Pregnant with Twins & Multiples: What you Need to Know https://www.oviahealth.com/blog/pregnancy/pregnant-with-twins-multiples/ Digital health personalized for every family journey Tue, 29 Jul 2025 15:46:37 +0000 en-US hourly 1 https://wordpress.org/?v=6.8.3 Pregnant with multiples: (Unofficial) week 1 https://www.oviahealth.com/guide/256544/pregnant-with-multiples-unofficial-week-1/ Sun, 13 Mar 2022 16:41:00 +0000 https://www.oviahealth.com/?post_type=article&p=256544 Welcome to week one of pregnancy! We have answers to all of your questions about being pregnant with twins or multiples — from the first week through birth and beyond. Let’s get started.

How are the babies?

The phrase “week one of pregnancy” can be a little misleading because, well… you’re not technically pregnant yet. It’s called “week 1” because gestation is counted from the first day of your last period through your due date.

With an average 28-day menstrual cycle, ovulation occurs right in the middle (or about 14 days after day one of your period) of your cycle. Whether your babies will come from one egg and one sperm, multiple eggs, or multiple sperm, they’re still waiting in the wings for their chance to fertilize.

So, while it’s called “week one of pregnancy,” you’re not officially one week pregnant (yet).

What’s new with you?

Since the embryos (fertilized eggs) have yet to form, you’re still in the preconception stage or maybe starting an IVF cycle. But if you’ve had multiples before, have a family history of twins, or are planning on transferring more than one embryo for an IVF pregnancy, the possibility of multiples might be at the forefront of your mind.

And while you can take an at-home pregnancy test in a few weeks, an ultrasound won’t be able to confirm whether it’s multiples until week six at the earliest. (Your first ultrasound might be closer to eight or ten weeks, depending on what your healthcare provider recommends).

At this point, you might be looking ahead to figure out your most fertile days so you and your partner know when to have sex. Or if you’re doing IVF, you’re still in the stage before the eggs are fertilized and transferred. And at the time of transfer, you’ll technically be about two weeks pregnant. If you’re doing IUI, you’re still a couple weeks out from the transfer.

Right now is all about taking good care of yourself to prepare for the journey ahead. Getting enough sleep, eating nutritious foods, staying active, drinking plenty of water, and taking a prenatal vitamin can help set you off on the right foot.

Reviewed by the Ovia Health Clinical Team

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]]> Pregnant with multiples: (Unofficial) week 2 https://www.oviahealth.com/guide/256548/week-two-with-multiples/ Sat, 12 Mar 2022 17:41:00 +0000 https://www.oviahealth.com/?post_type=article&p=256548 Good things come in twos — a sperm and an egg, two (or more) babies, and week two of pregnancy! This is a big week because you are about to conceive. Read on to learn more about week two with multiples.

How are the babies?

Gestation is counted from the first day of your last period. So saying you’re in “week two of pregnancy” is a little misleading, as you’re not actually pregnant quite yet.

If you’re trying to conceive (TTC), this is around the time you’ll enter your fertile window. Ovulation is within the next several days. The egg (or eggs) will be patiently awaiting the sperm’s arrival, hoping to fertilize and complete the journey to the uterus together as newly formed zygotes. There, they’ll become blastocysts, which implant into the uterine lining within a few days. At that point, you’ll officially be pregnant.

If you’re doing IUI, sometime this week, the semen will be transferred to your uterus. With IVF, eggs are retrieved around this time (or thawed if they were previously frozen) and fertilized with sperm in a lab. A few days later, multiple embryos (fertilized eggs) are transferred to the uterus. When implantation occurs, pregnancy begins.

What’s new with you?

Whether you’re trying to conceive without assistance or doing an IVF or IUI cycle, the two-week mark is too soon to take a pregnancy test. You’ll get the most accurate result after your missed period. But if you’re pregnant with multiples, you might have higher levels of the hormone hCG, which is what’s detected in an at-home pregnancy test.

You most likely won’t notice any pregnancy-related symptoms until several days after implantation occurs or potentially later. That said, if you’re carrying twins or multiples, you may experience more intense symptoms than those with only one baby. Still, the earliest signs of pregnancy usually don’t pop up until the fourth week.

