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Early Signs That You are Pregnant with Twins or Multiples

Parents who give birth to twins often say they intuitively knew they were carrying more than one baby from the very start. Even before their doctor heard two heartbeats or confirmed a twin pregnancy via ultrasound, they just knew.

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Do you have a feeling you are pregnant with twins or multiples?

There are some early signs that you could be expecting more than one bundle of joy! Scroll through to see if you might be pregnant with multiples and for tips on soothing your symptoms.

Sky High hCG

Studies have shown that pregnant people expecting twins or multiples may have higher hCG levels than those experiencing a singleton pregnancy. That said, hCG levels vary from person to person and pregnancy to pregnancy, so hCG levels are not definitive to determine a twin pregnancy. Some people have high hCG levels and only give birth to one baby; others have exceptionally low hCG levels and give birth to multiples.

If your doctor has been monitoring your hCG levels, talk to them about your levels, and ask if they indicate that you could be expecting multiples.

More Morning Sickness, More Babies

Hormone fluctuations cause pregnancy-related nausea and vomiting. If you are pregnant with twins or multiples, you will likely have higher hormone levels. These more elevated hormones increase the risk of extreme morning sickness and hyperemesis gravidarum. This condition can lead to dehydration, weight loss, and electrolyte imbalance. Of course, every pregnancy is different. Some parents experience little to no nausea and vomiting during their twin or multiple pregnancies.

Check out our blog post 11 Safe + Effective Morning Sickness Remedies for the best tips to relieve morning sickness.

Yuck! Food Aversions

It's common for pregnant people to experience strong aversions to certain foods, especially coffee, meat, fish and seafood, and (surprisingly) leafy green vegetables. Food intolerances can increase morning sickness. In this case, the smell or taste of specific foods and beverages could trigger nausea and vomiting.

No one knows for sure why food aversions occur during pregnancy. They may be caused by changes to your taste perception or the increased sense of smell commonly associated with pregnancy. Other studies suggest that food aversions and intolerances during pregnancy are a natural adaptation to reduce pregnancy's physical challenges.

Next Level Exhaustion

Fatigue is a common symptom of early pregnancy. Still, people who have experienced both singleton pregnancies and multiple pregnancies reported that they were far more tired when expecting multiples. Higher hormone progesterone levels and an increased basal metabolic rate may contribute to people's utter exhaustion when pregnant with multiples. The first trimester can be incredibly taxing for all pregnant people, as this is when a baby's foundational body systems are forming. Your body is undergoing rapid changes to support your pregnancy.

If early pregnancy fatigue is taking over your life, you can try:

  • Taking naps during the day (some people find sneaking in a short nap on their lunch break at work is helpful)

  • Going to bed early every night

  • Staying well hydrated

  • Ensuring you are eating a healthy balanced diet

  • Avoiding sugar and caffeine, which can cause fluctuations in your energy

  • Eating foods high in B vitamins

  • Going for a walk or other light daily exercise

Intense Breast Pain

Breast pain is a typical early pregnancy symptom that can be more intense when expecting twins or multiples. Your breasts are preparing to feed more than one baby, and the hormones that initiate these preparations may be higher. If you are experiencing intense pain and discomfort in your breasts, you can:

  • Stop wearing bras with underwires

  • Choose softer bras and ensure your bras fit properly

  • Avoid high impact physical activities such as running and jumping

Talk to your doctor if you experience burning pain, localized swelling, or notice a lump in your breast. These could indicate infection or other health concerns.

Non-Stop Peeing

Frequent urination is another symptom that many people experience during early pregnancy, sometimes even before a positive pregnancy test. Parents of multiples sometimes report that they found their trips to the bathroom were even more frequent than they were in other pregnancies. Of course, hormones are to blame for this symptom, too!

To reduce the number of times you have to run to the bathroom, we suggest:

  • avoiding drinking liquids before bed

  • limiting beverages with a diuretic effect like coffee, tea, and seltzer

  • being careful to empty your bladder each time you urinate

"Showing" Sooner Than Usual

If you are expecting twins or multiples, your belly may be bigger than expecting one baby. Looking "bigger" than would be expected for how far along you are can be a sign that you are expecting twins or multiples. Still, every body and every pregnancy is different.

Your doctor or midwife may notice that your fundal height measurements are significantly higher than expected if you are pregnant with multiples. To measure your fundal height, your care provider measures the distance between your pubic bone and the top of your uterus. After about 12 weeks of pregnancy, this measurement is an indicator of how well your baby, or babies, are growing. 

Your Resting Heart Rate is Increased

Just like your basal metabolic rate increases, your resting heart rate will increase during pregnancy. A normal resting heart rate is about 70 bpm (beats per minute), rising to 80-100 bpm in pregnancy. People who are pregnant with twins or multiples may have a resting heart rate higher than 100 bpm. If your resting heart rate is above 100 bpm, you may be diagnosed with tachycardia. Tachycardia can be a normal pregnancy condition but needs to be monitored by your primary care provider.

You can help keep your heart rate within a normal range by not smoking, reducing stress, and using mindfulness techniques like meditation and deep breathing.

Major Mood Swings

If you're feeling incredibly moody, you could be expecting twins or multiples. Blame it on all those extra hormones (again!). Intense feelings can be overwhelming for you, but keep in mind that they can go as quickly as they come due to hormonal fluctuations. Be sure to validate your feelings and give yourself space to recognize and accept how you feel in each moment; don't latch onto those feelings. Try journaling when you need to vent, chat with a friend, or consider seeing a therapist regularly.

Your Intuition Says it's Twins (or more!)

Your intuition is powerful! As we mentioned at the beginning of this article, many parents "just know" that they are pregnant with twins or multiples.

How Twin Pregnancies are Confirmed

Many twin pregnancies are discovered by ultrasound. Your doctor may suspect you are pregnant with more than one baby when checking your baby's heart rate or having alpha-fetoprotein levels tested. If your doctor suspects you may be pregnant with multiples, they will likely recommend you go for an ultrasound. 


Doulas of Orange County wholeheartedly congratulates you on your pregnancy! We love working with families in Orange County, California, and surrounding areas, expecting multiples. We have experienced professionals to support you through pregnancy, during your birth, and in the first year of your baby’s lives. We can connect you with the right professionals to provide the support you want and need.

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