How Does Pregnancy Care Change with Multiples?

When you find out you’re pregnant, you’ll naturally get on a schedule for prenatal care. You’ll see your doctor, have regular scans, make sure you eat and exercise appropriately, and cut out lifestyle habits that could put you and your baby at risk. When you’re carrying multiples, there are a few other things your doctor may add in to help take extra care of you and your babies.

At Physicians for Women - Melius, Schurr & Cardwell in Madison, Wisconsin, our team of expert obstetricians and midwives wants you and your babies to have the safest pregnancy and delivery possible. If you’re having multiples, we’re here to help you every step of the way, starting with specialized prenatal care.

Prenatal care schedule for multiples

Multiples are rare, but not too rare, at least for twins. Twins occur about once in every 250 pregnancies; triplets once in 10,000 pregnancies, and quadruplets once in every 700,000 pregnancies. Around 117,000 women every year have multiples, so you’ll have plenty of company if your first ultrasound shows more than one heartbeat!

However, multiples are at a greater risk of developing complications, so we see you more frequently than we would if you were carrying a single fetus.  We monitor you closely for any signs of health problems that could put you or your babies in danger, many of which are more common in women experiencing a multiple pregnancy:

• Gestational diabetes
• Hypertension
• Intrauterine growth restriction (IUGR)

We make sure you’re screened carefully for these and other potential risks. At around 20 weeks, we do a targeted ultrasound to check for any fetal abnormalities. This lets us get ahead of any potential problems, and even identify health issues that can be fixed in-utero, before your babies are born.

You’ll be scheduled for regular visits and repeat ultrasounds every week from week 20 onward. At 30 weeks, you might start experiencing premature contractions. If this happens, we check to see if your cervix is opening or not. If so, we may put you on bed rest until it’s time to deliver your babies to prevent very premature births.

If you’ve had a preterm birth before, we may recommend bed rest starting at or soon after the 24th week. However, many women are able to remain active until they deliver their multiples.

Preterm multiples

The most common complication with multiples is preterm birth, which affects more than half of all twins and almost all triplets or higher numbers of multiples.

Don’t be alarmed if your doctor or midwife tells you your babies are likely to come early. We’ll be prepared and will work with you to keep your babies in the womb as long as possible to ensure their safety and yours. 

Be prepared for your babies to spend some time in the NICU (neonatal intensive care unit) if they’re born before 34 weeks or have any complications. This is a normal procedure, just to ensure your newborns are healthy before you take them home.

Did one line on your pregnancy test turn into multiple heartbeats on an ultrasound monitor? Congratulations — you’re pregnant with multiples. Make an appointment to create your multiples pregnancy care plan by calling 608-207-7007 or booking your consultation online.