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Is It Twins? 10 Signs That You're Having Twins or Multiples

Symptoms of Twin Pregnancy

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Is it twins? Pregnant mothers often suspect that they are carrying more than one baby. Here are some of the most common signs of a twin or multiple pregnancy. Could you be having more than one? Check your symptoms against this list to see if you might be having twins or more.

1. Ultrasound Confirmation

Ultrasound scan
Andersen Ross/Digital Vision/Getty Images

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 for sure 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.

2. Doppler Heartbeat Count

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.

3. 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.

4. Abnormal AFP Test Results

AFP (Alphafetoprotein) screening is a blood test performed on pregnant mothers during the second trimester. Also known as maternal serum screening or triple marker screen, 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. 

5. Measuring Large for Gestational Age

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 causes the mother's uterus to expand beyond the range of a single pregnancy. However, other factors may also increase the measurements.

6. Weight Gain

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.

7. Excessive Morning Sickness

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 on this site reported enhanced morning sickness symptoms as an indicator of their multiple pregnancies. Experiences vary widely -- some do, some don't.

8. Early/Frequent Fetal Movement

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.

9. Extreme Fatigue

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 be an indication of multiples.

10. History/Hunches

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.

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