning sickness

While most women pregnant with twins will experience the same pregnancy symptoms as those pregnant with a singleton, many expectant mothers of twins reported increased nausea.

Due to increasing hCG (human chorionic gonadotropin), morning sickness associated with twin pregnancy can last longer into the pregnancy.

Breast tenderness

Very tender, swollen breasts with more intense pain is also a common sign of twin pregnancy due to a higher amount of hCG (human chorionic gonadotropin). 

Extreme fatigue

While most women experience extreme fatigue in their first trimester of pregnancy, women carrying twins report increased tiredness due to increasing hCG and progesterone hormone levels. 

Frequent Urination as early as 5 weeks gestation 

Although this is a common early symptom of pregnancy, frequent urination may start early as 5 weeks in a twin pregnancy due to increasing hCG and increased blood flow to the kidneys that tends to increase urine output. 

Measuring large for gestational age

Measuring large for gestational age is a possible indicator for a twin pregnancy, the uterus, and its non-fetal contents may achieve a volume of 10 L or more and the fundal height might be 5 cm higher than expected for singletons of the same fetal age. 

High AFP (Alpha-fetoprotein) Test result

An alpha-fetoprotein (AFP) screening, also known as the triple marker test, is a blood test performed during the second trimester, a positive high reading may indicate twin pregnancy. 

Intuition

This may not be very scientific, but many women expecting twins have a gut feeling that they’re carrying twins-they just know! It may be that they have dreams of twins or a hunch they can’t explain. Not very scientific perhaps but you can never go wrong with a mother’s intuition. 

The bottom line- every pregnancy is different from one another. It may be common for a twin pregnancy to have heightened pregnancy symptoms and a range of emotions from excitement to panic. Once you have learned you’re actually carrying twins, be sure to discuss your symptoms with your doctor, share your anxieties, ask questions, and support if needed.