As a busy independent midwife and mum of a gorgeous little girl,  midwife Amber Thatcher has hands on experience of twin pregnancies, births and the early days with twin babies.  We asked Amber what a mum to be expecting twins should ‘typically’ expect from her pregnancy and birth experience…

Your reaction to finding out you’re pregnant with twins, triplets or more may be anything from surprise, shock, excitement or a mix of emotions.  Either way, you’ll probably have lots of questions.  Here are some things to help you know what you can expect during your pregnancy and birth.

Antenatal Care

Ask if the hospital has a midwife or doctor who specialises in multiple births and try to arrange your antenatal appointments with them.  Don’t be rushed through the system; if you need extra time to work through your questions, ask for it. You may want to know, for example, what the hospital procedure is for multiple births and what special arrangements there are for antenatal care in multiple pregnancies.

Screening

You can still have screening with a multiple pregnancy.  The sonographer can take measurements during the routine scan at 10-14 weeks to assess the babies’ chances of having Down’s syndrome. Mothers expecting a single baby may have a blood test too, but this doesn’t work so well in multiple pregnancies, so it’s not used. If a high probability of Down’s syndrome is found, you will be offered a diagnostic test that can determine more accurately whether each baby has the syndrome.

Diagnostic tests carry a small risk of miscarriage because a needle is inserted into the uterus. The procedure can be more complex in multiple pregnancies, so you may need to go to a specialist hospital. Some people prefer not to have diagnostic tests, and the hospital will be able to talk through your choices with you, before you make your decision.

Tests for other rare conditions may be offered where there is a family history.

Scans

As with all pregnancies, the first ultrasound scan usually takes place at around 10-14 weeks’ gestation. This may be when you first find out you’re having twins (or more!) They’ll look at how many placentas there are and if the babies are in separate or shared amniotic sacs. If the babies share an amniotic sac they are certain to be identical. But sometimes identical twins have one each, so the presence of two amniotic sacs does not rule out your babies being identical.

If the babies share a placenta (monochorionic), it can lead to complications.  It’s sometimes hard to see, but if it appears to be the case, then the health team may want to scan the babies more regularly to make sure they continue growing well.

All pregnant mothers are offered an anomaly scan at around 18-22 weeks to check the babies are developing normally, but mothers of multiples will also probably have extra scans during the last months of pregnancy to check on their babies’ growth and their position. The timing and frequency of these scans varies according to the number of babies, their chorionicity (whether they share a placenta), your hospital’s procedure, and whether anything else needs monitoring such as how the babies are growing or the position of the placenta.

With twins, the position of the leading baby will be checked from about 34 weeks to help decide the best way for them to be delivered.