Every pregnant woman experiences pregnancy symptoms differently and each pregnancy for the same woman can be very different. My two pregnancies felt very different, the first I had relatively few symptoms, but my second, with the twins I had many more.

In terms of a twin pregnancy, the possible symptoms should be the same as a singleton, only they are often experienced more strongly, due to an increase of pregnancy hormone hCG, for example if you are suffering from extreme nausea and vomiting you may be checked to see if you are carrying twins.

Here are some possible pregnancy symptoms you may experience and some ideas and tips on things that may help you through:

Nausea and vomiting

Nausea and vomiting, or more commonly known as ‘morning sickness’, is probably one of the most common and well known symptoms of pregnancy, especially a twin pregnancy, though many people are lucky enough to escape this symptom. One of the causes is low blood sugar and for this reason it can be advised to eat little and often. I know this helped me, as whenever I got the slightest bit hungry I was sick, so eating little bits almost constantly throughout the day may help and maybe having a biscuit or something by your bed for whenever you wake up may be a good idea. Another reason for increased nausea and vomiting in a twin pregnancy is due to the pregnancy hormone hCG, which is higher in multiple pregnancies. This symptom usually improves by around 14 weeks, though for some it may continue throughout the pregnancy.

Severe vomiting is called hyperemesis gravidarum. If you are vomiting more than 3 times over 3 days get in touch with your GP or your midwife. It is possible you may become dehydrated and low in certain minerals. Occasionally this may mean a hospital admission until the symptoms are under control.

Tips :

  • Eat little and often
  • Drink plenty of fluids – try drinking fluids that also have nutrients in them eg. soup, fruit or veggie juices, milk shakes
  • Dry biscuits especially ginger
  • Carry nutritious snacks round with you as you never know when you will need it.
  • Try travel sickness bands.
  • Avoid foods that may trigger nausea, eg. spicy, fatty or foods with a strong smell.
  • Foods that are rich in zinc can help, eg. eggs, ginger, dairy, meat and fish.
  • Get plenty of rest (I found the more tired I felt the more nauseous I felt).

Heartburn and indigestion

In pregnancy your body produces large amounts of progesterone and relaxin hormones. These hormones relax the smooth muscle, including the muscles at the entrance to the stomach, which can let the stomach acid flow back up into the oesophagus, causing heartburn (a burning sensation). Additionally, this may be more common during twin pregnancy due to the increased pressure on the stomach from the very large uterus.

Tips:

  • Eat little and often, maybe eat six small meals rather than 3 large ones.
  • Have a glass of milk or yoghurt before going to bed may help neutralise the stomach acid.
  • Eat slowly and chew thoroughly.
  • Stay upright after eating for a few hours (maybe even sleep more upright, with lots of pillows).
  • Avoid foods that make it worse eg. spicy, fatty, cheese, tomatoes, chocolate alcohol, coffee.
  • Try some gentle exercise like yoga.
  • or haemorrhoids. Piles are rectal veins that become dilated (enlarged) and bulge through the anus. They are caused by an ob
  • Gaviscon (free on prescription from your GP)
  • If no improvement see your GP or midwife.

Backache

Backache is very common with all pregnancies, but especially multiple pregnancies. Backache occurs as the hormone relaxin stretches and softens the ligaments in preparation for labour. However, this also increases lots of minor aches and pains. Additionally, you are carrying a lot of weight with 2 babies and possibly 2 placentas, there is no wonder women experience low back pain.

Tips:

  • Try to maintain a good posture
  • Be careful when bending and lifting.
  • Try a pregnancy pillow in bed
  • Speak to your midwife or GP, they may be able to refer you to a physio if needed.

Constipation and piles

Constipation during pregnancy is very common due to high levels of hormones which cause muscles to relax, including the bowel therefore making it sluggish and also the size of the uterus cramping the bowels normal function. You shouldn’t just put up with constipation, as too much straining can increase the risk of developing piles struction of blood flow due to the babies, which causes blood to pool and the veins to enlarge or dilate. They can be a little uncomfortable and may bleed on passing stool, but are not dangerous.

