Women pregnant with twins have all sorts of questions from “How much weight should I gain?” to “Which prenatal tests should I undergo?” But no question is more complex or confusing than, “Is my twin pregnancy high risk?” I see this question everywhere on Internet pregnancy forums, and frankly, some of the answers that well-meaning posters give are just plain wrong. With that in mind, I decided to devote a post to that one question.
So are all twin pregnancies considered high risk?
Simple answer—yes. If you are pregnant with twins, triplets or other higher-order multiples, your doctor will consider you “high risk” regardless of your age, previous medical history, or lifestyle.
Why, you ask? Blame it on a design glitch—the female body was never meant to carry more than one baby at a time. Therefore, a woman expecting multiples has a greater chance of complications such as preeclampsia, gestational diabetes, placenta previa and of course, preterm labor than say, her neighbor who’s expecting a singleton. Furthermore, the babies could run into a bit of trouble as well. If a mom is having monozygotic or identical twins, for instance, her babies have a slight risk of developing twin-to-twin transfusion syndrome (TTTS), a rare but serious progressive disorder that occurs in a small percentage of identical twins who share a common placenta.
The medical community agrees as well. The Mayo Clinic website states, “Specific factors that might contribute to a high-risk pregnancy include [a multiple pregnancy.] Pregnancy risks are higher for women carrying twins or higher order multiples.”
The National Institutes of Health says, concurs. “Risk factors for a high-risk pregnancy can include [multiple births.] The risk of complications is higher in a twin pregnancy and increases with more fetuses in the uterus.”
That said, however, I do need to make a distinction here. Although it’s true that all twin pregnancies are high risk, you personally may not ever develop a single complication. For instance, my pregnancy was considered high risk not only because I was carrying twins but I was also 36 years old at the time. A double whammy! Yet I sailed through my pregnancy without so much as a hangnail. In fact, whenever I went to my prenatal appointments (and with a high-risk pregnancy, I had way more appointments than if I were expecting a singleton), I would be teased with the same lighthearted joke. After I would dutifully pee in a cup, stand on the scale and then have my blood pressure taken, my nurse would exclaim, “You should be the poster child for twin pregnancy! You’re lookin’ that good!”
If you are expecting twins, you may never need to see a perinatologist (a doctor who specializes in high-risk pregnancies) or go on bed rest but having a “high risk” classification is still important to your twin pregnancy. First, many insurance companies will then step up and cover any additional medical expenses that you may incur (i.e. prenatal tests). But more importantly, I believe that knowledge is power. Knowing that you fall into this category makes you hyper aware, diligent, curious, eager for more information—information that could help you get the best possible care for you and your babies. Information that could possible save the lives of your babies. When you know that you may go into preterm labor, for instance, you’re more apt to learn the warning signs and perhaps prevent a preterm delivery. Or, you may be more apt to pack on the pounds early in your pregnancy, an important step in building a strong and healthy placenta.
So don’t be afraid of a high-risk classification. Own it, baby! Wear it! And make it work for you!