How to Have a Healthy Twin Pregnancy

  • By: Sandra
  • Date: March 18, 2022
  • Time to read: 7 min.

Are you pregnant with twins? Congratulations! Twins are a blessing, but they do come with their own set of challenges.

Twins are more likely to be born prematurely and they are also at an increased risk for health problems so it is important to take care of yourself and your babies, from the beginning of your twin pregnancy.

Importance of Fluids

Not only is getting enough food important for twin pregnancies, so is drinking enough fluids. Drinking at least eight glasses of liquid a day eases constipation and reduces the risk of a urinary tract infection. 

Your body needs the extra fluid to help transport nutrients to your babies, build cells, and remove waste from both your system and the babies’. The added fluid builds additional blood, amniotic fluid, and tissue. When you are carrying only one baby , you only need to drink an extra quart of fluids a day, but with twins, you’ll need at least an extra gallon.

You don’t have to drink all of that water though – you can also get fluids from other sources such as soups, fruits and vegetables, and even ice cream! Just be sure to avoid drinks with caffeine and alcohol.

Nourish Your Body with Nutrients

Just as you need to drink plenty of fluids, you also need to make sure your body is getting enough nutrients – especially important if you are carrying twins to ensure your babies health and delivery not one but two healthy babies.

A balanced diet is key, but there are some specific nutrients that are especially important for twin pregnancies.

Folic acid is one such nutrient; it helps to prevent birth defects of the brain and spine. You should be taking a prenatal vitamin with 400 micrograms of folate (or folic acid) per day.

Another important nutrient for twins is iron. Iron helps to build red blood cells, which carry oxygen throughout your body. You should aim for 27 milligrams of iron per day – more if you are pregnant with twins or have a history of anemia.

Good sources of dietary iron include lean red meat, poultry, fish, eggs, legumes (beans and lentils), nuts, and fortified cereals. Vitamin C helps your body to absorb iron, so try to include some vitamin C-rich foods in your diet as well.

Calcium is another important nutrient for twin pregnancies; it helps to build bones and teeth in the babies, and also helps to reduce the risk of preterm birth. You should aim for at least 1000 milligrams of calcium per day. Good sources of calcium include dairy products, fortified orange juice, broccoli, and kale.

Cut out the Caffeine

Through the years, women have heard conflicting news reports on whether caffeine will increase their chances of miscarriage. During 2008, however, evidence has come to light strongly suggesting that cutting out the stimulant altogether during pregnancy is a good idea.

Researchers at Kaiser Permanente Division of Research found that women who consumed about 200 milligrams of caffeine (that’s about two cups of coffee) a day doubled their risk of having a miscarriage.

Furthermore, even women who consumed less than 200 milligrams a day had a 40 per cent chance of miscarriage. Although some say more research needs to be done, err on the side of caution and try a cup of herbal tea. (I drank a cup of hot water in the morning. Not quite the same, but it gave me the illusion of that earthy cup of joe.)

Taboos – Smoking/Alcohol

The dangers of smoking have been known for years, but the hazards of tobacco are magnified even more during pregnancy. Not only does smoking while pregnant put your life at risk by increasing your chances for heart disease and cancer, but it also has been associated with low birth weight, placenta previa, vanishing twin syndrome, miscarriages, sudden infant death syndrome (SIDS), and even preterm labor.

Another taboo to avoid during pregnancy is alcohol. Women who drink regularly during pregnancy often have children with fetal alcohol syndrome, a serious condition that includes mental retardation, growth deficiencies, and abnormalities.

Various conflicting reports on how much alcohol during pregnancy is safe are inconclusive—so once again, a pregnant mom should err on the side of caution and omit alcohol completely from her lifestyle. And of course, the use of illegal drugs such as marijuana and cocaine are potential time bombs to a pregnant woman. Avoid them at all costs.

Tips for Increasing Chances of a Healthy Pregnancy

Healthy Diet

  • Follow a healthy diet high in calcium, iron, folic acid, and especially protein. Vary your food consumption to be sure that you’re getting a variety of nutrients, and eat plenty of fresh fruits and vegetables.

How Much Weight Gain?

  • Shoot for a 40 to 45 pound weight gain gaining the majority of weight by Week 28. A normal weight gain for a twin pregnancy should be about 40lbs. Two babies just naturally require more gestational weight.
  • And don’t forget—protein, protein, protein. The more the better when it comes to a multiple pregnancy. So think meat, chicken, fish, beans, and dairy. Protein shakes can also be a great way to get in your recommended daily intake.