Tips:

  • Eat plenty of fibre eg. fruit, vegetables, whole grain cereals, whole grain bread
  • Drink plenty of fluids
  • Speak to your GP or midwife, there may be other medication or creams that can be prescribed.

Sleeplessness and fatigue

Your mind is racing, your tummy is growing rapidly, you feel sick, you have heartburn and are very uncomfortable! It is no wonder that you are experiencing insomnia! However, you are also more prone to anaemia (an iron deficiency in the blood which causes tiredness), so speak to your GP or midwife if your symptoms persist as you may need a blood test to check your iron levels.

Tips:

  • Get plenty of gentle exercise and fresh air.
  • Drink plenty of fluids during the day, but stop drinking an hour before bed to reduce those night time trips to the bathroom.
  • Try to get as comfortable as possible in bed, you may need extra pillows, under the bump, between your legs etc. There may not be much room left in the bed for your partner, but if you are suffering, maybe they should sacrifice something too?!
  • Try a warm relaxing bath before bed
  • Listen to music
  • Eat plenty of food rich in iron, eg. beef, sardines, spinach, greens, dried fruit, potatoes with their skin on.

Anxiety and mood swings

Again, there is no wonder pregnant women experience anxiety and mood swings, especially when they have just been given the news they are about to have not just 1 but 2 babies! Hormones are racing around your body, your mind is racing with so many different feelings and emotions. You are terrified how on earth you are going to cope with 2 babies at once. What will life be like? Will the babies be ok? You have so may questions! I don’t think anyone would expect you not to have some mood swings and worries. I know throughout my pregnancy, one minute I would feel so excited and happy and the next I’d be in tears, terrified of the unknown! It is all perfectly normal, but if you are worried do speak to your midwife, they are there to help.

Tips:

  • Talk to your partner
  • Talk to your family and friends (I don’t know what I would have done without the support of everyone)
  • Talk to your midwife
  • Get in touch with a local twins group where you can meet other mums with twins (I found this invaluable!)
  • It is ok to cry
  • Try some relaxation techniques
  • Tamba (twins and multiple birth association) is a very good source of online information and support where you can chat to other mums of twins

Increase urination

You will probably find you spend a large proportion of your day in the bathroom. One reason is due to the increased volume of body fluids and kidney efficiency. Also, as you get bigger the pressure of the uterus on the bladder means the size of the bladder decreases. Ensure you still keep drinking plenty of fluids.

Swelling

During pregnancy many people experience fluid retention or swelling, particularly of the feet and ankles (called oedema). Most swelling just means a little discomfort, however if your hands or face become puffy or if the swelling continues for more than 24 hours at a time you should contact your midwife, as it could be a sign of the beginning of pre-eclampsia.

Tips:

  • Avoid standing for too long
  • Keep your feet elevated when sitting
  • Drink plenty of fluids
  • Regular gentle excercise (eg. walking)

Baby brain/absent-mindedness

There are studies suggesting that up to 68% of mums to be, suffer from forgetfulness and 54% find it difficult to concentrate. You are not alone if you are becoming more and more forgetful, I know I certainly did! Unfortunately it does not disappear the minute the babies are born either. However, baby brain is not harmful, just more frustrating for you and other people around you.

Tips:

  • Get as much sleep as you can as fatigue will make it worse
  • Drink plenty of fluids as dehydration can exacerbate the symptoms
  • Avoid caffeine
  • Write things down (take a notepad everywhere you go)

This is not an exhaustive list of twin pregnancy symptoms as other symptoms may include headaches, cravings, sensitivity to smell, nasal congestion, pain and discomfort, breast enlargement and itching.

This information is a guide, if you have any worries or queries please get in touch with your midwife or GP.