Week two is an exciting time, but you’ll have to play the waiting game a little longer. And even when you get a positive, it’ll be another few weeks until an ultrasound confirms you’re having multiples. While counting down the days until it’s official, you might try focusing on eating healthy foods, staying active, and getting plenty of sleep.

Reviewed by the Ovia Health Clinical Team

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]]> 3 weeks pregnant with multiples https://www.oviahealth.com/guide/256594/three-weeks-pregnant-with-multiples/ Fri, 11 Mar 2022 17:42:00 +0000 https://www.oviahealth.com/?post_type=article&p=256594 Three is a magic number, and this week, there are lots of amazing changes happening to you and your babies-to-be. Let’s dive into what you can expect when you’re three weeks pregnant with multiples!

How are the babies?

The three-week mark is right around the time when your little bundles of joy (or rather, little bundles of cells) will be implanting into your uterus. This is considered week three of pregnancy because gestation is counted from the first day of your last period. However, implantation is the point when you’re officially pregnant.

The bundles of cells are now separating into layers. The inner cells are dividing and will make embryos (your babies’ bodies), and the outer cells are implanting into the wall of your uterus, forming protective structures called membranes, and the placenta (how the babies will get nutrients from you). As the cells continue to multiply, the embryos will grow bigger and eventually develop into the babies’ body parts and organ systems.

Another cool thing about the three-week mark? The embryos already have genetically predetermined hair and eye color.

What’s new with you?

You’re getting closer to being able to take a pregnancy test, though you might want to wait until after your missed period to get the most accurate result. At-home tests measure the hormone hCG, which begins to be released after implantation and doubles about every 48-72 hours throughout the first trimester.

If you’re pregnant with multiples, you might have higher levels of hCG early on. That said, an ultrasound won’t be able to confirm you’re pregnant with multiples until close to six weeks.

While it might be too soon to take a pregnancy test or get a sonogram, you could start experiencing some early pregnancy symptoms during week three. You might notice light spotting, which could be a sign of implantation. Bloating, mild cramping, and sore breasts are also common during the very early weeks of pregnancy. And those carrying twins or multiples might experience more intense symptoms than people pregnant with one baby.

As you wait to take a pregnancy test, we recommend taking prenatal vitamins, eating nutritious foods, and staying hydrated. And pay attention to how you’re feeling. With lots of changes on the horizon, it’s essential that you take care of your mental health, too. 

Reviewed by the Ovia Health Clinical Team

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]]> 4 weeks pregnant with multiples https://www.oviahealth.com/guide/256645/four-weeks-pregnant-with-multiples/ Thu, 10 Mar 2022 17:42:00 +0000 https://www.oviahealth.com/?post_type=article&p=256645 The gestation period is counted from the first day of your last menstrual cycle, which was a few weeks ago. Though you’re in week four now, you probably ovulated (released an egg) about two weeks ago and implantation occurred about a week ago — pregnancy math can be confusing! While it’s just the beginning, some big changes are happening with you and your babies right now. Here’s the lowdown on what you should know when you’re four weeks pregnant with multiples!

How are the babies?

The blastocysts (groups of cells that will become your babies) have burrowed into the uterine wall, and are also connecting with your blood supply and gearing up to start building the placenta.

As the cells rapidly multiply, the inner layers are becoming embryos — this is what your babies are called between 5-10 weeks gestation. While they’re only the size of poppy seeds now, the embryos will grow bigger every day. As early as four weeks, the neural tubes will begin to form, which will ultimately develop into your little ones’ brains and spinal cords.

What’s new with you?

Let’s talk about pregnancy tests. Week four is around the time when you’ll be missing your period, which means you can take a test. At-home pregnancy tests measure hCG. The hormone starts being released into your body by the developing pregnancy after it implants into the wall of your uterus. Your blood hCG levels will typically double every 48-72 hours throughout the first trimester. Though four weeks can still be too soon for a positive home pregnancy test, those who are pregnant with more than one baby might get a positive result sooner because they may have higher levels of hCG early on.

