Pregnant with twins can be both overwhelming and exciting. If your health care provider has told you that you’re carrying twins, you may probably have many questions: What symptoms should I expect? How is my baby growing? Or what kind of lifestyle changes should I make? The good news is: your baby will now be referred to as a fetus rather than an embryo.

Symptoms to Expect

When you are 10 weeks pregnant with twins, you may experience some similar symptoms with women who are in a single pregnancy. However, women pregnant with twins can expect to spend more time with the obstetrician. You can also expect to gain more weight, experience more morning sickness, and spotting may be more common on you.

1. Visible Veins

During a twin pregnancy, the growing uterus will put more pressure on the veins that return blood from the legs, and hence it will become harder for blood to leave the legs. The extra weight of twins creates an even heavier burden on the deep veins in your legs. This often leads to blood pooling that causes many veins to swell. Bluish veins may also appear on your breasts as your blood supply increases due to the milk glands that normally enlarge during the pregnancy’s first few months.

2. Indigestion and Constipation

During pregnancy with twins, intestinal muscle contractions that typically move food through your intestines slow down. Additionally, the extra iron you are getting from a prenatal vitamin results in uncomfortable gas and constipation. Furthermore, the pressure on your rectum from your growing uterus often results in indigestion and constipation, which may keep you feeling bloated throughout the pregnancy. However, drinking plenty of fluids and adding fiber to your diet should help alleviate the conditions.

3. Pregnancy Glow

When you are 10 weeks pregnant with twins, an increased production of the hormone human chorionic gonadotropin (HCG), and increased blood volume will work in tandem to create a pregnancy glow. Increased blood volume brings more blood to the vessels, and it results in plump and slightly flushed skin. The hormones progesterone and HCG cause the skin glands on the face to secrete more oil, and help make skin look shinier, suppler, and smoother.

4. Other Symptoms

Aside from the symptoms above, you might also continue to experience physical symptoms the same as weeks before. However, your symptoms may be more severe due to your twins, and can include:

• Increased fatigue
• Change in mood
• Dizziness
• Nausea and/or vomiting
• Headaches
• Food craving
• Increased vaginal discharge/spotting
• Jabbing sensation in lower belly (Round ligament pain)
• Breast soreness

How Do Your Babies Grow During This Week?

When you are 10 weeks pregnant with twins, each of your babies will be about the size of a kumquat, or 1.2 inches long from crown to rump. Your twins are growing rapidly now, and your typical weight gain is between 1 to 1.5 pounds during this week, and your total weight gain should between 10 to 15 pounds until now. Apart from this, your babies grow generally in the same way as that of single pregnancy. Developments that are underway include:

• Brain: The brain structure is complete and brain mass is increasing.
• Ears: The outside ears will be fully developed by the end of this week, and they sit very low on the head. As the head grows larger, they will move to the right spot on either side of the head.
• Eyes: The basic optical structure is in place, and they are still on either side of the head, and the eyelids are fully functional.
• Mouth: The tooth sockets are beginning to form under the gum line.
• Limbs: The arms are also now bent at the elbow, and flexible. The knees and ankles are beginning to develop, and the fingernails are beginning to grow.
• Abdomen/pelvis: The intestines are fully developed and pancreases are now in the abdomen. The digestive tract is now functioning, and the liver is secreting bile. Genitalia start to take on male or female characteristics.

What Should You Notice During This Week?

1. First Prenatal Appointment

You should have your first prenatal appointment scheduled when you are 10 weeks pregnant with twins. This is usually the first time you will see your obstetrician during pregnancy. The purpose of this appointment is for the obstetrician to obtain a medical history from you and your spouse, and plan your care for pregnancy and the birth. It's also an opportunity for you to ask any questions that you may have and discuss the schedule for future appointments, ultrasound scans, blood tests, and prenatal classes. The answers you provide to the obstetrician will help identify any factors that may affect your pregnancy, especially if there is a family history of preeclampsia. The obstetrician will also do some health assessment tests, such as urine tests, at this and future prenatal appointments. You can expect to spend more time at the appointments, and there may be more appointments scheduled for multiple fetuses.

2. General Health

During a twin pregnancy, you will need to take care of yourself and your developing babies. Do not drink alcohol or smoke during pregnancy, and avoid all other toxic substances such as drugs during this period of time. Be sure to discuss all medications you are taking with your health care provider, and take a good prenatal vitamin.

3. Exercise

30 minutes per day of exercise such as yoga, swimming, or walking is another way to maintain your health during pregnancy. Speak with your health care provider about your current or desired exercise program to make sure it is safe.

4. Beauty

Everybody wants to look their best, but using permanent hair color is not recommended during the first 12 weeks of pregnancy. Consider using a semi-permanent dye instead. Be sure to talk with your obstetrician about any other cosmetics you’re using that may be detrimental during pregnancy.

5. Food

Although it is safe to eat some fish during pregnancy, it is recommended that you limit yourself to 8-12 oz. of fish and shellfish per week. If you plan on eating albacore tuna or tuna steak, it is recommended to limit this fish to 6 oz. per week. More importantly is to avoid eating swordfish, shark, and tilefish and king mackerel while pregnant, because they have high levels of mercury which may be harmful to the brain and nervous system of your babies.