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What to Expect When You’re Expecting Multiples (video)

Carrying multiple babies may require higher level of prenatal care

Carrying multiple babies may require higher level of prenatal care

Finding out that you’re expecting a baby is exciting and life-changing — and when you’re expecting more than one, the excitement multiplies. However, being pregnant with twins, triplets or more also may require a higher level of prenatal care.


In this video, San Diego Health host Susan Taylor talks with obstetrician and gynecologist Sean Daneshmand, MD, medical director of the Scripps Clinic Perinatology Program, about the potential risks of multiple pregnancies.

Why are multiple births riskier?

Multiple pregnancies increase the mother’s risk of developing complications, such as preeclampsia, which occurs when her blood pressure abruptly increases. Preeclampsia can cause symptoms including sudden weight gain, swelling in the face or hands, severe headache, and visual disturbances. Without treatment, it also can lead to seizures.


Having multiple births also raises the risk of gestational diabetes, which is diabetes that develops during pregnancy. The mother’s excess blood sugar is passed to the baby, which can cause the baby to gain too much weight and possibly be born prematurely and have health problems.


Even without gestational diabetes, preterm birth is one of the biggest risk factors in multiple pregnancies. Babies who are born very early can have significant complications, such as blindness, cerebral palsy and respiratory issues. The earlier babies are born, the higher the risk of complications.

In addition, when a mother is having at least two babies, there is a higher chance of birth defects and chromosome abnormalities that can cause conditions like Down syndrome.


“When we think about pregnancy, we think about mom, placenta and baby. The placenta is the liaison between the two. It passes oxygen and nutrients from mom to baby, and gets rid of toxins,” explains Dr. Daneshmand. “So it’s important to know how many placentas babies have. If babies each have a placenta of their own, and they’re in a separate sac, complications are lowest. But sometimes twins share one placenta and have two separate sacs, or even share the same sac, and those complications go up.”


Perinatologists are obstetricians who specialize in caring for women with high-risk pregnancies. Since 2018, the Scripps Clinic Perinatology Program has specialized in providing care to women with high-risk multiple pregnancies across the county.


“We are consultants to obstetricians, family practitioners and midwives, and we partner with other subspecialists in adult and pediatric medicine to make sure that we take the best care of our moms and babies,” says Dr. Daneshmand. “We’re part of the team during mom’s pregnancy, and we also have highly trained physicians and support staff who care for preterm babies at our neonatal intensive care units at all Scripps facilities.”

How can moms help reduce their risk of complications?

Women expecting multiple births should follow their obstetrician’s recommendations to help reduce their risk; for example, doctors may recommend taking low-dose aspirin or baby aspirin daily to reduce their risk of preeclampsia, or taking iron supplements because moms carrying multiple babies tend to be more anemic.


 In general, says Dr. Daneshmand, pregnant women should try to focus on reducing inflammation. These guidelines can help:


  • Get plenty of sleep.
  • Exercise, but avoid any exercises that put you at risk for a fall or injury.
  • Eat a well-balanced diet. Don’t eat sweets, cakes or cookies, and avoid hormones or antibiotics in your food. Include foods that promote blood flow like pomegranate, beets, leafy green vegetables and berries.
  • Avoid smoking.
  • Avoid drinking alcohol or caffeine.


In addition to caring for your body, focus on your emotional well-being and try to minimize stress.


“All of us respond differently to how do we cope with stress, so do whatever it is that makes it better for you to manage stress,” says Dr. Daneshmand. “Also, find some silent moments for yourself in a quiet place. Moms need to be selfish. They need to be taking care of themselves and be tuned in with their body.”