If you have a family history of multiples or transferred more than one embryo during an IVF treatment, you might be anticipating the possibility of more than one baby. Just bear in mind that an ultrasound won’t be able to confirm you’re pregnant with twins or multiples for a couple weeks or so. The good news is that by the time you find out double or triple the fingers and toes are coming your way, you’ll have already been in the pregnancy mindset for a few weeks.

You might start noticing some early pregnancy symptoms in the fourth and fifth weeks, like fatigue, sore breasts, increased cervical mucus, digestive issues, or bloating. With multiples, you may experience more intense symptoms than if you were pregnant with only one baby. But not always, so don’t fret if you’re not feeling particularly intense symptoms.

If you get a positive this week, congrats! Feel free to do a little celebrating. On top of that, make sure you’re taking a prenatal vitamin, and get in touch with your healthcare provider to schedule your first prenatal appointment.

Reviewed by the Ovia Health Clinical Team

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]]> 5 weeks pregnant with multiples https://www.oviahealth.com/guide/256649/five-weeks-pregnant-with-multiples/ Wed, 09 Mar 2022 17:43:00 +0000 https://www.oviahealth.com/?post_type=article&p=256649 Something missing this month? Your period! While you might not be menstruating, there’s a lot going on in your uterus right now. Let’s dive into what you can expect when you’re five weeks pregnant with multiples!

How are the babies?

Though they have entered the embryo stage, your little ones are still teeny-tiny (each roughly the size of a peppercorn). But they’re developing quickly and getting bigger every day. In fact, they’ll double in size by the end of the week. With growth this fast, you might be relieved you don’t need matching sets of clothes yet.

During week five, your babies-to-be are forming neural tubes. The tail-like formation makes them look kind of like tadpoles at the moment, but they’ll grow into it once the tubes close and eventually develop into brains and spinal cords (AKA the nervous system).¹

And that’s not all! This week, your babies’ other organs and bodily systems are starting to develop, including their stomachs, intestines, kidneys, livers, blood vessels, and hearts.² While it’s most likely a little too soon for the heartbeats to show up on an ultrasound, your healthcare provider will probably be able to detect them soon.³

What’s new with you?

Having missed your period, if you haven’t yet, this is the ideal time to take a pregnancy test. Pregnancy tests are more accurate after your expected period hasn’t arrived.

When you get a positive pregnancy test, go ahead and do a little celebrating. You’ll also want to start or continue taking a prenatal with folic acid to support this crucial development stage. If you haven’t already done so, please contact your healthcare provider to schedule your first appointment.

If you have a family history of twins or have transferred multiple embryos during an IVF treatment, the possibility of more than one baby might be on your mind. And if you’re pregnant with multiples, there’s a chance you’ll experience more intense symptoms than if you were carrying only one baby.⁵ Some of the most common early pregnancy symptoms include mild cramping, bloating, constipation, sore breasts, increased cervical mucus, food aversions, a heightened sense of smell, and a frequent urge to pee.

One of the most anticipated early pregnancy symptoms is nausea. If you’re feeling queasy, you might try eating frequent snacks and small meals throughout the day, as being hungry can make the nausea worse. It’s also very important to stay hydrated. Many people find cold and/or tart liquids to be easiest to tolerate. Similarly, eating foods or drinks that contain ginger can calm your tummy. Getting plenty of rest is also helpful. If you’re unable to keep food down, be sure to let your provider know.

Reviewed by the Ovia Health Clinical Team

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]]> 6 weeks pregnant with multiples https://www.oviahealth.com/guide/256651/six-weeks-pregnant-with-multiples/ Tue, 08 Mar 2022 17:43:00 +0000 https://www.oviahealth.com/?post_type=article&p=256651 By week six, pregnancy is in full bloom. If you haven’t already confirmed it by taking a test, there’s a good chance you’ll start noticing some tell-tale signs. Here’s what you should know about being six weeks pregnant with multiples.

How are the babies?

Your little ones are now each about a quarter-inch long (or roughly the size of a blueberry) and getting bigger every day. This may seem itty-bitty — and it is — but it’s pretty impressive how much they’ve grown in just a few weeks.

