Risks of a multiple pregnancy

Healthy multiples are born every day. Still, it's important to be aware of complications that can happen. Complications can include:

• Premature birth. The more multiples you're carrying, the less likely it is for your pregnancy to go to full term. If you have symptoms of preterm labor, you might be given shots of a steroid medicine to speed lung development. Even then, there could be complications after the babies are born, including trouble breathing and eating, vision conditions and infections. Treatments to prolong pregnancy, such as bedrest, aren't recommended. These methods haven't been proved to lessen disease and death in newborns.
• Gestational diabetes. If you're carrying multiples, your risk of diabetes that starts during pregnancy is higher. Gestational diabetes causes high blood sugar that can affect your pregnancy. Your healthcare team can help you learn to manage your blood sugar. You might meet with a doctor called an endocrinologist who treats hormonal conditions, a registered dietitian and a diabetes educator.
• High blood pressure. If you're carrying multiples, your risk of high blood pressure conditions during pregnancy is higher. One type of blood pressure condition is called preeclampsia. It can cause damage to organs such as the kidney and liver in a pregnant person. Some pregnant people with preeclampsia need to have their babies delivered early.
• C-section delivery. For twins, vaginal delivery often is possible if the first twin is in a head-down position. If not, you may need a C-section. Sometimes, complications after the vaginal delivery of the first twin might mean the pregnant person needs a C-section to deliver the second twin safely. For three or more multiples, it's very common to need a C-section.
• Twin-twin transfusion. With identical twins, blood vessels in a shared placenta can cause one twin to receive too much blood and the other too little. This is a serious complication for both. It may lead to heart complications and the need for treatment while you're still pregnant.