Confirming twins w/o ultrasound - Mothering Forums
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I'm Pregnant > Confirming twins w/o ultrasound
josie423's Avatar josie423 08:04 AM 10-02-2012

Hey ladies! I'm 20+3 with my fifth baby. At 12-13 weeks I was measuring 17-18 and at my 20 week appt. yesterday I was measuring 25. It is not unusual for me to measure ahead at 20-30 weeks and by 24-28 it starts evening out. I've never measured so far ahead right from the beginning though. Since my last appt. at 12 weeks I've lost 6 lbs (went to a grain-free diet) and when she went to check my FH she seemed really surprised I wasn't measuring small. She immediately wondered about twins, which she's never mentioned with my other babies.


She listened to the h/b and felt around a bit, but didn't look for a second h/b. She had a hard time getting the one and she doesn't like using the doppler long, I imagine that's why she didn't look further. She also says based on positioning it can be hard to find two heart beats. She said we'll wait and see. Part of me is totally fine with that and part of me is dying to know, haha! She said there's nothing wrong with not knowing right now, less to worry about.


Anyone have any twin stories, such as finding out without an u/s? How did you find out/confirm? How many weeks? Was your pregnancy different? What was movement like? I'm trying not to drive myself crazy, but I'm failing! I am telling myself it is probably one, but this pregnancy has been *different*. I see her again at 25 weeks, hoping to get more answers then. smile.gif

Adaline'sMama's Avatar Adaline'sMama 08:41 PM 10-02-2012

At 20 weeks, I can find two heartbeats in less than 2 minutes, so she shouldnt really have to search too hard for the second one. They are not always in the same place, but they are pretty easy to find because they are loud.  They still move around alot, so their positions are different sometimes. I have some extra padding, and it was easy to find their heartbeats until now, but at this point in gestation it really shouldnt be that hard to find with the doppler. 


My pregnancy was pretty similar- No extra morning sickness, no extra symptoms at all really. I didn't feel different, other than the fact that I was huge- and quick. Now at 20 weeks, Im measuring about 30. At 10 weeks I measured 16, at 15 weeks I measured 22. 


Id be dying to know for sure, for a few reasons:


~ if youve lost 6 lbs, you'll need to really strive to gain if there are two babies in there

~ I personally would want to know if they are mono or di- basically how high the risks are 

~does your midwife do twin homebirths? Id hate to wait to find out, and then have to switch to an OB/MD at the last minute because the midwife didnt want to do it. But, I like planning ahead.



Basically, the big question I would ask myself is would you follow the recommendation for monoamniotic twins to be delivered via c section. If so, then I would want to find out immediately so that I could stop planning a homebirth. 

josie423's Avatar josie423 01:26 PM 10-03-2012

I don't think she felt two distinct baby shapes and that's why she didn't search more for a second h/b. And also because it took her using the fetoscope and then two different dopplers to find the one h/b she found. She was in the correct spot the whole time, but for some reason it kept picking up my h/b instead of the baby's.


Yes, she does twin homebirths, she's done three this year. If we're still thinking twins at my next appt, I will talk to her about the risks and whether I should have an u/s to find out more. After a couple days to chew on all of this, I *honestly* think it is one, but I'm trying to prepare a little just in case.


A question, what is movement like? Would I be feeling tons of movement if it was two? The movement just feels normal to me.

Adaline'sMama's Avatar Adaline'sMama 02:21 PM 10-03-2012

For me, the movement has been totally normal. In fact, I had way more (and stronger) movements from DS by this point in the pregnancy. The only thing that is weird is that right now they are both transverse in opposite directions, so Im getting movements on two totally different sides of my belly. That feels really weird, because typically by the time you feel movement on both sides of the babies are much bigger, and therefore the movements are way stronger. 

josie423's Avatar josie423 02:57 PM 10-03-2012

Hmmm, I'm getting movement on both sides of my belly too. From down low to up at my ribs. Maybe this will just be a bigger babe for me (was charting, so sure of my dates)? The movement feels like it is coming from one, but I don't know what two feels like.. My others were small. And I felt much more movement with my last baby than with this one (ones?). When you lie on your back, how big is your 'baby lump'? Mine feels big for a 20 weeker. 