Regular exercise is important, too. Try to get in at least 30 minutes of moderate activity on most days of the week. Walking is a great option, but check with your doctor before starting any new exercise routine.

It’s important to stay active during your twin pregnancy, but make sure you check with your health care provider before starting any type of exercise routine when you are expecting twins. Walking is always a good option, as is swimming and prenatal yoga. We’ve done a guide on tips for twin pregnancy exercises.

Prenatal Vitamins

Take prenatal vitamins (containing folic acid) and minerals, especially calcium and iron. Your body just needs a lot more than a singleton pregnancy so make sure you speak to your doctor about your requirements.

You are considered a high-risk pregnancy whether carrying fraternal twins or identical twins, both put you in the high-risk pool. Most twin pregnancies will be heavily monitored from the first trimester and you should have a good support system put in place so that you get not one but two healthy baby when babies arrive. However, there is a lot you can do yourself in staying healthy and much of this includes diet. If you are unsure speak to a registered dietitian to get the best advice on your twin pregnancy diet.


Get plenty of rest. This is often hard to do with two active babies inside you, but it’s important for both your health and the health of your babies. Try to get at least eight hours of sleep a night if possible.

Don’t wait until your doctor puts you on mandatory bed rest—rest often by either napping frequently or putting your feet up for 30 minutes at least three times a day.

In the third trimester, you may also want to sleep on your left side. This will help improve blood flow to the placenta and babies.

Prenatal care

Never miss a doctor’s appointment. Read everything you can on multiple pregnancies. Ask questions and discuss your concerns with your physician. It is work, especially if you are carrying identical twins, to see a maternal-fetal medicine specialist.

High blood pressure, gestational diabetes, and preeclampsia are all more common in twin pregnancies.

Stay informed and be an active participant in your own care to ensure a healthy pregnancy.


Drink, drink, drink, and then drink more (water, juice, and milk).


Don’t wait until you’re exhausted to rest or starving to eat. Use your common sense when it comes to caring for your body. Avoid alcohol, don’t smoke or take any kind of drugs, and always wear your seat belt while driving.

Choosing Baby Names x
Choosing Baby Names

Body language

No one knows the patient better than you. Learn to listen to your body and promptly respond to its needs. When you are having more than one baby its vital that you listen to what your body is telling you.

Staying Comfortable

A woman carrying twins in Week 30 is carrying the same weight as a woman carrying a singleton at term. For the mom carrying multiples, comfort becomes harder and harder to achieve. Try the following devices to help ease your aches.

  • Flats or sandals. During pregnancy it’s not uncommon for feet to increase a full size (and often they don’t return to their prepregnancy size after birth). To keep your feet comfortable, wear comfy flat shoes, sandals, or a strong pair of flip-flops. But be careful—pregnant woman are not known for their sense of balance.
  • Support hose. It’s not just for the senior set anymore. Wearing support hose (such as Pintoli Women’s Comfy Compression Socks) will help alleviate swelling of the feet and ankles (edema) by forcing the blood back to your heart, and aid in the prevention of varicose veins.
  • Belly support. Toward the end of the second trimester and throughout the third, the weight of twins on a pregnant woman’s back can be intense and painful. Relieve the pressure by wearing a belly support, a minigirdle that wraps around the lower stomach and back. It is available at most maternity stores, through maternity catalogs, and, of course, online. (BellaBand Women’s New Everyday Bellaband is a good choice.)
  • Maternity/nursing bra. A good maternity bra with flaps that open to enable breastfeeding not only gives support to heavy breasts, decreasing the chances for a backache, but it may also help prevent stretch marks.
  • Maternity pillow. Essential to a good night’s sleep, a maternity pillow that comfortably cradles your burgeoning belly should top every pregnant woman’s shopping list. (Leachco Snoogle Total Body Pillow works well.)


Usually, the journey itself isn’t harmful to your babies, but with the added chance of preterm labor or other complications that women carrying multiples sometimes experience, most doctors suggest that their patients stay close to home after they reach Week 30.

One Final Thought

Being pregnant with twins takes a lot of work and diligence on your part to ensure a healthy outcome, but it’s just nature’s way of mentally preparing you for what lies ahead. After the birth of your twins, you’ll soon realize that pregnancy was the easy part.