Think you’re carrying more than one baby? These twin pregnancy symptoms could potentially indicate multiple buns in the oven! 

By Alesandra Dubin
Updated February 26, 2020
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Women carrying multiples experience a wide range of symptoms, just like women with singleton pregnancies do. That said, certain physical signs might clue you into how many babies are in the womb. Check out these early twin pregnancy symptoms that could potentially hint at multiple babies-to-be. 

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Elevated hCG Levels

When you become pregnant, the body starts making human chorionic gonadotropin hormone (hCG). Levels surge in the first few weeks of pregnancy—in fact, home pregnancy tests work by detecting hCG in your urine. Higher-than-normal levels of hCG may indicate that you're pregnant with multiples, but you’ll need to wait until your ultrasound for 100% certainty. 

"Twin pregnancies often have increased hCG levels, but so do sometimes singleton pregnancies," says Amos Grunebaum, M.D., director of obstetrics and the chief of labor and delivery at New York-Presbyterian, a professor at Weill Cornell Medical College, and a medical health advisor for Fairhaven Health. "There is a wide range of normal hCG levels both for twins and singletons, and it's impossible to be sure it's twins even when the early hCG levels are elevated."

Exaggerated Pregnancy Symptoms

Many pregnancy symptoms are caused by hormonal changes. It makes sense that women expecting twins—who have even more substantial hormonal changes—may experience more severe symptoms. "When a woman is pregnant with twins, she's at a higher risk for many things happening, over (one who is pregnant with) singletons," says Christine Greves, M.D.,an OB-GYN at Winnie Palmer Hospital for Women & Babies in Orlando. Common early pregnancy symptoms include fatigue, frequent urination, breast tenderness, and food cravings. 

Severe Morning Sickness

Due to elevated levels of pregnancy hormone hCG, women carrying multiples may have more nausea and vomiting than those carrying only one baby, says Dr. Greves. An extreme version of morning sickness called hyperemesis gravidarum is also more likely. Hyperemesis gravidarum causes nausea and vomiting so severe that a woman may need intravenous fluids and other assistance, Dr. Greves says.

A Bigger, Earlier Bump

Dr. Grunebaum says that speedy weight gain isn’t a definitive indicator of twin pregnancy because height, previous weight, diet, and body type also come into play. However, many moms of multiples say their quickly-growing bellies tipped them off.

One or More Risk Factors

Certain women have greater risk of twin pregnancy than others. Some factors that raise your chances include:

  • Family history of fraternal twins
  • Fertility treatments like in vitro fertilization (IVF)
  • Advanced maternal age (over 35 years old)
  • BMI over 30
  • Above average maternal height
  • You’ve had previous pregnancies

Mother's Intuition

Just as some women have a hunch they’re pregnant, others might instinctively guess they’re expecting twins. You can’t deny the power of maternal instincts! 

The Bottom Line on Twin Pregnancy Symptoms

It’s fun to guess whether you’re carrying one or two babies. But no matter how many twin pregnancy symptoms you’re experiencing, you need an ultrasound to determine exactly how many babies you’re carrying. "You can guess as much as you want, but until you have the ultrasound examination, it's all just speculation," says Dr. Grunebaum. Luckily, most mamas don't have to wait long to know for sure. "Today, twins can usually be diagnosed as early as six to seven weeks of the pregnancy," he adds.

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