Twins, Triplets or More

If you are pregnant with twins, triplets (or more), you will likely experience pregnancy differently than those women who are pregnant with a single baby.

You may experience more severe morning sickness or breast tenderness. You may gain weight more quickly. Rest assured, however, that multiple births are increasingly common these days, and your Hoag Women’s Health Institute team is ready to help guide you, and your babies, on this exciting journey.

Diet & Exercise

Most women who are pregnant with multiples need to gain more weight than women who are pregnant with one baby. The rule of thumb on pregnancy diet is to increase your daily calories by 300 a day for each baby. So, if you are pregnant with twins, that’s 600 extra calories a day. However, if you are pregnant with triplets or more, talk with your obstetrician about the right amount of weight gain for you.

Staying active during multiple pregnancy is important for your health, but you may need to avoid strenuous exercise. Try low-impact exercise, such as swimming, prenatal yoga, and walking. You should aim for 30 minutes of exercise a day. If problems arise during your pregnancy, your OB/GYN may recommend that you avoid exercise.

Prenatal Care

You likely will have more frequent prenatal care visits than women with single babies, and in your second trimester, you may have ultrasound exams every 4 to 6 weeks. If a problem arises, your doctor may order additional tests or more frequent ultrasound exams.


The most common complication of multiple pregnancy is preterm birth. More than 50% of all twins are born preterm. Triplets and more are almost always born preterm.

Being pregnant with multiples also increases your risk of preeclampsia, gestational diabetes and postpartum depression. Your Hoag perinatologist will work with you to minimize your risk and help guide you to a healthy pregnancy and delivery.


Multiples are more likely to experience growth problems in utero than singletons. They are also more difficult to screen for genetic issues. For example, screening tests for genetic disorders that use a sample of your blood are not as sensitive if you’re pregnant with more than one baby. It is possible to have a positive screening test result when no problem is present.


While the chance of cesarean birth (C-section) is higher with multiples, Hoag makes every effort possible to honor your birth plan. In some cases, twins can be delivered by vaginal birth. How your babies are born depends on the number of babies and the position, weight, and health of each baby, as well as your health and how your labor is going.