How Pregnancy Differs When You're Expecting Multiples

Expecting multiples? It’s a journey that requires extra care, preparation, and medical attention compared to a single pregnancy. Here’s what you need to know:

• Symptoms start earlier and feel stronger: Morning sickness and fatigue can be more intense.
• Higher risks: Preterm labor, preeclampsia, gestational diabetes, and low birth weight are more common.
• More frequent checkups: Expect additional ultrasounds and specialized monitoring.
• Delivery planning is key: Cesarean sections are more common, and delivery often happens earlier than 40 weeks.
• Nutrition and rest matter: Increased caloric intake, hydration, and rest are critical for supporting your health and your babies’ growth.
• Consider stem cell banking: Each baby requires separate collection kits, offering future medical options for your family.

Preparation is everything - work closely with your healthcare team, adjust your lifestyle, and plan for early delivery to support a healthy pregnancy and safe delivery for your multiples.

Medical Considerations for Multiple Pregnancies

Carrying more than one baby comes with its own set of challenges, requiring extra care and attention throughout your pregnancy. Your healthcare team will keep a close eye on potential complications that are more common with twins, triplets, or higher-order multiples.

Higher Risks and Complications

Multiple pregnancies are associated with higher risks compared to carrying a single baby. One of the most frequent concerns is preterm labor, as twins and other multiples are often born before the full 40 weeks of pregnancy.

Preeclampsia, a condition involving high blood pressure, is more likely to occur with multiples. Similarly, the chances of developing gestational diabetes increase, which may lead to earlier glucose testing during pregnancy. Your healthcare provider will likely schedule more frequent check-ups to monitor your blood pressure and overall health closely.

Another concern is low birth weight, as multiples must share the limited space and nutrients available in the womb. For identical twins who share a placenta, there’s also the risk of twin-to-twin transfusion syndrome, a condition where blood flow between the babies becomes uneven. This condition requires specialized monitoring and, in some cases, medical intervention.

Delivery Options and Planning

While labor may feel similar to that of a singleton pregnancy, delivering multiples often requires a different approach. Your delivery plan will hinge on factors like the babies’ positions, your health, and your doctor’s expertise with multiple births.

Dr. Jeanne S. Sheffield, a Maternal-Fetal Medicine Specialist at Johns Hopkins Medicine, notes that even planned vaginal deliveries for twins involve a "double setup."¹ This means the medical team prepares for a cesarean section in case complications arise during labor.

Cesarean sections are more common with multiples, especially if the first baby isn’t positioned head-down or if the care provider is less experienced with vaginal twin deliveries. This approach ensures the medical team can quickly adapt if complications occur with the second baby during delivery.

Recovery after delivering multiples can take longer, and many hospitals have protocols for neonatal intensive care unit (NICU) observation. This ensures each baby receives close monitoring during those critical first hours and days after birth.

Dr. Sheffield emphasizes the importance of choosing a healthcare provider who is experienced in managing twins and comfortable with both vaginal and cesarean deliveries. Your care team for a multiple pregnancy may include maternal-fetal medicine specialists, neonatologists, and additional nursing staff to provide the specialized attention you and your babies need.

These increased risks highlight the importance of personalized prenatal care, laying the groundwork for the nutritional and lifestyle adjustments discussed in the next section.

Nutrition and Lifestyle Changes for Multiple Pregnancies

Carrying more than one baby means your body is doing extra work, and it needs extra care to match. Adjusting your diet and lifestyle is key to supporting your health and your babies’ growth. Always work closely with your healthcare provider to create a plan tailored to your specific needs.

Increased Caloric and Nutritional Needs

When you're expecting multiples, your body requires more calories and protein than usual. Nutrients like iron, folic acid, and calcium also become even more important for supporting the development of your babies and maintaining your own health. These dietary changes can also help you better handle the physical and emotional challenges that often come with carrying multiples.

Taking Care of Your Physical and Emotional Well-Being

Your symptoms may feel more intense during a multiple pregnancy. For example, nausea can be more frequent, but eating small, regular meals can help keep your blood sugar stable and ease discomfort. Fatigue is another common issue, so make rest and quality sleep a priority whenever possible.

Staying hydrated is crucial, too, as your blood volume increases significantly. Keep a water bottle handy and sip fluids throughout the day. As your pregnancy progresses, you may need to adjust your exercise routine to suit your changing body. Gentle activities like walking, swimming, or prenatal yoga - modified for a multiple pregnancy - can keep you active without overexertion.

It’s also important to watch for warning signs. If you notice persistent headaches, vision problems, unusual swelling, or reduced fetal movement, reach out to your healthcare provider right away. Joining support groups for parents expecting multiples can also provide valuable advice and encouragement.

