Like many women, I first learned I was pregnant when my home pregnancy test was positive. To confirm the results, I went to my doctor for a blood draw. The next day, he called and said something I’ll never forget: “Yes, you’re pregnant. In fact, your hormone levels are so high, we just don’t know how many are in there.”
Those jarring words were my first indication that I might be pregnant with twins — news that was officially confirmed four weeks later at my first ultrasound.
Although women expecting twins and multiples may experience a varied range of symptoms — just like women with singleton pregnancies do — there are some early signs that can indicate you’re carrying more than one baby.
1. Elevated HCG Levels
For various reasons, doctors may monitor HcG (human chorionic gonadotropin) levels. HcG is a hormone detectable in pregnant women’s blood or urine about 10 days post-conception; it increases at a rapid rate, peaking about 10 weeks into the pregnancy. Twins may produce an elevated level of HcG. However, the standard HcG level for twins also falls within the normal range for singletons.
Using harmless sound waves, a Doppler system amplifies fetal heart sounds, usually distinguishable late in the first trimester. An experienced physician or midwife can detect more than one heartbeat, indicating a multiple pregnancy. However, the sounds can be misleading; what appears to be a second heartbeat may actually be background noise or, rarely, the mother’s own heartbeat.
About 50% of pregnant women experience some amount of vomiting or nausea associated with their pregnancy. Moms of multiples certainly aren’t exempt, but neither are they doomed to a double dose. Only about 15% of respondents in a poll reported enhanced morning sickness symptoms as an indicator of their multiple pregnancies. Experiences vary widely — some do, some don’t.
Just as a multiple pregnancy may cause a mother to measure large, it may also result in an increased weight gain. How much weight a woman gains can vary depending on her height, body type and how much she weighed pre-pregnancy. Increased or rapid weight gain more than likely reflects eating choices rather than twins; generally, mothers of twins only gain about 10 lbs. more than singleton mothers.
AFP (Alphafetoprotein) screening is a blood test performed on pregnant mothers during the second trimester. Also known as maternal serum screening or multiple marker screening, it is used to identify increased risks of certain birth defects. A twin pregnancy can produce an unusually high — or “positive” — result. Generally, your medical caregiver will respond by scheduling an ultrasound for further assessment.
Throughout the pregnancy, the doctor or midwife may measure the height of the uterine fundus (from the top of the pubic bone to the top of the uterus) as a way of indicating gestational age. A twin or multiple pregnancy may cause the mother’s uterus to expand beyond the range of a single pregnancy. However, other factors may also increase the measurements.
Feeling a baby — or babies — move inside the womb is one of the most thrilling aspects of pregnancy. Although many moms of multiples do experience more frequent or earlier fetal movement, there is considerable disagreement among medical professionals on the subject. For some women, recognizable feelings of movement occur earlier in subsequent pregnancies, whether there is one baby or more.
This is the most commonly reported complaint during pregnancy with multiples. Sleepiness, lethargy, and exhaustion during the first trimester can be enhanced because the body is working overtime to nurture more than one baby. In some cases, the fatigue can be attributed to other factors (work, stress, poor nutrition, having other children), but it can also indicate multiples.
While the other items in this list refer to some kind of visible evidence — exaggerated symptoms, abnormal test results, etc. — we can’t disregard the power of a mother’s intuition. A family history of multiples, or a powerful hunch can be convincing indicators. Follow up with your doctor about these feelings.
Seeing is believing… the only way to indisputably confirm a twin or multiple pregnancy is to see it — via ultrasound. An ultrasound image can indicate without a doubt if there is more than one fetus. Ultimately, no matter what other signs or symptoms you have, the only way you’ll know is to have an ultrasound. If you have suspicions that there may be more than one, discuss your concerns with your medical caregiver. It is very unlikely that an ultrasound view would miss an additional baby, especially in the second or third trimester. However there have been cases of hidden twins, and sometimes extreme higher order multiple pregnancies, such as quintuplets or sextuplets, have not provided an accurate count of the number of babies.