Four weeks past conception your babies-to-be are starting to develop facial features. Their C-shaped bodies and tail-like neural tubes make them look a bit like sea creatures this week. While they still have about a month to go before they’ll resemble humans, their eyes, ears, jaws, arms, and legs are already forming.

Your babies’ neural tubes will also close this week, kickstarting the formation of the brain and spinal cord. Among other organs, their tiny hearts are continuing to form and grow bigger, now beating at a regular rhythm.

With so much happening on the development front, taking a prenatal vitamin is more important than ever. If you haven’t already started, pick up a bottle with folic acid — the B vitamin has shown to help prevent some neural tube birth defects. This is also an important time to kick less healthy habits if you haven’t already done so. No amount of alcohol has been found to be safe during pregnancy, so it’s best to avoid it altogether. And tobacco has been found to cause birth defects, growth issues, and early delivery, so now is a great time to stop tobacco use altogether.

What’s new with you?

While your babies are busy growing and developing, there’s a lot going on with your body too. Halfway through the first trimester is often when fatigue sets in. Building an entirely new organ (the placenta) can make you feel extra tired and sleepy, and if you’re carrying twins or triplets, multiple placentas might be forming.

Your body is pumping more blood than usual to deliver nutrients to your little ones, which can drain your energy as well. So don’t be surprised if you have the sudden urge to take a midday nap (or two). We encourage you to get all the rest you need, but if you’re up for it, doing some gentle yoga or going on a walk might help perk you up. And if you want to go to bed by 8:00pm, by all means, tuck in.

At this point, you may also have tender breasts or notice changes in the shape or color of your nipples. These normal symptoms are signs that your body is starting to prepare itself for breastfeeding.

A majority of pregnant folks have morning sickness during the first trimester, and those carrying multiples might experience more intense nausea. Having said that, everybody’s different, and not everyone expecting twins or triplets will be queasy in early pregnancy. If you’re feeling sick to your stomach, we recommend eating several small snacks throughout the day and staying hydrated. It might also help to take your prenatal with a meal, avoid triggering smells, and eat foods or drinks with ginger. If you can’t keep food down or are throwing up several times a day, be sure to tell your healthcare provider.

Something else you should call them about? Any amount of vaginal bleeding or spotting, even if it’s brief. This symptom is common, but it’s always best to let your provider know so they can find out what might be causing it.

Speaking of, if it’s not already on the calendar, you’ll want to schedule your first prenatal appointment. Depending on your provider, it could be as soon as this week or as late as week 10. It might still be too early for an ultrasound to detect the heartbeats and confirm you’re pregnant with multiples, but you’ll probably know within the coming weeks.

Reviewed by the Ovia Health Clinical Team

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]]> 7 weeks pregnant with multiples https://www.oviahealth.com/guide/256654/seven-weeks-pregnant-with-multiples/ Mon, 07 Mar 2022 17:43:00 +0000 https://www.oviahealth.com/?post_type=article&p=256654 It’s week seven, meaning you’re halfway through the first trimester! Slowly but surely, every precious part of your babies is beginning to take shape. Here’s what to expect when you’re seven weeks pregnant with multiples.

How are the babies?

Still growing like wild, your babies-to-be are now each the size of raspberries and just under a half-inch long. Their relatively large, round heads are their most prominent features, which makes sense, as their brains are expanding by about 100 cells a minute!

But don’t worry, the rest of their little bodies are continuing to develop as well. This week, the starts of tiny arms, fingers, legs, and toes are taking shape.¹ And as their brains, hearts, and other organs continue to grow, your little ones are forming bone, teeth, nostrils, ears, and eyes.²

What’s new with you?

For many, first trimester symptoms are in full swing by week seven. You might be experiencing enlarged or sore breasts and nipple changes, so this could be a good time to get some comfier bras.³

Depending on whether you’re carrying fraternal or identical babies, you’re also building one or more placentas.⁴ This is one reason why you might feel particularly tired over the next few weeks. Bloating and a persistent urge to pee are common at this stage as well. Bloating is due to your changing hormones and needing to pee constantly is mostly a result of your growing uterus putting pressure on your bladder. Because your uterus may double or triple in size with multiples, this is a particularly common symptom if you’re carrying multiple babies. 