Preparing for Labor and Delivery with Multiples

After tackling prenatal care and nutrition, it’s time to focus on labor preparation - especially important when expecting multiples. Delivering twins, triplets, or more can bring unique challenges, so planning ahead can make a big difference. Starting early ensures you're ready for the possibility of preterm labor and gives you peace of mind as your due date approaches.

Planning for Early Labor

Multiples are often born ahead of schedule. Twins frequently arrive a few weeks early, while pregnancies involving three or more babies tend to deliver even sooner. With this in mind, it’s smart to pack your hospital bag well in advance. Include essentials for yourself, your partner, and each baby, so you’re ready to go at a moment’s notice.

Keep an eye out for signs of labor, such as contractions, back pain, or pelvic pressure, and notify your healthcare provider immediately if they occur. Depending on your situation, your doctor may recommend reducing your activity level or even a hospital stay to manage early labor risks.

Plan how you’ll get to the hospital quickly. Map out a few routes, keep your car in good condition, and make sure your partner or support person knows the plan. This way, you can focus on the big day without worrying about logistics.

Once these basics are covered, turn your attention to creating a birth plan that fits the unique needs of a multiple pregnancy.

Hospital and Birth Plan Preparation

Given the higher likelihood of complications with multiples, your birth plan should emphasize flexibility and preparedness. While it’s helpful to outline your preferences, remember that things can change quickly, especially if a cesarean delivery becomes necessary - a common scenario with multiple births.

Take a tour of your hospital’s labor and delivery unit, including the NICU, so you’re familiar with the environment. Many hospitals prefer to deliver multiples in an operating room, even for planned vaginal births, to ensure immediate access to emergency care if needed.

Confirm that your delivery team includes the right specialists. Multiple births often require extra hands, such as pediatricians, neonatologists, additional nurses, and an anesthesiologist, to handle the needs of both you and your babies.

Prepare for the possibility of a longer hospital stay. While single-baby deliveries often allow for a quick discharge, multiples - especially those born preterm - may need extended observation or time in the NICU. Discuss rooming-in policies with your care team to understand how bonding, feeding, and care will be managed, especially if your babies require different levels of attention.

Finally, while your birth plan might include preferences like skin-to-skin contact, pain relief options, or delayed cord clamping, staying flexible is key. Choose a support person who can advocate for your wishes and keep everyone informed, so you and your partner can focus on welcoming your babies into the world.

Newborn Stem Cell Banking: Options for Multiples

When preparing for the arrival of multiples, it's worth considering the long-term advantages of newborn stem cell banking. Why? Because each baby has a unique genetic makeup, storing stem cells individually ensures a perfect match for each child. This could play a crucial role in future medical treatments for your children or even other family members.

Why Stem Cell Banking Makes Sense for Multiples

Storing stem cells from each baby offers a significant advantage: it reduces the risk of rejection if treatments are needed. Plus, having stem cells from multiple siblings increases the chances of finding a match for other family members, broadening potential treatment options.

Americord Registry takes this a step further by using advanced preservation techniques to ensure the highest quality storage. Their CryoMaxx™ Processing method involves manual processing for cord blood and minimal handling of perinatal tissues, preserving the maximum potential of the stem cells. These cells are stored in 5-compartment vials, allowing for multiple therapies from a single collection.

Americord Registry's Family Plans for Multiples

Americord offers flexible family plans tailored for parents expecting multiples. These plans let you choose the level of stem cell and tissue preservation that fits your family's needs and budget for each baby. Payment plans are available to make the process more manageable.

Pricing is subject to change. Please visit Americord’s pricing page for the most up-to-date information.

If you're expecting twins, you'll need two plans - one for each baby. For triplets, three plans are required, and so on. Americord’s Stem Cell Consultants are on hand to guide you through these options, helping you select the best plan for your family's needs and budget.

The $280 due today covers the collection kit and shipping for each baby, ensuring you're fully prepared for delivery day. This thoughtful approach to stem cell banking is an excellent addition to your preparations for welcoming multiples into your family.

Conclusion: Supporting a Healthy Multiple Pregnancy

Carrying multiples comes with its own set of challenges, requiring extra care and thoughtful preparation. Many aspects of this journey will differ from a singleton pregnancy, and navigating it successfully means working closely with your healthcare team, focusing on nutrition, and planning ahead for labor and delivery.

Comprehensive prenatal care is a cornerstone of a healthy multiple pregnancy. Regular check-ups help catch potential complications early, while tailored nutrition plans ensure you and your babies get the nutrients you need. Thoughtful meal planning plays a big role in supporting a healthy pregnancy.

