You may not have seen it coming, but your ultrasound showed two little hearts beating inside your belly. First of all, congratulations: twice the love awaits you. And yes, also twice everything! How does a twin pregnancy happen? What should you pay attention to during this pregnancy? How does childbirth proceed? We’ll help you gain clarity so you can experience this period with peace of mind.

How do twins form?

The probability of expecting twins is about 1 in 85. This increases with age, especially after 35. This may be explained by the body mobilizing more resources, which can lead to multiple ovulations during the same cycle. Fertility treatments or artificial insemination also increase the chances of a multiple pregnancy. These treatments are more commonly used when parents are older. Pregnancy is a little more complex than when it is a singleton pregnancy. There are two main types.

What are the types of twins? : dizygotic or fraternal twins

Dizygotic twins account for 80% of twin pregnancies. They occur when 2 eggs are fertilized by 2 spermatozoa.

Two fetuses then form, each with their own placenta and amniotic sac.

The placentas then coexist in the uterus.

The future babies can be the same sex or different sexes.

They will resemble each other like typical brothers and sisters because their genetic makeup is not the same.

What are the types of twins? : monozygotic or true twins

Monozygotic twins account for 20% of multiple pregnancies. They occur when a fertilized egg divides into 2. Two embryos then form. The future babies share the same genetic makeup, are necessarily the same sex, and look very much alike. There are 3 types of implantation, which vary depending on when the egg divides.

La grossesse bichoriale et biamniotique : 2 placentas et 2 poches amniotiques

When separation occurs less than 2 days after fertilization, each egg will have its own placenta and amniotic sac. This is called a bichorial and biamniotic twin pregnancy.

La grossesse monochoriale et biamniotique : 1 placenta et 2 poches amniotiques

Pregnancy is monochorionic and diamniotic when separation occurs between the 3rd and 7th day after fertilization. The twins share the same placenta, which has 2 distinct umbilical cords.

La grossesse monochoriale et monoamniotique : 1 placenta et 1 poche amniotique

When separation occurs after the 8th day after fertilization, it is called a monochorionic and monoamniotic pregnancy. The two eggs share the same placenta and the same amniotic sac.

What medical precautions should be taken in the case of a twin pregnancy?

If you are pregnant with twins, your medical follow-up will be more thorough. This pregnancy requires follow-up by a specialized gynecologist-obstetrician . It is automatically considered high-risk, although it can still proceed without complications.

In general, a twin pregnancy places greater demands on your body than if you were expecting a single baby. Your pelvic floor, skeleton, muscles, and skin are particularly strained by the volume and weight of your babies.

During a twin pregnancy, your body secretes more HCG hormones , which are pregnancy hormones. This higher level increases the likelihood of nausea . You are also more prone to hypertension and water retention.

During a singleton pregnancy, healthcare professionals recommend a weight gain of between 12 and 15 kg. For a twin pregnancy, the recommendation is approximately +3/4 kg. Since physical activity is more limited, weight gain can be higher . Even if your needs are slightly greater, just like in a singleton pregnancy, adopt a healthy and balanced diet . It’s often said that you shouldn’t eat twice as much, but twice as well! ;)

The risks of gestational diabetes during a twin pregnancy are higher. It is generally advised to pay close attention to your diet. Anemia—that is, an iron deficiency that leads to a decrease in hemoglobin levels—is also more common during twin pregnancies. Doctors recommend supplementation from the beginning of pregnancy.

During your pregnancy, check-ups with the gynecologist are more frequent, as are ultrasounds. The doctor checks for any significant growth delays, signs of premature contractions, and monitors the length of the cervix. These examinations are precautionary measures, and most twin pregnancies proceed without any problems.

During your medical follow-up, the medical staff will be particularly attentive to signs of:

• Premature birth , as multiple pregnancies account for 20% of premature births , and 7% of twins are born very prematurely. A premature baby may be exposed to certain complications, which is why the medical team is particularly attentive. To make things easier for you, you can turn to the LILLYDOO diaper subscription , the best ally for your peace of mind. You can place your order a few weeks before your due date, so you’ll already have your stock of diapers before your little explorers are born.

• Intrauterine growth retardation (IUGR) : les jumeaux partagent les mêmes ressources placentaires , and when these are limited, development can slow down. This can also be related to circulatory problems in the mother at the end of pregnancy. IUGR can result in a birth weight that is too low.

• A transfused or transfusing syndrome in monozygotic twins A twin pregnancy involves a risk of fetal transfusion syndrome . This means that one twin deprives the other of the shared blood supply. This can lead not only to deficiencies and growth delays in one baby, but also to complications due to overfeeding the second baby. Regular ultrasounds are therefore particularly important during a twin pregnancy, in order to detect early any potential disparity in the babies’ growth and, if possible, to treat it.

What to watch out for during a twin pregnancy?

During a singleton pregnancy, there are already precautions to take. During a multiple pregnancy, they are even more important because it is considered high-risk. You should therefore take it as easy as possible:

• Limited physical activity. A twin pregnancy is more tiring, and premature births are more common. Rest is recommended, and physical activities even gentle ones should be limited. Of course, you can walk, but it is important to listen to your body and not push yourself.

• Congé de maternité prolongé. In France, maternity leave, if you are pregnant with twins, lasts 34 weeks: 12 prenatal and 22 postnatal. You can also benefit from pathological leave of 2 weeks before delivery and 4 weeks after. This leave allows you to rest; do not hesitate to discuss it with the medical team monitoring your pregnancy. If you deliver prematurely, the prenatal leave you have not taken will be transferred to your postnatal leave; it is not lost.

What are the particularities of a twin birth?

As with a straightforward delivery, you can bring a birth plan to the maternity ward. Of course, it will be respected as much as possible, while preserving your health and that of your babies .

A delivery is considered premature before 37 weeks of pregnancy, knowing that a pregnancy lasts about 41 weeks. According to the CNGOF (National College of French Gynecologists and Obstetricians), there are different milestones depending on the type of pregnancy:

• Uncomplicated bichorial : if labor has not occurred earlier, it is scheduled between 38 weeks of amenorrhea (WA) and 40 WA.

• Uncomplicated monochorionic biamniotic : if delivery has not occurred earlier, it is scheduled between 36 and 38 weeks of pregnancy.

• Uncomplicated monochorionic monoamniotic : if delivery has not occurred earlier, it is scheduled between 32 and 36 weeks of gestation.

During the delivery of dizygotic twins, you have an equal chance of delivering vaginally or by cesarean section. However, the rate of cesarean births or instrument-assisted births (forceps, vacuum, etc.) is higher. For monozygotic twins, delivery is always performed by cesarean section.

Twin birth carries a higher risk. Notably, postpartum hemorrhages are more frequent because the placenta is larger and the uterus is more relaxed. If you deliver vaginally, you will inevitably be in a cesarean section room with an obstetrician-gynecologist and an anesthesiologist present in case you or your babies need them. The time interval between the two babies should be short to avoid certain complications.

Twin pregnancy is a bit more challenging than a straightforward pregnancy, but it is also a source of many joyful moments. Now that you’re prepared for various eventualities, we’d like to lend you a helping hand with the choice of first names . Finding one isn’t always easy—so two... Good luck! :)