While the frequent need to pee will likely continue through the third trimester, there might be an end in sight for one common symptom: morning sickness. Nausea typically starts to subside by the beginning of the second trimester for many people, though it’s different for everyone. Thanks to all the hormones coursing through your veins, you may also start to have new food cravings or develop aversions to things you typically like.

For some, a multiples pregnancy could mean more intense symptoms, like fatigue and nausea.³ And yet others might not experience any.⁵ Everyone is different, so don’t worry if you’re not showing any obvious signs yet.

You won’t know whether you’re carrying multiples until you have your first ultrasound. However, if they run in your family, you’ve had a previous twin pregnancy, or you transferred more than one embryo during an IVF treatment, you might be anticipating the possibility.

Your first prenatal appointment may be as early as six weeks, but it is typically closer to 10 weeks.⁶ In any case, at this point, your healthcare provider will be able to detect the heartbeats and confirm you’re carrying multiples. Get your check-up on the calendar, continue taking a prenatal vitamin, and try to be patient as you wait to find out how many tiny fingers and toes are growing in your belly.

Reviewed by the Ovia Health Clinical Team

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]]> 8 weeks pregnant with multiples https://www.oviahealth.com/guide/256656/eight-weeks-pregnant-with-multiples/ Sun, 06 Mar 2022 17:44:00 +0000 https://www.oviahealth.com/?post_type=article&p=256656 Your babies-to-be are dancing up a storm and won’t be embryos for much longer. Here’s what’s going on when you’re eight weeks pregnant with multiples.

How are the babies?

Underneath their see-through skin, your little ones’ teeny-tiny internal organs are almost fully formed, though they’ll continue to develop through the third trimester. The tail-like neural tubes are now closed and will soon disappear completely, which means your babies are starting to look more like humans.¹

Webbed fingers and toes are poking out from their wee limbs, which are growing longer every day.² Their facial features are becoming more prominent, too, as itty-bitty lips, noses, and eyelids take shape.¹ The lungs start to form in week eight as well.²

Their heads currently make up about half their body weight, but your babies will be more proportioned in the second and third trimesters. Now each about the size of a small strawberry and just over a half-inch long. Though you can’t feel it yet, your bundles of joy are moving around like crazy and this can be captured on ultrasound already! ³

What’s new with you?

Even though your babies are still tiny, you might start to notice your pants fitting tighter. This is caused by a combination of physical changes that happen during pregnancy, including water retention, bloating and gas, and your growing uterus.

Morning sickness (or more like any-time-of-day sickness) during the first trimester is common. Everyone is different, but if you’re pregnant with twins or triplets, you might experience more intense nausea.⁴

If you’re feeling queasy, we recommend eating small meals and snacks throughout the day and drinking plenty of water. It might also help to take your prenatal vitamin with a meal, avoid triggering smells, or sip some ginger ale. If you can’t keep anything down or are throwing up several times a day, be sure to let your healthcare provider know.

On the other hand, you might start having some cravings for various types of foods. One theory is that you crave the nutrients your body needs. Follow your body’s lead and work in the foods you are craving alongside your typical diet. For many, the diet in early pregnancy is rather limited by what you can and cannot tolerate. So sometimes cravings provide a much-needed desire for food that is absent during the more nausea-driven moments. If you have questions about the safety of any of your cravings, reach out to your provider and check in with them. There is a condition known as pica where cravings for non-food items can be very strong. There’s no need to be embarrassed by this, but it can signal a nutrient deficiency and should be monitored so please don’t hesitate to discuss it with your provider. 

As the placenta (or placentas) continue to form and your body pumps more blood to deliver nutrients to your babies, don’t be surprised if you feel sleepier than usual.³ There’s nothing wrong with hitting the hay early and taking midday naps. But if you’re up for it, going on a walk, doing a gentle yoga flow, or just stretching for 15 minutes might actually make you feel more energized.

