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This topic is for women who are pregnant with more than one baby. It focuses on the questions that are specific to multiple pregnancies. For information on what to expect during pregnancy, labour, and childbirth, see the topic Pregnancy.

What is a multiple pregnancy?

A multiple pregnancy means that a woman has two or more babies in her uterus. These babies can come from the same egg or from different eggs.

Babies that come from the same egg are called identical. This happens when one egg is fertilized by one sperm. The fertilized egg then splits into two or more embryos. Experts think that this happens by chance. It isn't related to your age, race, or family history.

If the babies you're carrying are identical, they:

• Are either all boys or all girls.
• All have the same blood type.
• Probably will have the same body type and the same colour skin, hair, and eyes. But they won't always look exactly the same. They also won't have the same fingerprints.

Babies that come from different eggs are called fraternal. This happens when two or more eggs are fertilized by different sperm. Fraternal twins tend to run in families. This means that if anyone in your family has had fraternal twins, you're more likely to have them too.

If the babies you're carrying are fraternal, they:

• Can be both boys and girls.
• Can have different blood types.
• May look different from each other or may look the same, as some brothers and sisters do.

See a picture of identical and fraternal babies in the uterus.

What causes a multiple pregnancy?

If you take fertility drugs or have in vitro fertilization to help you get pregnant, you're more likely to have a multiple pregnancy.

Fertility drugs help your body make several eggs at a time. This increases the chance that more than one of your eggs will be fertilized. When in vitro fertilization is used to help a woman get pregnant, the doctor may put several fertilized eggs in the uterus to increase the chances of having at least one baby. But this also makes a multiple pregnancy more likely.

You're also more likely to have more than one baby at a time if:

• You're age 35 or older.
• You're of African descent.
• You've had fraternal twins before.
• Anyone on your mom's side of the family has had fraternal twins.
• You've just stopped using birth control pills.

What are the risks of a multiple pregnancy?

Any pregnancy has risks. But the chance of having serious problems increases with each baby you carry at the same time.

If you're pregnant with more than one baby, you may be more likely to:

• Develop a problem that causes your blood pressure to get too high (pre-eclampsia).
• Develop a type of diabetes that can occur while you're pregnant (gestational diabetes).
• Deliver your babies too early. When babies are born too early, their organs haven't had a chance to fully form. This can cause serious lung, brain, heart, and eye problems.
• Have a miscarriage. This means that you may lose one or more of your babies.
• Have a baby born with a birth defect that occurs when something is wrong with the genes or chromosomes. Certain genetic disorders may be more likely to occur in multiple pregnancies.

Keep in mind that these problems may or may not happen to you. Every day, women who are pregnant with more than one baby have healthy pregnancies and have healthy babies.

How can you tell if you're carrying more than one baby?

While you may feel like you're carrying more than one baby, only your doctor can say for sure. He or she will do a fetal ultrasound to find out. This test can give your doctor a clear picture of how many babies are in your uterus and how well they're doing.

If the test shows that you're carrying more than one baby, you'll need to have more ultrasounds during your pregnancy. Your doctor will use these tests to check for any signs of problems that your babies may have as they grow.

What type of treatment will you need?

If you're pregnant with more than one baby, you'll need to see your doctor more often than you would if you were having just one baby. This is because you and your babies have a greater chance of developing serious health problems.

Your doctor will do a physical examination at each visit. It's important that you go to every appointment. Your doctor may also do a fetal ultrasound, check your blood pressure, and test your blood and urine for any signs of problems. Early treatment can help you and your babies stay healthy.

You're having multiples. Now what?

The thought of having more than one baby may be scary, but it doesn't have to be. There are some simple things you can do to keep you and your babies healthy.

The best thing you can do is take care of yourself. The healthier you are, the healthier your babies will be.

While you're pregnant, be sure to:

• Go to every doctor's appointment.
• Eat healthy foods. Take in plenty of calories from foods rich in folic acid, iron, and calcium. These nutrients are essential for the healthy growth of your babies. Breads, cereals, meats, milk, cheeses, fruits, and vegetables are all good choices. If you're not able to eat enough because of severe morning sickness, call your doctor.
• Don't smoke, drink alcohol, or use illegal drugs.
• Avoid caffeine. (Or limit your intake to 300 mg or about 500 mL (2 cups) of coffee each day.)^{footnote 1}
• Avoid using any medicines, vitamins, or herbs unless your doctor says it's okay.
• Talk to your doctor about what activities are okay for you to do while you're pregnant.
• Get a lot of rest.

After your babies are born, you may feel overwhelmed and tired. You may wonder how you're going to do it all. This is normal. Most new moms feel this way at one time or another.

Here are some things you can do to ease the stress:

• Ask your family and friends for help.
• Rest as often as you can.
• Join a support group for moms with multiples. This is a great place to share your concerns and hear how other moms cope with the demands of raising multiples.
• If you feel sad or depressed for more than 2 weeks, call your doctor.