Having More Than One Baby

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Whilst being exciting, it may come as a shock to find out you are pregnant with more than one baby. For many, this will be at the first scan. You will have lots of questions and choices ahead that you may not have anticipated. Don’t worry, your midwife will support you to develop a plan of care that is suitable for your type of multiple pregnancy ).

Types of Twins


Dichorionic Diamniotic twins are not identical. They have their own placentas and amniotic sacs.


Monochorionic Diamniotic twins are identical. They share a placenta but have their own amniotic sacs.


Monochorionic monoamniotic twins are identical. They share a placenta and are in the same amniotic sac.

Before 16 weeks of pregnancy, the specialist team will meet you to talk about when you will be seen and who you will be seeing.

If you are pregnant with more than two babies, the team will explain their type. In some circumstances, you may be referred to a different hospital with more advanced facilities.

What Will My Recommended Care Be?

When you are having more than one baby, the only accurate way to ensure they are growing well is with ultrasound scanning. This will be offered to you at regular intervals throughout your pregnancy. This is to:

  • ensure your babies are growing equally
  • determine their positions to help you decide how you would like to birth them
  • check the blood flow to each of your babies
  • make sure they are growing well
Try not to compare their size to any growth guides as these are based on one baby in the womb.

With identical twins, you will be offered fortnightly  scans from 16 weeks. With non-identical twins, you will be offered scans every four weeks  from 24 weeks. After each of your scans, you will see the specialist team, which will be a doctor and a midwife. They will explain the results of your scan and make a plan with you.

Before 24 weeks, further discussions will be planned with you and your partner to inform you of potential risks and treatments. For example:

Premature Birth

50% of twin and triplet pregnancies will be born before 37 weeks. Due dates are calculated as if you were expecting a single baby, so have in mind an earlier arrival date. You may be transferred to a neighbouring hospital with enhanced services if you go into labour prematurely.

Signs of Early Labour

If early labour is suspected, the benefits of treatment will be explained to you, such as how we may help your baby’s lungs function better if they are born early. We’ll also explain when to call for advice or come in for review.

Pre-Eclampsia & Anaemia

Extra care will be taken to monitor for pre-eclampsia and anaemia as you are at an increased risk. Additional blood tests and blood pressure checks are also offered.

Your Birth

Identical twins in separate amniotic sacs are offered birth at 36-37 weeks if they remain uncomplicated.

Non-identical twins are offered birth at 37-38 weeks if they remain uncomplicated.

Identical twins in the same amniotic sac are offered birth at 32-34 weeks.

Triplets are offered birth at around 35 weeks.

At present, about 45% of all twins are born by caesarean. Triplets or more are almost always born by a planned caesarean birth.

About 5% of all twin births need a caesarean birth for the second twin when the first baby has been born vaginally. In twin pregnancies, the position of your babies will influence what is recommended for you.

Twin positions


Leading twin head down Vaginal birth offered.


Leading twin head not down Caesarean birth offered.


Leading twin head down Vaginal birth offered.


Leading twin head not down Caesarean birth offered.


Leading twin head not down Caesarean birth offered.


Leading twin head not down Caesarean birth offered.

Other things to consider are:

  • If you’ve had vaginal births before
  • If you’ve had caesarean births before
  • If there any concerns for your babies found during scans
  • If there are any concerns for you

If your choice is to have a vaginal birth, there are some extra options we’d like you to think about. Continuous monitoring of your babies is recommended. This may limit how mobile you are in labour.

There is a possibility that your contractions may slow down after the birth of your first baby. A drip with medication will help to ensure that there isn’t too long until the birth of your second baby. It also helps with any bleeding after birth.

Choosing an epidural for pain relief can make you more comfortable if the second baby needs assistance from the medical team. It can be topped up for pain relief should you need a caesarean for your second baby.

A multiple pregnancy will lead to many choices and decisions for you and your family. Your midwife and specialist team will be there to create a maternity journey that is personalised to you.

Explanation Point

Placentathe organ responsible for nourishing and protecting a foetus during pregnancy
Amniotic sacthe thin fluid-filled membrane that surrounds and protects a growing foetus
Ultrasound scanninga procedure that uses high-frequency sound waves to create an image of part of the inside of the body and monitor an unborn baby.
Pre-eclampsiaA condition that develops in pregnant women,diagnosed by high blood pressure and proteins in urine
Anaemianot having enough healthy red blood cells or haemoglobin to carry oxygen to the body's tissues
Caesarean birthan operation to deliver your baby through a cut made in your tummy and womb
Epiduralan injection in your back to stop you from feeling pain in part of your body
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