Reviewed by the Ovia Health Clinical Team

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]]> 9 weeks pregnant with multiples https://www.oviahealth.com/guide/256659/nine-weeks-pregnant-with-multiples/ Sat, 05 Mar 2022 17:46:00 +0000 https://www.oviahealth.com/?post_type=article&p=256659 Whether you’ve known about your babies for a bit or just heard those hearts beating together for the first time, we excitedly welcome you to week 9! Let’s talk about what to expect when you’re nine weeks pregnant with multiples.

This is an important week because your babies’ body parts are now mostly formed, although they’re far from being fully developed. From this point forward, your little ones will work on growing bigger and stronger in preparation for their grand entrance into the world. 

How do twins and other multiples happen?

Finding out you’re expecting multiples can come as quite a surprise! Most multiple pregnancies aren’t visible on an ultrasound until between 6 and 8 weeks of gestation, so likely, you’ve only just caught wind of the news. It’s normal to feel ecstatic, nervous, or just plain overwhelmed when you find out you’re expecting multiples, especially if this is an unexpected surprise.

Multiple pregnancies happen in a few different ways. You’ll get a better understanding of your babies’ origin story when your provider identifies their arrangement within their sacs. Keep reading to find out more.

Identical twins (triplets, and beyond) happen when a single fertilized egg (zygote) divides into two or more identical zygotes. Multiples who are identical have the same exact genetic material; this means they will be of the same physical sex, and their appearance will be, well, identical — or very close to it! 

This type of pregnancy happens simply by chance, so identical multiples do not run in families. Depending upon when in the process the zygote splits, your babies may share both layers of their sacs (amnion and chorion) and be in the same space as each other without any separating membrane. In this case, they would also share a single placenta. In other cases, they may have separate amniotic sacs (inner layers) but share the same chorion (outer layer of the sac). And in some cases, they may each have their own amnion, chorion, and placenta.

Fraternal multiples happen when more than one egg is released during ovulation, and each is fertilized by a different sperm cell. Because fraternal multiples come from their own eggs, they’re no more similar genetically than other full siblings. Fraternal twins, triplets, and even quadruplets have their own placentas and amniotic sacs, as well as chorionic sacs. 

That said, it’s possible you could be carrying a mix of identical and fraternal multiples! For example, if one egg split in half but you released multiple eggs during ovulation, you could have two identical (twins) and one fraternal triplet. 

What are your babies up to this week?

Your little ones have developed identifiable limbs and lost their embryonic tails, making them clearly recognizable as babies on an ultrasound. At 9 weeks, they are just shy of an inch long and weigh approximately 0.07 ounces each — roughly the size of a cherry! Their hearts are pumping, and they’ll continue to grow rapidly as the weeks progress. 

What can I expect from a twin or multiple pregnancy?

It’s perfectly normal to feel a wide range of emotions when you first find out you’re expecting multiples. You likely envisioned one baby, and it can understandably take time to adjust to the news. 

Twin or multiple pregnancies require a bit more monitoring, which often means more frequent appointments, typically later in pregnancy. Twins and multiples can pose a higher risk of certain complications, so it’s important to keep up with your appointments and listen to your provider’s recommendations for a healthy pregnancy.

The American College of Obstetricians and Gynecologists reports that women who are carrying multiples are likely to have more severe early pregnancy symptoms as compared with singleton pregnancies. This could mean increased nausea, breast tenderness, and fatigue. Listen to your body and rest as needed. Fortunately, these symptoms most often recede after the first trimester. You’re almost there! 

Reviewed by the Ovia Health Clinical Team

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Sources

  • American College of Obstetricians and Gynecologists. “Multifetal gestation: Twin, triplet, and higher order multifetal pregnancies.” National Guideline Clearinghouse. U.S. Department of Health and Human Services, May 2014. Retrieved May 15 2021.
  • Mayo Clinic Staff. “Twin pregnancy: What multiples mean for mom.” Mayo Clinic. Mayo Clinic, Updated December 17 2024. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/twin-pregnancy/art-20048161.
  • “FAQ: Multiple pregnancy.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, July 2015. Last reviewed: May 2025.
]]> 10 weeks pregnant with multiples https://www.oviahealth.com/guide/256661/ten-weeks-pregnant-with-multiples/ Fri, 04 Mar 2022 17:46:00 +0000 https://www.oviahealth.com/?post_type=article&p=256661 Your doubly precious pregnancy has officially entered double digits. Expecting triplets or quadruplets? We’re multiplying our excitement for you accordingly! Let’s talk ten weeks pregnant with multiples!

