Signs That You Might Be Expecting Twins

Newborn Twins in Hospital Sleep Together in Plastic Crib
Jill Lehmann Photography / Getty Images

With the incidence of twin pregnancies on the rise, the chance of having multiple babies in your pregnancy is more common than ever. Twin pregnancies are often able to be detected at the first prenatal appointment, but maybe you've been prompted early on by a dream, passing comment, or premonition. There are several signs and symptoms of a twin pregnancy that could serve as helpful clues.

Only your doctor or medical caregiver can tell you for sure, so be sure to follow up on your suspicions. But until confirmed otherwise, there's always the potential for a twin pregnancy.

Although each pregnancy is different, read on to discover some of the more common signs that might mean you're pregnant with twins. 

You Have Exaggerated Symptoms

pregnancy morning sickness
Extreme symptoms may indicate a twin pregnancy. Yuri_Arcurs / Getty Images

The symptoms of pregnancy are wide-ranging: Morning sickness, food cravings, fatigue, frequent urination all are commonly experienced by pregnant women. It might not come as a surprise that the presence of two babies exacerbates these symptoms.

Some pregnant moms of multiples report intensified symptoms of nausea, fatigue, breast tenderness, food cravings, or the like. It's more common in women who have experienced a previous pregnancy and thus have a basis ​for comparison. 

You Have Characteristics That Increase the Odds

pregnant belly with twin flowers
Could It Be Twins?. MorePixels / Getty Images

While sometimes a twin pregnancy just "happens," there are some characteristics that increase the odds that a woman will have twins or multiples, including:

  • Fertility treatments: As hormonal treatments such as in vitro fertilization (IVF) become more common, the frequency of twin births increases, as well, thanks to the resulting ovarian stimulation that may release more than one egg at a time.
  • Increased maternal age: Above the age of 30, the likelihood of releasing more than one egg while ovulating increases.
  • Family history: Having "the twin gene" makes a woman more susceptible to having a fraternal twin birth, in which more than one egg is released at once. There is no gene that results in an identical twin birth, where one egg splits in half—that is strictly up to chance!
  • Higher Body Mass Index (BMI): A BMI above 25 is associated with an increased probability of having twins.
  • Conceiving while breastfeeding or taking birth control pills: Hormone fluctuations may affect your odds of having twins.

However, many incidences of twins are random and not attributable to any specific cause or characteristic. For many families, their double blessing is simply a result of luck!

You Have Elevated hCG or AFP Levels

Monitoring hCG Levels in Pregnancy
Elevated hCG levels may be a sign of twins. Ian Hooton / Getty Images

Early in pregnancy, doctors or midwives may perform common screenings to check hCG (human chorionic gonadotropin) levels, a hormone produced during pregnancy. If the levels are high or accelerated, it may indicate a multiple pregnancy. 

An AFP (Alphafetoprotein) screening occurs later in pregnancy and tests for the proclivity of chromosomal abnormalities or birth defects. This type of testing may be referred to as maternal serum screening, triple screen, quad screen or penta screen. Based on the screening result, doctors may recommend further testing. An abnormally high result could be caused by the presence of multiple babies such as twins.

In either case, unexpected results are cause for further investigation, which could confirm the presence of twins.

You Feel Fetal Movement Early

Man Listening to Pregnant Belly
Feeling fetal movement early could be a sign of twins.

One of the most exciting moments of pregnancy is feeling the baby move within your womb. That fluttery, swishing, quivery feeling from deep within your belly connects you to your unborn child, cementing the bond between mother and baby. Some women describe it as butterflies or a swimming fish. Usually, women can feel this sensation, known as quickening, about midway through the pregnancy, between 16 and 25 weeks' gestation. 

Although there's not much science to support it, some moms of twins report feeling movement earlier and more frequently in pregnancy, sometimes as early as the first trimester. It might even be their first clue that there are more than just two tiny hands and two tiny feet waving around in the womb. Women who have had a previous pregnancy generally recognize fetal movement earlier. After all, they have a basis of comparison and more awareness of the sensation, leading them to conclude that there's something more. 

You're Measuring Large for Gestational Age or Gaining Weight Rapidly

There's no doubt that carrying two babies has a big impact on a woman's body. Not only are moms of twins likely to gain more weight, but their uterus will also stretch and expand to accommodate the extra baby.

Most doctors and midwives will monitor weight gain and fundal height (a measurement between the pubic bone and the top of the uterus) during routine appointments. An excess of either may point to a multiple pregnancy, although there are plenty of other explanations, such as increased levels of amniotic fluid. If your caregiver has reason to suspect multiples, they'll investigate further.

You Have a Sneaking Suspicion

double yolk egg
Double Yolk Egg. PeskyMonkey / Getty Images

The old wives' tale that double yolks are a sign of twins may ring true for some! Start noticing any potential signs and tapping into your early maternal instincts. Dreams, premonitions, intuition, hunches...many moms of twins look back in hindsight and realize they encountered these serendipitous signs shortly before they found out they were pregnant with more than one baby.

Confirming a Twin Pregnancy

Current medical technology makes a diagnosis of twins much more accessible than in the past century. Two ways to confirm a twin pregnancy are through ultrasound and fetal Doppler monitor.

Two Babies are Visible on Ultrasound

twin ultrasound
Early Ultrasound Image Shows Twins. Chris Sternal-Johnson / Getty Images

Ultrasound uses sound waves to create an image of the womb. A transducer sends high-frequency sound waves into the body; as the sound waves bounce off organs and structures, they produce electrical signals that are converted into images. This peek into the womb can clearly show the presence of two fetuses, or even two embryos early in the pregnancy.

In the past, ultrasound scans could potentially miss a twin pregnancy, for example, if two embryos were close together and one embryo was obscuring the other. But the clarity and precision of modern imaging, as well as more frequent use of ultrasound during pregnancy, makes it less likely that a twin would remain hidden. 

Two Distinct Heartbeats are Heard

Listening to heartbeats with doppler fetal monitor
Listening for two heartbeats. Oleksiy Maksymenko / Getty Images

There are several tools that can be used to listen for a fetal heartbeat during pregnancy, including a stethoscope, fetoscope, or Doppler monitor. With careful listening, a doctor or midwife can sometimes detect multiple distinct heartbeats and might suspect that there are twins. If so, an ultrasound scan can provide confirmation.

However, listening for heartbeats can be tricky and certainly not foolproof. It can be difficult to distinguish individual heartbeats, especially if they beat at about the same pace. And, the sound of mom's heart can muddle the results. 

A Word From Verywell

Trust your intuition. If you have a feeling that you might be having twins—a strong suspicion that just won't pass—be sure to mention it to your doctor or midwife. Ultimately, whatever your signs or symptoms, an ultrasound can tell if you're right and you'll then receive the medical attention appropriate for a multiple pregnancy. And, if you're wrong, you'll be able to enjoy your singleton pregnancy with peace of mind. 

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