Like many women, I first learned I was pregnant when my home pregnancy test was positive. To confirm the results, I went to my doctor for a blood draw. The next day, he called and said something I'll never forget: "Yes, you're pregnant. In fact, your hormone levels are so high, we just don't know how many are in there."
Those jarring words were my first indication that I might be pregnant with twins -- news that was officially confirmed four weeks later at my first ultrasound.
Although women expecting twins and multiples may experience a varied range of symptoms -- just like women with singleton pregnancies do -- there are some early signs that can indicate you're carrying more than one baby.
As in my case, elevated levels of the hormone hCG (human chorionic gonadotropin) in the blood may indicate that you're pregnant with twins. If these numbers seem to spike in an early test, you could be having more than one baby -- but it's not definitive.
"Twin pregnancies often have increased blood hCG titers, 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 titers both for twins and singletons, and it's impossible to be sure it's twins even when the early hCG titers are elevated."
When you consider that many pregnancy symptoms are related to hormonal changes in the expecting woman's body, it stands to reason that mamas 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., ob-gyn at Winnie Palmer Hospital for Women & Babies in Orlando. "For example, due to the elevated pregnancy hormone bhCG, she may have more symptoms of nausea and vomiting than a woman carrying only one baby."
In fact, women who are carrying twins may be more likely to suffer from the extreme version of morning sickness called hyperemesis gravidarum, which is when nausea and vomiting is so severe that a woman may need intravenous fluids and other assistance, Dr. Greves says.
In my twin pregnancy, I wore a bikini by the pool at the four-month mark, and a stranger told me she thought I was "very big for only four months." Her bad manners aside, it was in fact two babies pushing my bump out bigger, earlier.
Of course, while these symptoms of a twin pregnancy might help clue you in to your impending mom-of-multiples, doctors say there's no real way to be sure until an ultrasound confirms it.
"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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