Double the Joy: A Guide to Twin Pregnancy in Singapore

Carrying twins can be an exciting and unique journey that brings double the joy, but it can also mean double the challenges. Whether you’ve just found out that you’re having twins or are already quite far along in your pregnancy, it’s normal for a mother to have lots of questions about what lies ahead. 

Twin pregnancies often need extra care and support because of the additional demand your body goes through. To help you navigate this journey, let’s talk more about twin pregnancies to ensure you get all the support and information you need to have a safe and joyful pregnancy.

What is twin pregnancy?

A twin pregnancy occurs when you’re carrying twins – two babies growing together in your womb. This type of multiple pregnancy can happen in two main ways:

• Fraternal twins (dizygotic):

  • When two eggs are fertilised by two different sperm, the resulting twins may not look alike and can even be of different sexes.

• Identical twins (monozygotic):

  • When one fertilised egg splits into two, the resulting twins have the same genetic makeup and often very similar appearances.

Twin pregnancies are usually considered more risky than single-baby pregnancies because they put more strain on the body. This means your doctor will recommend more frequent antenatal care to make sure both babies are developing well. 

In Singapore, mothers carrying twins can get special care and monitoring. This helps to make sure the pregnancy is safe and healthy for both the mother and the babies.

How common are twin pregnancies in Singapore?

Naturally, twins occur in about 1 in every 80 pregnancies, though the likelihood can vary depending on several factors. Older women who have children are more likely to have twins, especially those over 35. This is because hormonal changes can lead to the release of more than one egg during ovulation.

The rate is also higher among women who undergo fertility treatments, such as IVF (in vitro fertilisation) or ovulation-inducing medication. In IVF pregnancies, twins may occur in around 20-25% of cases, depending on the number of embryos transferred. As assisted reproductive technologies (ART) have become more common in Singapore, the number of multiple pregnancies has increased slightly over the years.

Identical vs fraternal twins

When you're pregnant with twins, you might wonder whether they are identical or not. These two types of twins – monozygotic and fraternal – are formed in different ways and have unique characteristics. Here's how they differ:

Whether you’re expecting identical or fraternal twins, every twin pregnancy is unique and deserves attentive, personalised care. Request an appointment with Thomson Medical to learn more about prenatal monitoring and support available for mothers carrying twins in Singapore.

Symptoms of a twin pregnancy

Every pregnancy is different, but if you're carrying twins, you may notice certain signs that feel stronger or happen earlier than expected. While these symptoms can sometimes be a sign of a twin pregnancy, only a medical scan can confirm this.

Early signs of a twin pregnancy

Some mums-to-be experience:

• More intense morning sickness due to higher hormone levels

• Faster-than-expected weight gain in the first trimester

• Extreme fatigue as your body works harder to support two babies

• A noticeably larger belly for your stage of pregnancy

• Earlier or stronger baby movements

These signs alone can’t confirm that you’re having twins – they simply suggest the possibility.

Screenings to confirm a twin pregnancy

Your doctor can confirm whether you’re expecting twins through a few key prenatal screenings:

• Ultrasound scan (around 6-8 weeks): 

  • Prenatal ultrasound is the most accurate way to confirm a twin pregnancy and identify whether they are identical or fraternal twins.

• Blood tests: 

  • Higher-than-normal hCG levels may indicate a multiple pregnancy.

• Physical check-up: 

  • Your doctor may notice a larger uterus earlier in pregnancy compared to a singleton pregnancy.

Risks of a twin pregnancy

While having twins can be an exciting experience, it's important to know that twin pregnancies come with a slightly higher risk compared to single pregnancies. To help Mum understand more of these risks, here are the common twin pregnancy risks, including:

• Preterm (premature) birth (before 37 weeks):

  • Twins are more likely to arrive early, so close monitoring is essential.

• Low birth weight:

  • Because twins share the womb, each baby may have a smaller birth weight.

• Gestational diabetes:

  • Higher hormone levels can increase the risk of having gestational diabetes, making regular glucose screening important.

• Preeclampsia (pregnancy-induced high blood pressure):

  • Preeclampsia is more common in multiple pregnancies and requires careful monitoring.

• Twin-to-twin transfusion syndrome (TTTS):

  • A rare but serious condition that can occur in identical twin pregnancies where twins share a placenta.

• Higher chance of caesarean section (C-section) delivery:

  • Due to positioning or other birth-related factors.

With comprehensive prenatal care and regular antenatal check-ups, most mums carrying twins can go on to have healthy pregnancies and babies.

Lifestyle tips for a twin pregnancy

When you’re carrying twins, taking extra care of your body becomes even more important. Your nutritional needs, rest, and monitoring requirements may be different from a single pregnancy. These simple lifestyle tips for twin pregnancy can help support a healthy and comfortable journey:

• Eat a balanced diet:

  • Include more calories, protein, iron, calcium, and folic acid to support both babies’ growth. Nutrient-dense meals with whole grains, lean meats, and leafy greens are especially beneficial.