Preparation for delivery is equally important. Since multiples often arrive earlier - typically between 32 and 37 weeks - it’s wise to have your hospital bag packed by 28 weeks and to discuss delivery options with your doctor well in advance. Whether a vaginal delivery or C-section is recommended will depend on your unique circumstances, and your healthcare provider will help you make the best decision.

Another important consideration is stem cell banking, which can provide an additional layer of security for your family. For multiples, each baby requires a separate collection kit, and the process is handled individually for each child. As Americord Registry explains:

Yes, you can bank cord blood for twins, triplets, or other multiples! Each baby will require their own separate collection kit, and the banking process (and associated fees, in some cases) will apply individually to each child. Banking for multiples can be particularly valuable as it provides potential matched sibling donors within the family. Americord may offer discounts for enrolling multiples.

Having stem cells banked can be especially valuable for families with multiples. Siblings have a 25% chance of being a perfect HLA match and a 50% chance of being a half match, which can lead to better outcomes in procedures like transplants. For example, in 2020, a young boy named Eli was successfully treated for Sickle Cell Disease using stem cells banked from his younger brother Gus through the Americord Cares program.² According to their mother, Eli has been thriving since the transplant - an inspiring reminder of the potential benefits of forward-thinking preparation.

A multiple pregnancy requires extra planning and support, but with the right resources and proactive steps, you can set the stage for a healthy pregnancy and a bright future for your family. From enhanced prenatal care to innovative options like stem cell banking, these measures can make all the difference for you and your babies.

FAQs

What lifestyle changes can help support a healthy pregnancy with multiples?

Supporting a healthy pregnancy when you're expecting multiples calls for some thoughtful changes to your daily routine. Getting enough rest is key - cut back on demanding activities and make time for regular breaks throughout the day. This can help ease the strain on your body and may even extend the length of your pregnancy. Gentle exercises, like pelvic floor strengthening, can also play a helpful role in keeping you comfortable and prepared.

Nutrition becomes even more important during this time. You’ll need about 600 additional calories daily, but it’s not just about eating more - it’s about eating smart. Focus on nutrient-packed foods such as lean proteins, whole grains, fresh fruits, and vegetables. Don’t forget to stay hydrated, as your body will need extra fluids to meet the increased demands.

Equally important is surrounding yourself with a strong support network. Whether it’s family, friends, or your healthcare team, having people to lean on can make the physical and emotional challenges of carrying multiples more manageable.

Pair these lifestyle adjustments with regular prenatal checkups, and you’ll be giving yourself and your babies the best chance at a healthy pregnancy.

How can I prepare for preterm labor when expecting twins or more?

Preparing for preterm labor when you're carrying multiples means taking thoughtful steps to protect your health and your babies' development. Partnering with a healthcare provider who has experience with multiple pregnancies is key - they'll keep a close eye on your progress and provide care tailored to your unique needs. Make it a priority to attend all prenatal checkups and follow their guidance closely.

If there are early signs of labor, your doctor might recommend scaling back physical activity or suggest treatments like corticosteroids to help your babies' lungs mature. Staying in good health through balanced nutrition, staying hydrated, and getting enough rest can also make a big difference. It's equally important to know the warning signs of preterm labor and have a plan ready for quick access to a hospital equipped with a NICU, just in case.

What are the advantages of stem cell banking for each baby in a multiple pregnancy, and how is it done?

Stem cell banking for each baby in a multiple pregnancy offers a chance to secure a potentially life-saving resource for future medical needs. The cord blood and tissue from each baby are rich in stem cells, which can be used in treatments like transplants or regenerative medicine. This can provide families with reassurance, knowing they have taken a step to prepare for potential health challenges down the road.

The process itself is simple and mirrors what’s done in any pregnancy. At birth, the cord blood and tissue from each baby are collected separately and preserved through cryogenic storage. No extra or specialized procedures are required for multiples, and typically, there’s an adequate amount of stem cells collected from each baby. For families welcoming twins, triplets, or more, this can be a meaningful way to prepare for the unique journey ahead.

References

1. Johns Hopkins Medicine. (n.d.). Jeanne S. Sheffield, M.D. Retrieved from https://www.hopkinsmedicine.org/profiles/details/jeanne-sheffield
2. Americord Registry. (n.d.). A Brother's Bond: Sibling's Newborn Stem Cells Help Treat 10-Year-Old with Sickle Cell Disease. Retrieved from https://production.americordblood.com/articles/a-brothers-bond-siblings-newborn-stem-cells-help-treat-10-year-old-with-sickle-cell-disease