Two placentae, two sacs

This information is based on the antenatal care pathway for women with uncomplicated TWIN pregnancy. You will have at least 8 appointments of which at least 6 will include scans which should take place in a twins/triplets clinic.

11-14 weeks
11-14 weeks
Booking appointment and dating scan 11-14 weeks 
Information you should receive

Your midwife or doctor should give you information about:

  • Nutrition and diet, including vitamin D, iron and folic acid supplements
  • Antenatal screening tests
  • Your pregnancy care pathway
  • Information on twin antenatal classes
  • Specialist multiples support groups – Twins Trust, Multiple Birth Foundation and local multiples groups
  • Parent information pack on multiple pregnancy
  • Healthy Start vouchers
  • Mental health and postnatal depression
  • Exercise, including pelvic floor exercises

 

The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan to estimate when the babies are due
  • Tell you what type of multiple pregnancy your pregnancy is
  • See if you may need additional care or support
  • Plan the care you will get throughout your pregnancy
  • Measure your blood pressure and test your urine
  • Offer you screening tests, make sure you understand what is involved before you decide to have any of them and discuss results
  • Discuss timing and how you’ll give birth and pre-term birth
  • Advise you on the use of aspirin if you are at risk of high blood pressure
  • Discuss and check any health issues that may affect your pregnancy

 

 

16 weeks
16 weeks
16 week appointment with a multiples midwife 
Information you should receive

Your midwife should give you information about: 

  • The ultrasound scan you will be offered at 20 weeks and help with any concerns or questions you have
  • Where to have your babies
  • Maternity benefits
The care you should receive

Your midwife should:

  • Review the results of any screening tests
  • Measure your blood pressure and test your urine
  • Your specialist consultant should carry out an antenatal check and explain any risks for your type of pregnancy
  • Discuss recommendations and choice for your birth and early labour
20 weeks
20 weeks
20 week appointment with a multiples midwife and team 
Information you should receive

Your midwife or doctor should give you information about: 

  • Antenatal classes and book if wanted
  • Breastfeeding
  • The importance of babies’ movements and contact numbers
The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out a detailed ultrasound scan to check the physical development of your babies
  • Measure your blood pressure and test your urine
  • Carry out a blood test to check for anaemia
24 weeks
24 weeks
24 week appointment with a multiples midwife and team 
Information you should receive

Your midwife or doctor should give you information about:

  • Any need for experienced enhanced team referral e.g. physio, mental health
  • Provide a MAT B1 certificate – medical evidence of your pregnancy for your employer (any time after 20 week scan)
The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan and discuss results
  • Measure your blood pressure and test your urine
  • Discuss the risks and signs of early labour
  • Carry out blood test for anaemia (if not already done)

 

26 weeks
26 weeks
26 week appointment with a multiples midwife (if not already discussed) 
Information you should receive

Your midwife should: 

  • Discuss any anxieties regarding pending life changes, demands of two or more babies, coping strategies and the effect on relationships
  • Provide information about mental health issues and post-natal depression
The care you should receive

Your midwife should:

  • Measure your blood pressure and test your urine
  • Discuss timing and choice of birth
  • Discuss anti-D treatment if rhesus negative
28 weeks
28 weeks
28 week appointment with a multiples midwife and team
Information you should receive

Your midwife or doctor should help you with any concerns or questions you have.

 

The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan and discuss results
  • Measure your blood pressure and test your urine
  • Carry out a blood test
  • Discuss timing and type of delivery (date for induction or elective caesarean) including use of steroids if not already been discussed
  • Discuss and agree birth plan and include in notes
  • Discuss breastfeeding checklist
  • Organise a Health Visitor referral

 

 

30 weeks
30 weeks
30 week appointment with a multiples midwife (if not already discussed) 
Information you should receive

Your midwife should give you information about:

  • Breastfeeding and postnatal care
The care you should receive

Your midwife should:

  • Discuss and record the results of any tests
  • Discuss labour, birth and coping strategies (birth plan)
  • Measure your blood pressure and test your urine

 

32 weeks
32 weeks
32 week appointment with a multiples midwife and team 
Information you should receive

Your midwife should give you information about: 

  • Vitamin K
  • Newborn screening tests
The care you should receive

Your midwife, doctor or sonographer should: 

  • Carry out an ultrasound scan and discuss the results
  • Measure your blood pressure and test your urine
  • Carry out a blood test

 

34 weeks
34 weeks
34 week appointment with a multiples midwife 
Information you should receive

Your midwife should: 

  • Discuss any anxieties and postnatal depression
  • Advise you on care provided by the multiples midwife once your babies are born
The care you should receive

Your midwife should:

  • Discuss and record the results of any screening tests
  • Measure your blood pressure and test your urine
36 weeks
36 weeks
36 week appointment with a multiples midwife and team 
Information you should receive

Your midwife or doctor should give you information about:

  • Breastfeeding, including hints and tips for success
  • Caring for your newborn babies
  • Vitamin K and screening tests for your newborn babies
  • Your own health after the babies are born
The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan and discuss results
  • Measure your blood pressure and test your urine
  • Discuss induction of labour or caesarean procedure
  • Plan for delivery at 37 weeks if not delivered
  • If planned delivery declined, weekly appointments with specialist until delivered

 

37 weeks
37 weeks
37 week appointment with a multiples midwife
The care you should receive

Your midwife or doctor should:

  • If your babies haven’t arrived, discuss induction of labour or caesarean procedure and offer course of steroids if necessary


At least 2 hospital appointments should be with a doctor who specialises in multiple pregnancies, one of which should be at 16 weeks.