• Stay hydrated:

  • Your body needs more fluids to maintain healthy blood volume and support the placentae. Aim to drink water regularly throughout the day.

• Get adequate rest:

  • Twin pregnancies can be more physically demanding, so try to reduce heavy work and stress, and prioritise rest whenever possible.

• Take prenatal vitamins:

  • Your doctor may recommend a higher folic acid intake (around 1 mg daily for twins) to support foetal development and prevent birth abnormalities.

• Attend regular antenatal check-ups:

  • More frequent visits help doctors monitor both babies’ growth and your overall well-being, ensuring early detection of any issues.

Remember, a twin pregnancy can be both exciting and challenging, but with mindful self-care and proper prenatal guidance, you can enjoy a smoother, healthier pregnancy journey.

Preparing for delivery of twins in Singapore

As you get closer to the end of your twin pregnancy, it is important to start thinking about the birth. Carrying twins is often more complicated, so it's good to be prepared and have a medical team to support you.

• Choose the right hospital:

  • Opt for a hospital with a well-equipped Neonatal Intensive Care Unit (NICU) and facilities experienced in handling multiple births.

• Understand your delivery options:

  • If both babies are in good positions, it may be possible to give birth naturally. However, it is more common to have a caesarean section (C-section) when there are twins, especially when there is a risk to the safety of the babies or the mother.

• Seek specialist care:

  • Choose an obstetrician experienced in twin pregnancies and multiple births for close monitoring and expert guidance throughout your delivery journey.

• Plan your birth preferences:

  • Talk to your doctor about your birth plan. This includes what you want to happen during the birth, how you want to manage pain, and if you want your partner to be there.

Every twin birth is unique, and being informed can help you feel more confident and prepared when the big day arrives.

Caring for two newborns

Bringing home two babies at once is both heartwarming and challenging. Caring for twins requires extra planning, patience, and plenty of support – but with a few practical strategies, you can make daily routines smoother and more manageable.

• Feeding:

  • Whether you’re breastfeeding or formula-feeding, it helps to plan a feeding schedule that works for both babies. Many mothers of twins learn tandem breastfeeding, which allows both babies to feed at the same time.

• Sleep routines:

  • Try to synchronise naps and bedtime so you can rest while your babies sleep. Consistency will help both little ones adjust to a predictable routine.

• Build a support system:

  • Having a confinement nanny, family member, or night nurse can make a big difference in managing feeds, sleep, and recovery during the early weeks.

• Stay organised:

  • Use baby tracking apps or simple charts to record each baby’s feeds, naps, and diaper changes – this can make it easier to spot patterns and ensure both babies are getting what they need.

Caring for twin newborns can be tiring, but it’s also an incredibly rewarding experience. With good planning, reliable help, and the right resources, you can create a calm and nurturing environment for both your little ones.

At Thomson Medical, our experts can help mums to take care of twins, ensuring a healthy and confident journey for both you and your babies. Request an appointment with us for early monitoring.

FAQ

How early can a twin pregnancy be detected?

A twin pregnancy can usually be confirmed by an ultrasound scan between 6 and 8 weeks. This early check helps your doctor determine whether you’re carrying identical or fraternal twins.

Is a twin pregnancy harder?

Physically, yes. Being pregnant with twins can be more demanding as your body supports two growing babies. You'll probably need to rest more, eat more healthily, and go to the doctor more often to make sure both babies are developing well.

Are twin pregnancies considered high-risk in Singapore?

Yes. In Singapore, all twin pregnancies are usually thought of as high-risk pregnancies. This is because there is a higher chance that there might be complications like preterm birth or preeclampsia. But if you get regular check-ups and the right care, most twin pregnancies go well.

What is the most high-risk type of twin pregnancy?

The monochorionic-monoamniotic (MoMo) twin pregnancy is considered the most high-risk type. In this rare situation, both babies share one amniotic sac and one placenta, which can lead to complications such as cord entanglement.

What age is considered high risk for twins?

Women over the age of 35 have a higher chance of conceiving fraternal twins due to hormonal changes that release more than one egg during ovulation. However, pregnancies at this age also carry increased health risks and require close medical monitoring.

What were your first signs of a twin pregnancy?

Early signs of a twin pregnancy can include stronger morning sickness, faster belly growth, extreme fatigue, or earlier baby movements. But these signs vary for each woman – the only way to confirm is through an ultrasound scan.

Do I need to take more folic acid if I’m carrying twins?

Yes. Mothers carrying twins are often advised to take 1 mg (1,000 mcg) of folic acid daily, as it helps support foetal development and prevents neural tube defects. Always follow your doctor’s specific advice on prenatal supplements.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique situations, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.