Accessibility Tools
Multiple Pregnancy

What is a Multiple Pregnancy?

A pregnancy with more than one baby growing inside the womb at the same time is called a multiple pregnancy.

Types of Multiple Pregnancies

Fraternal Multiples: The release of more than one egg during the menstrual cycle and its fertilization with different sperm results in the formation of more than one embryo that implants and grows in the uterus. These are fraternal multiples that do not look alike and can be of the same or different sex.

Identical Multiples: Sometimes, a single egg, after fertilization, divides into two or more embryos having the same genetic identity. These are identical multiples.

What Increases the Chance of Multiple Pregnancy?

The chances for multiple pregnancy are increased in the following situations:

  • Family history of multiple pregnancies
  • Women older than 35
  • Being of African American heritage
  • Increased secretion of hormones that stimulate ovaries to release eggs
  • Invitro fertilization (IVF)

Signs and Symptoms of a Multiple Pregnancy

The symptoms of multiple pregnancy may include:

  • Greater appetite
  • More morning sickness
  • Excess weight gain
  • A highly expanded uterus
  • Severe fatigue


Multiple pregnancy can be diagnosed by the following tests or procedures:

  • Blood test for human chorionic gonadotropin (hCG): hCG is a hormone produced only during pregnancy. Elevated levels of hCG are detected in a multiple pregnancy.
  • Blood test for Alpha-fetoprotein: This is a protein produced by the liver of developing babies and elevated blood levels of this protein are seen in the case of multiple pregnancies.
  • Ultrasound: An ultrasound is an imaging technique used to examine your baby growing in the uterus. Sound waves which reflect off your baby are processed to create images. Ultrasound may reveal a multiple pregnancy at 11-14 weeks and offer clear visibility of the multiple pregnancy after 20 weeks.


Multiple pregnancy can be associated with certain complications including:

  • Preterm Birth: Mothers carrying more than one baby have higher chances of preterm labor that may lead to complications such as low birth weight, underdeveloped organs, breathing difficulty, and learning problems in the newborn.
  • Gestational Diabetes: Mothers develop increased resistance to insulin due to elevated hormones produced by the placenta.
  • High Blood Pressure: Women carrying multiples are twice as likely to develop gestational hypertension, a common condition among pregnant women.
  • Placental Abruption: The placenta may separate from its wall before delivery.
  • C-Section Delivery: Most women having multiples may need a C-section delivery because monitoring 2 or more babies during vaginal delivery could be difficult and increase the risk of problems like cord compression.
  • Twin-to-Twin-Transfusion-Syndrome: It is common in identical twins or multiple pregnancies where abnormal blood vessel connections are formed in the placenta. One baby may receive insufficient nutrients resulting in improper growth or even death of the other.
  • Postpartum Depression: Women with multiples experience higher levels of postpartum depression.

Measures to Stay Healthy During a Multiple Pregnancy

The following measures will help you stay healthy and help prevent complications:

  • Frequent check-ups to monitor your babies
  • Eating a nutritious diet
  • Taking enough fluids
  • Getting enough rest
  • Taking prescribed medications
  • Taking vitamin supplements, if necessary
  • Gaining the necessary weight
  • Refraining from strenuous activities
American College of Obstetricians and Gynecologists American College of Surgeons American Board of Obstetrics and Gynecology