Pregnant With Twins? Ten Ways to Tell


You just found out that you’re pregnant and you can’t wipe that smile off your face! But with the rise in twinning, you also may be wondering, “Am I pregnant with twins?” You could be as these days about one in 30 moms-to-be are. Yet waiting nine months to get the definitive answer is akin to torture! Luckily, most women find out they’re having twins during their first few weeks of pregnancy, plenty of time to adjust to the news or even more importantly, decorate the nursery! Here are ten telltale signs that you may be having more than one. But remember, each one by itself is no guarantee but several clustered together will increase your odds.

  • The Use of Fertility Drugs.

If you used clomiphene citrate (Clomid), the most common of all ovulating-inducing drugs, to help you conceive you may be in for a double surprise. But depending on why your doctor prescribed the drug could mean the difference between a single or double pregnancy. For instance, if she recommended taking Clomid because you were not ovulating or ovulating only sometimes, then your chances of twinning increases slightly, maybe by one or two percent. If you ovulate on your own, however, and Clomid was prescribed for other various reasons, then your chances of having twins jumps to nearly 10 percent. (Although some doctors speculate it’s even higher.)

  • Elevated hCG Level.

That’s how it happened for me. After a positive home pregnancy test that I took on the day of my missed period, I made an appointment to see my OB/GYN. She promptly gave me a blood test to confirm that I was indeed pregnant. Two days later the phone rang. A nurse told me that my hCG (a pregnancy hormone) level was “elevated” and she wanted me to come in for an ultrasound. Panicked, I asked if I should worry. “Oh, no,” she said. “We just need to see if you miscalculated the date of your last period or if you’re pregnant with twins.”

  • Ultrasound Exam.

My elevated hCG level prompted an ultrasound exam at six weeks where we could see two, tiny flickering heartbeats on the screen. Bingo! Most pregnant women, however, don’t get their first ultrasound until somewhere between Week 16 to 20.

  • Rapid weight gain during the first trimester.

Due to increased blood volume and uterine size, some women carrying twins have a higher than average weight gain during the first 12 weeks of pregnancy than women carrying singletons.

  • Measuring large for gestational age.

If on a routine prenatal visit, your fundal height (tip of the uterus to pelvic bone) seems unusually large for your week of pregnancy (you think you’re six weeks pregnant but the fundal height indicates Week 8 or 10), a doctor may order an ultrasound to confirm or rule out multiples.

  • More than one heartbeat.

Somewhere between Week 10 to 12, an experienced doctor or midwife can pick up the sound of a second heartbeat.

  • Abnormal AFP test results.

The alphafetoprotein blood test (AFP) used to screen for certain birth defects is routinely given sometime during the second trimester. When the results of the test come back “high,” it could mean a neural tube defect or a multiple pregnancy. (Don’t panic if you have a high result but are not pregnant with twins. This test notoriously has “false positive” results.)

  • Heightened pregnancy symptoms.

Due to the increased production of hormones during a twin pregnancy, you may experience extreme fatigue or constant morning sickness, breast tenderness, a voracious appetite, and even anemia (low iron).

  • Personal history.

Are you over age 30? (As women get older, they produce higher levels of gonadotropins, a hormone that stimulates the ovaries to release more eggs.) Are you slightly overweight? (If your body mass index—BMI—is 30 or above, your chances of twinning is much greater than women with BMI of 20 or less.) Do you already have fraternal twins? (Women who already have fraternal twins double her chances of having twins again.) Do fraternal twins run in your family? (Some women inherit a gene for hyperovulation, a predisposition to produce multiple eggs in a single cycle.)

  • An intuitive feeling.

Some women report that they “just knew” that they were pregnant with twins.


A copy of the book Double Duty.