This care checklist covers the level of care you should be offered from the time of your first hospital scan, in addition to the routine care that is offered to all women during pregnancy. It aims to reduce risks and improve outcomes for you and your babies.

You should be seen in a dedicated twins/multiples clinic by a specialist team, who have more knowledge about multiple pregnancies, all the time. This would include a midwife, sonographer and doctor. This pathway is based on national best practice and hospitals receive extra funding to look after multiple pregnancies.

If you arrive at the hospital in labour you should be seen by a senior obstetrician with an expertise in twins/multiples who should produce a clear plan for your babies birth, including monitoring the babies and how they will be born.

If you are not receiving the care you would expect please raise it with the PALS team (patient liaison) at your hospital and let us know – [email protected]. We can then liaise with the hospital regarding the correct level of care that should be offered.

Feel free to share this with your midwifery team and use it as a checklist for each appointment.

Different Types of Multiple Pregnancy

There are different types of multiple pregnancy so each care pathway is slightly different.

Twins can be dichorionic (they have separate placentas) or monochorionic (they share a placenta).

Triplets have a few possible combinations:

Trichorionic – each baby has a separate placenta

Dichorionic – two of the babies share a placenta and the third baby is separate

Monochorionic – all three babies share a placenta

It is possible for twins and triplets to share an amniotic sac as well as a placenta, Monochorionic/Monoamniotic. Although rare, these pregnancies need extra care, closer monitoring by a specialist and an individual care pathway which will include scanning every 2 weeks after 16 weeks gestation. For twins, an earlier birth is recommended between 32-34 weeks. For triplets, the timing of birth will be decided and discussed with you individually and you may also be referred to a different hospital that has more experience of triplet pregnancies

Click the buttons below to see what care you should be receiving for your type of pregnancy.

Twin Pregnancy 

Triplet Pregnancy

More information can be found here:

https://www.nice.org.uk/guidance/ng137/informationforpublic

https://www.twinstrust.org/pregnancy/antenatal-care