A multiple pregnancy means you're pregnant with two or more babies. It can be both exciting and scary. You might wonder how this pregnancy will be different. You may want to know how it will affect your health. And you will want to learn how it can affect the health of your babies.

A multiple pregnancy can happen if you use fertility treatment. Or it can happen naturally. Twins may run in the family. A multiple pregnancy is often found early when you have an ultrasound.

A multiple pregnancy is a high-risk pregnancy. This means it has a higher risk for problems. Your prenatal care will need to include:

• More prenatal visits. This helps your doctor closely watch your health and the health of your babies. It's important to check the growth of your babies. Your weight and nutrition will also be checked. And your doctor will watch for problems.
• Repeated ultrasounds. These are used to check the growth of the babies. They also check the volume of amniotic fluid. These tests start in your second trimester. You may have an ultrasound every 4 to 6 weeks.
• Tests to check your health. You may have earlier blood sugar tests. This is to see if you have gestational diabetes. You may be tested earlier for iron-deficiency anemia. Your doctor will also check your blood pressure often.
• Tests to check the health of the babies. You may have amniocentesis. Or you may have chorionic villus sampling (CVS). These are done to test for birth defects. You may have a nonstress test. This is to check the heart rates of the babies.
• Preparing for birth. A multiple pregnancy raises the risk for preterm birth. It also raises the risk for a cesarean section (C-section). It's important to talk about these with your doctor.

At prenatal visits, you'll get guidance on:

• Nutrition.
• Prenatal vitamins.
• Activity.
• Expected weight gain.

Being pregnant with twins or more raises your risks for all the problems that can happen in pregnancy. This is why you need extra prenatal care. Many of the problems can be managed better if they are found early.

The risks during pregnancy include:

• Low red blood cell count (anemia).
• Gestational diabetes.
• Gestational high blood pressure (preeclampsia).
• Severe morning sickness and fatigue.
• Preterm birth (before 37 weeks).
• Babies not gaining weight normally (fetal growth restriction).
• Monochorionic babies. This is when babies share a placenta and amniotic sac. It can raise the risk for twin-to-twin transfusion syndrome (TTTS). This is uneven blood flow between the babies.

The risks after birth include:

• Health problems of premature babies and NICU care.
• Postpartum depression.
• Heavy bleeding after birth (postpartum hemorrhage).
• Low birth weight.
• Birth defects.

Contact your doctor now or seek immediate medical care if:

• You have a fever of 100.4°F (38°C) or higher, or as directed by your doctor.
• You have symptoms of postpartum depression.
• You have heavy bleeding.
• You have symptoms of eclampsia.
• You have headaches.
• You have an increase in blood pressure.