Adaline'sMama's Avatar Adaline'sMama 03:29 PM 10-03-2012

Im not sure what you mean by "baby lump". I am feeling movement on both sides, like all the way over on my left and all the way over on my right. (There are feet on both sides :) ) 

josie423's Avatar josie423 04:45 PM 10-03-2012

I knew I should have clarified more, haha. The best way to describe it is the outline of the baby when you lie and your back and he/she/they are anterior. smile.gif I have a layer of fat that is making it really hard to distinguish parts, I can just feel a big bulge and I can feel the back.

Adaline'sMama's Avatar Adaline'sMama 07:25 PM 10-03-2012

When I lay on my back there is a vertical bulge in the middle, like there has been all three times- I previously thought it was the baby's back, but its not. Those are my abdominal muscules :)


 I cant feel baby outlines yet. But in the last ultrasound, I was shown by drawing outlines on my stomach exactly where and how big they were and they are both the same size that DD was at 20 weeks. Not two smaller babies, but two babies the same size as DD- I have no clue how that doesnt make my belly measuring 40 weeks, but it doesnt. But, I also have a layer of fat. Like you, Ive had babies close together. These will make 4 babies in three years, which makes it a little harder to figure out where they are at this gestation. 

josie423's Avatar josie423 07:39 AM 10-04-2012

I always thought that was the baby I was feeling (my bulge is more horizontal all below my belly button) but maybe it is just my abs. Thanks for all the info! You've been very helpful! I'm just going to try to not obsess and be anxious. 

littlebearsmama's Avatar littlebearsmama 10:23 AM 10-26-2012

     One indicator that I was carrying more than one baby was hiccups in two different places. Now they were at different times, too, which made it tricky, but the babies were big enough by then to not be expected to move around so much. Another sign, though I was toward the end of the pregnancy, was that one baby's head was in my pelvis and there was that other little hiccup on the side.

      My midwife listened for two heartbeats with a doppler but said that even though she picked up heart tones on different sides of my uterus, they were the same beats per minute. Never got a diagnosis of twins (or confirmation of my twin suspicions, for that matter) until my little girl was born and we heard another heartbeat in utero.

     Oh, and I had a successful, uncomplicated twin home waterbirth. It was amazing and it's totally possible.  I know there are reasons why I wasn't meant to "know" for certain about my twin girls, but it's not adviseable for everyone. My advice: listen to your intuition. You're the Mama, after all.

josie423's Avatar josie423 11:40 AM 10-26-2012

Thanks for your input!! I'm 24 weeks tomorrow and measuring about 30-31 and still wondering. I bought a prenatal heart monitor at BRU (not a doppler and not as good as one, more like an amplified stethoscope) and from day to day get the heartbeat in drastically different spots, but not at the same time & it's always in the 160s. I've felt hiccups just once and was wondering what twin hiccups would be like, if it were twins. :) Did you feel extra movement? The movement I feel is pretty normal, albeit very high, already being at my sternum. I don't really know what to think anymore.. I feel like it could be two but it's probably one. I'm thinking the most likely option is a lax uterus and more amniotic fluid or a bigger baby. smile.gif


I went to our local crisis pregnancy center for a free u/s but the turned me away because I have prenatal care and I'm further along. That was really my only option as DH doesn't want one period (he doesn't know I went, oops haha!) and there's no way he'd pay for one. Oh well! Hopefully I'll know more at my 25 week appt.

littlebearsmama's Avatar littlebearsmama 01:31 PM 10-26-2012

No, I didn't feel more movement than I had with my singleton pregnancy. Also, when palpitating, I could distinctly feel the baby's back and bottom on my left side with an extra bump on the right. I couldn't quite figure out that extra bump. Also, if you find yourself with an extra bump or two, there might be a gap separation between where one baby ends and the other begins. Somewhere, exploring on the web, there was a description for this gap which turns out to be an indicator of mulitples also.