Last week, your babies’ embryonic tails disappeared, and their body parts became more easily identifiable. By now, your babies have completed the most significant portion of their first trimester development. 

Your little ones are now working to grow and strengthen their bodies, which have taken on that adorable baby shape! 

How do twins and other multiples happen?

Finding out you’re expecting multiples can come as quite a surprise! Most multiple pregnancies aren’t visible on an ultrasound until between 6 and 8 weeks of gestation, so likely, you’ve only just caught wind of the news. It’s normal to feel ecstatic, nervous, or just plain overwhelmed when you find out you’re expecting multiples, especially if this is an unexpected surprise.

Multiple pregnancies happen in a few different ways. You’ll get a better understanding of your babies’ origin story when your provider identifies their arrangement within their sacs. Keep reading to find out more.

Identical twins (triplets, and beyond) happen when a single fertilized egg (zygote) divides into two or more identical zygotes. Multiples who are identical have the same exact genetic material; this means they will be of the same physical sex, and their appearance will be, well, identical — or very close to it! 

This type of pregnancy happens simply by chance, so identical multiples do not run in families. Depending upon when in the process the zygote splits, your babies may share both layers of their sacs (amnion and chorion) and be in the same space as each other without any separating membrane. In this case, they would also share a single placenta. In other cases, they may have separate amniotic sacs (inner layers) but share the same chorion (outer layer of the sac). And in some cases, they may each have their own amnion, chorion, and placenta.

Fraternal multiples happen when more than one egg is released during ovulation, and each is fertilized by a different sperm cell. Because fraternal multiples come from their own eggs, they’re no more similar genetically than other full siblings. Fraternal twins, triplets, and even quadruplets have their own placentas and amniotic sacs, as well as chorionic sacs. 

That said, it’s possible you could be carrying a mix of identical and fraternal multiples! For example, if one egg split in half but you released multiple eggs during ovulation, you could have two identical (twins) and one fraternal triplet.

What are your babies up to this week?

Your little ones have developed identifiable limbs and lost their embryonic tails, making them clearly recognizable as babies on an ultrasound. At 10 weeks, they are just shy of an inch long and weigh approximately 0.14 ounces each — roughly the size of a strawberry! The skin covering their bodies is still translucent, but they’re now able to bend their limbs. They’re also beginning to develop finer details, like tiny fingernails.

What can I expect from a twin or multiple pregnancy?

Hearing you’re carrying multiples can certainly come as a shock. By now, you’ll be able to see your babies on an ultrasound and hear their heartbeats. Whether you’re overjoyed or overwhelmed (or a mix of both), know your feelings are valid. We’re here to offer support!

People carrying multiples will have a greater amount of healthcare visits and ultrasounds than those who are pregnant with singletons. These visits are to ensure you and your babies are healthy! Multiples may pose a higher risk of certain complications, so it’s essential to attend all scheduled appointments and follow your provider’s guidelines closely.

It’s not just your imagination if you feel like your morning sickness symptoms are amplified. The American College of Obstetricians and Gynecologists reports that multiple pregnancies bring about more severe symptoms of nausea, fatigue, and breast tenderness. Luckily, your symptoms should begin to wane after the first trimester, and you’ve almost reached that milestone. You’ve got this!

Reviewed by the Ovia Health Clinical Team

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Sources

  • American College of Obstetricians and Gynecologists. “Multifetal gestation: Twin, triplet, and higher order multifetal pregnancies.” National Guideline Clearinghouse. U.S. Department of Health and Human Services, May 2014. Retrieved May 15 2021.
  • Mayo Clinic Staff. “Twin pregnancy: What multiples mean for mom.” Mayo Clinic. Mayo Clinic, Updated December 17 2024. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/twin-pregnancy/art-20048161.
  • “FAQ: Multiple pregnancy.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, July 2015. Last reviewed: May 2025.
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