You have just discovered that you are having a multiple pregnancy. Whether you are ecstatic, shocked, or overwhelmed, you may have many questions at this point. One question you may have pertains to how much weight gain with twins or other multiples you can expect during the next several months.
Why is weight gain with twins important?
Eating right and gaining the recommended amount of weight is necessary for any pregnancy, but this is particularly important when carrying more than one baby due to the increased risk of preterm labor and low birth weight in a multiples pregnancy.
Weight gain is especially important between weeks 20 to 24 of pregnancy. If a mother of twins gains 24 pounds by the 24th week of pregnancy, she reduces her chance of preterm labor. Early weight gain is also vital for the development of the placenta, which aids in the passing of nutrients to the babies.
How much should I gain?
Weight gain depends on a number of factors including height, body type, and pre-pregnancy weight. However, most women who are carrying twins are encouraged to gain 35 to 45 pounds. Women carrying triplets are advised to gain 50 to 60 pounds.
At this time there is not enough information on quadruplets and quintuplets to suggest any guidelines. Because opinions vary, discuss your specific weight gain with your healthcare provider who will be most familiar with your specific healthcare needs.
How quickly should I gain weight?
Women carrying twins will only gain 4 to 6 pounds during the first trimester and 1 ½ pound per week during the second and third trimesters. If you are carrying triplets, you should expect to gain 1 ½ pound per week throughout the entire pregnancy.
Once again, because opinions vary, consult with your healthcare provider and keep them informed on your weight gain.
Want to Know More?
- Are My Twins Identical or Fraternal?
- Complications in a Multiples Pregnancy
Being obese when you're pregnant increases the chance of some complications such as gestational diabetes. Make sure you go to all your antenatal appointments so your pregnancy team can monitor the health of you and your baby. To find out if you are obese (very
overweight), use the BMI healthy weight calculator. If you are obese (usually defined as having a BMI of 30 or above) and pregnant, do not try to lose weight during your pregnancy. It will not reduce the chance of complications and may not be safe. The best way to protect
you and your baby’s health is to go to all your antenatal appointments. This is so your midwife, doctor and any other health professionals can help with any problems you might face and take steps to prevent or manage them. It's important to eat a healthy, balanced diet and do some
physical activity every day. You should be offered a referral to a dietitian or other health professional for advice on healthy eating and physical activity. Being physically active in pregnancy will not harm your baby. Try eating healthily (including knowing what foods to avoid in pregnancy) and
doing activities such as walking or swimming.Your weight during pregnancy
Eating and exercise
If you were not active before pregnancy, it's a good idea to consult your midwife or doctor before starting a new exercise plan when you're pregnant.
Your care in pregnancy
If you are obese in pregnancy, you'll be offered a test for gestational diabetes.
You may also be referred to an anaesthetist to discuss issues such as pain relief in labour. You're more likely to have an instrumental delivery (ventouse or forceps or a caesarean section), and it can be difficult for an epidural to be given.
Talk to your midwife or doctor about your birth options. Ask if there are any particular safety concerns for you around giving birth at home or in a birthing pool.
You may be advised to give birth in a hospital where there's easy access to medical care if you need it.
Find out more about your options on where to give birth.
Possible problems if you're overweight in pregnancy
Being overweight increases the chance of complications for you and your baby. The higher your BMI, the higher the chance of complications. The increasing chances are in relation to:
- miscarriage
- gestational diabetes
- high blood pressure and pre-eclampsia
- blood clots
- the baby's shoulder becoming "stuck" during labour (The Royal College of Obstetricians and Gynaecologists has more information about shoulder dystocia)
- heavier bleeding than normal after the birth
You are also more likely to need an instrumental delivery (forceps or ventouse), or an emergency caesarean section.
Possible problems for your baby if you're overweight in pregnancy
Problems for your baby can include being born early (before 37 weeks), and an increased chance of stillbirth.
There is also a higher chance of your baby having a health condition, such as a neural tube defect like spina bifida.
Although the chances of these problems increase if you are obese, most pregnancies will result in a healthy baby.
You can find out more in a leaflet from the Royal College of Obstetricians and Gynaecologists : Being overweight in pregnancy and after birth.