How are your urine strips turning out? Some mothers pregnant with twins may drop a bit of protein which may or may not be associated with preeclampsia. No matter how many babies you've got cookin', it's so important to eat enough protein. Good luck, Mama.

P.S. After my first set of twins, I'm now pregnant again and kind of in a similar boat as you are...measuring big, but too early to palpitate clearly.

josie423's Avatar josie423 01:47 PM 10-26-2012

I have been feeling extra bumps too. I feel the main baby parts on my right, where all my babies liked to hang out, but what feels like extras on the left. It could be a weird position, but I've been feeling that since 20ish weeks when the baby seemed a little small to take up that much space. I read something recently about a ridge that can sometimes be felt with twins if they are in separate sacs. I've only seen my midwife twice, the first visit my urine strip was totally normal and the second time I was spilling trace ketones which we attributed to my body adjusting to the grain-free diet I started at 13 weeks (I lost 6 lbs from 12-20 weeks and am just now gaining a little). For several weeks earlier on I was spilling moderate ketones.


How far apart were your girls born? Were you pretty convinced it was twins? What a lovely birth that must have been! How would you feel about a second set?? Ah, the suspense!! 

littlebearsmama's Avatar littlebearsmama 02:37 PM 10-26-2012

Yes, the ridge. That's it! I felt it distinctly when I looked for it, though it must have been at least 30 plus weeks when I did. I had suspicions of twins, but also excuses for every multiple pregnancy symptom that I had (polyhydraminos, just another big baby, maybe the baby swiveled a perfect 180). Funny. Now it seems that I should have known all along!

josie423's Avatar josie423 02:45 PM 10-26-2012

Oh dear, you're making me wonder even more, haha! Were you big? I don't think I look big enough for twins, but I don't know...!

littlebearsmama's Avatar littlebearsmama 02:54 PM 10-27-2012

Oh yes. I was big. Measured 3 to 5 cm bigger every prenatal. At 42 weeks, when my girls were born, I measured 57 cm!. People thought I was bigger than the average pregnant woman, but I didn't think much of it. Thought maybe I just forgot how big I get when I'm growing a baby. Ha ha!

themothership's Avatar themothership 05:18 PM 10-27-2012

I have measured anywhere from right on (at 12 weeks) to 9 cm big (at 17 weeks) but average of 2-5 cm ahead. I have had an ultrasound and at 20 weeks there was only 1 in there, but the baby is a bit big. We thought twins before that, but now there is distinct lack of baby on my left side, with the exception of legs/arms. 

josie423's Avatar josie423 07:17 PM 10-27-2012

Here I am yesterday at 23+6.


We will see how it turns out!! I see my midwife on 11/5, hopefully she'll be able to tell by then. Thanks for the input ladies!! thumb.gif

WildKingdom's Avatar WildKingdom 07:47 PM 10-27-2012

I'm not sure what your reasons are for avoiding ultrasound, but in your case if the measurements you are giving here are accurate, you should get one.  It's not just to see if it's twins.  If you have polyhydramnios, it could be a sign of some serious underlying issues with your baby.


Not to scare you or anything, but twins are not the only thing that could make you measure large.  Some of those things that could cause polyhydramnios would make it less safe for you to birth at home, as your baby might need immediate medical care.

josie423's Avatar josie423 05:57 AM 10-28-2012

Yes, I'm aware there are several other things that could cause larger FH measurements, including simply having a 5th baby in 6 years. We've always opted out of u/s and my husband is adamantly against getting one. The only way he'd be open to one is if my m/w recommended one and she hasn't. We're following her guidance.

WildKingdom's Avatar WildKingdom 08:27 AM 10-28-2012
Gently, have you considered getting a second opinion from another medical professional? Several things in your story greatly concern me. The weight loss, still measuring 7 weeks ahead despite weight loss, the ketonuria- all are red flags. The fact that your MW had so much trouble getting fetal heart tones in a 20 weeks fetus is also concerning. That should not be so difficult. It could mean that she is just really bad at finding fetal heart tones (concerning) or that there is something wrong with the baby (God forbid).

