Signs That You Might Be Expecting Twins

During pregnancy, you may wonder if you're having more than one baby ... that is, twins or multiples. It does occur to most pregnant mothers at one time or another. Could you be pregnant with twins? Maybe you've been prompted by a dream, passing comment, or premonition. Or perhaps some aspect of the physical experience of pregnancy feels out of the ordinary, and you wonder whether you could be carrying twins. Some of the signs and symptoms of a twin pregnancy only hint at the possibility, leading to further investigation for confirmation. Of course, only your doctor or medical caregiver can tell you for sure, so be sure to follow up on your suspicions. But, read on to discover and explore some of the clues that show you might be pregnant with twins. 

Two Babies are Visible on Ultrasound

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

Advances in medical technology make a diagnosis of twins much more accessible than in the last century. 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. (See Can There Be a Hidden Twin?) 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. 

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, their uterus will 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 too many ice cream sundaes!) If your caregiver has reason to suspect multiples, they'll investigate further.

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 fish swimming. 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's something more than two tiny hands and two tiny feet waving around in their 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. 

If you're feeling early or frequent fetal movement, be sure to mention it to your medical caregiver. 

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

That's a lot of letters! Both are acronyms that merely refer to common screenings performed during pregnancy. Early in pregnancy, doctors or midwives may check hCG (Human chorionic gonadotropin) levels, a hormone produced during pregnancy. If the levels are high or accelerated, it may indicate a multiple pregnancy. 

AFP (Alphafetoprotein) screening occurs later in pregnancy and tests for 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 Have Extreme Symptoms

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

The symptoms of pregnancy are numerous, and not always particularly pleasant. Morning sickness, food cravings, fatigue, frequent urination... all are commonly experienced by pregnant women. So it might not come as a surprise that the presence of two babies exacerbates these symptoms. Some -- though not all, by any means -- 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 Any of the Characteristics That Increase the Odds

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

 What makes you more likely to have twins? While sometimes a twin pregnancy just "happens," there are some characteristics that increase the odds that a woman will have twins or multiples. Perhaps most significantly, fertility treatments may make you more likely to have twins or multiples. Other factors, such as maternal age, family history, or a higher BMI may increase a woman's chances of having twins. Additionally, some women find themselves pregnant with twins after conceiving while breastfeeding or taking birth control pills.

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 "getting lucky"!

You Have a Sneaking Suspicion

double yolk egg
Double Yolk Egg. PeskyMonkey / Getty Images

Dreams, premonitions, intuition, 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. In my case, it was a prevalence of double yolked eggs when I was baking. I found out I was pregnant with twins in December, during the holiday season. In the week leading up to that fateful day, I was doing a lot of baking and cracked open several eggs with the telltale double yolk. I'd never seen that before, and haven't encountered one since -- surely the universe was trying to tell me something! 

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. Trust your "mother's instinct." Ultimately, whatever your signs or symptoms, an ultrasound can tell if you're right and you'll 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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