Please reconsider this hands-off approach, especially since you are having a homebirth.
josie423's Avatar josie423 08:56 AM 10-28-2012

No, I haven't considered getting a second opinion. At 20 weeks I was measuring 5 weeks ahead, which I did at 20 weeks with my last baby and it evened out by 30ish weeks, I think at my 28 week appt I was measuring a couple cms ahead with him. Right now, the 7cm ahead is by my own measurement which could definitely be off! I started this pregnancy about 20 lbs heavier than my normal pre-pregnancy weight and at 13 weeks switched to a grain-free diet and that, imo, is why the weight loss occurred and my midwife agrees. For several weeks after cutting grains out I craved all things protein and wasn't getting enough carbs which I have since corrected. I'm no longer passing ketones, except for trace here and there if I've gone too long without eating. And I've gained some weight.


I don't feel that my midwife is bad at finding the heartbeat since she's been doing this for close to 30 years. She got it for a second with the fetoscope and then couldn't hear it again so she got the doppler. The first one she used was close to dead so she switched to the second one. It took longer than normal and it kept picking up my h/b but she did get it and it was nice and strong. She was in the right spot the whole time, the doppler just wouldn't get it. A couple weeks ago I bought a prenatal heart monitor at Babies R Us, which from my understanding is nowhere near as good a doppler and have gotten a strong heartbeat in the 160's every day.

withlittlelungs's Avatar withlittlelungs 12:39 PM 10-28-2012

I had no signs of twins until my 20 week appointment when I started measuring 5 weeks ahead (at my other two appointments I was right on track). At my 16 week appointment it took a long time to find the HB because baby kept moving, yet we still didn't have any indication of two HB. After the MW took my measurements at my 20 week, she looked around and found 2 HB. One lower in my abdomen and one higher by my ribs (but she had to really search around). Then we did a u/s just to confirm. 
I just found out about my twins a few days ago, but from what I read I would seriously consider getting a u/s. I was only planning on 1 this pregnancy and I didn't feel super happy about getting an unplanned one at the MW's office (but I seriously needed to confirm if it was twins for many different reasons). I think it is important to be informed for the sake of you and your baby especially planning a home birth (we are too, fingers crossed!). 
Please keep us updated! 

Youngfrankenstein's Avatar Youngfrankenstein 05:39 AM 10-29-2012

OP, I totally get that you want to be low intervention.  My last birth was a homebirth.  I saw a midwife and saw a practice of CNMs for awhile.  I did get the 20 week anatomy scan.  I think having one ultrasound in your shoes outweights the not knowing.  You don't have to commit to changing your entire schedule of pre-natal care.


If you need help finding a place that will do no/low cost ultrasound that you can do discreetly, I can try to help you out.


Take care and congratulations on your baby!

josie423's Avatar josie423 06:51 AM 10-29-2012

Thanks so much for your response!! Since I see my midwife in a week, I think I'm going to wait it out for the time being. If she's still undecided next week, then I'll take the necessary steps to get the info I need, hopefully DH is on board. I tried our crisis pregnancy center but they turned me away. shrug.gif There are 3D places in the area if I decide to get one. Thanks again!


And Ellie, congrats on your twins!! :D

withlittlelungs's Avatar withlittlelungs 01:15 PM 10-29-2012

Thanks, Josie! I hope your appointment goes well, and that you get a more definitive answer! I only have a few minutes of waiting before we confirmed via u/s and my head was already spinning. I can't imagine walking around for weeks not knowing

josie423's Avatar josie423 01:56 PM 10-29-2012

It is indeed tough not knowing!! Deep down I really feel it is probably one and that this baby is just bigger. I'm trying to tell my son (almost 5) that it is most likely one and he gets so upset each time and is insisting that it is either 2 boys or a boy and a girl. Poor boy! I'll update when I know more. orngbiggrin.gif

talk de jour's Avatar talk de jour 07:18 PM 10-29-2012
I'm going to share my story with you, because to be honest, my heart sunk here because your story is very familiar to me.

It was always hard to find the heart tones on my son Eli, who is 3 months old now, no matter who did it -- nurse, doctor, whoever. You'd find it, and then you wouldn't, and it was all over the place.

I was also huge. Enormous. I looked full-term pregnant by the time I was 6 months along. I chalked it up to the fact that I am very, very short. But by the time I was 33 weeks pregnant, I measured a full 40+ weeks, and my OB sent me for a specialty ultrasound at a MFM clinic to find out what was going on. We knew it wasn't twins, but I was a little iffy on dates, I thought I could be as much as 3 weeks more pregnant than the dates we were using. I figured I would just have a bigger baby because I was further along than we'd assumed, and I was totally looking forward to the extra ultrasound to get more baby pics!

Then we got to the extra ultrasound and the techs were kind of looking around all weirdly, and they weren't talking much, and we became concerned. I could see the measurements they were taking up on the screen, and they were all consistent with the 34 week fetus I was then carrying -- except for the stomach. It measured something crazy like 28 weeks. Weird, huh?

So they grilled me and grilled me about my glucose test (which I'd passed with flying colors) and my blood pressure (which has always been low, even when I was pregnant) and I was just like, WTF guys? Then they told me -- it was excess amniotic fluid! Psh, I thought! Whatever! I googled and it said it was usually nothing, just some extra fluid, the vast majority of the time. It could also be gestational diabetes, which I knew I couldn't possibly have, and there was a small chance there would be something wrong with the baby's digestive system where it wasn't swallowing right. I figured it was the Nothing choice. They sent me to a... fetologist? I don't think that's the right word, but a guy who was a fetus expert and did fetal surgery and all kinds of crazy stuff.

First, a tech did the ultrasound. She couldn't find a stomach bubble. Just plain couldn't find it. I was freaking out.

Then the fetologist came in and did his thing. He said he found the stomach, he saw the baby swallowing, he said everything was just fine. I had to go back for non-stress tests every week the rest of the pregnancy, but it was fine. Just severe polyhydramnios, that's all -- your normal amniotic fluid index is, I think, 15 to 20 cm. I had 30 to 35!!! They were going to just doublecheck the baby when he was born and make sure everything was okay. And we had to be really careful if my water broke before I went into the hospital -- when you have polyhydramnios, your baby never engages into the pelvis. But if your water breaks, the baby immediately engages into the pelvis, and there is a huge, huge, huge risk of cord prolapse and strangulation because it happens so swiftly.

Anyway. Eli was born at 39 weeks, and we chose to have a controlled induction and artificial rupture of membranes for his safety. He came out just fine, well, he had an extra thumb, but the pediatrician checked him over and said everything else was perfect.

It was weird -- he didn't eat for more than a few minutes at a time, but heck, he was a newborn! And he kept coughing up this weird foamy stuff. Everybody figured it was just crud from his respiratory system that didn't get squeezed out because he ended up being a C-section.

After being awake for 48 hours, I finally decided at midnight the night after his birth that I HAD to get some sleep, which I hadn't been able to do because I was paranoid he'd cough up some more of that crap and choke on it. So I gave him to the nurse for a few hours and she was going to bring him to me if he got hungry, and I was going to be able to get a few hours.

Our lives completely changed that night.

About 5 in the morning on July 25, a doctor came and woke me up and took a seat in my room. Eli had coughed up more stuff. And then he had aspirated the stuff, and turned blue, and fainted, and then had a seizure, and had bloody stool. He was only saved from death after the hypoxic episode and subsequent seizure by quickly being "bagged," put on oxygen and given immediate resuscitation. If we had been home sleeping that night, Eli would have died or have irreversible, severe brain damage. As quickly as paramedics come, they wouldn't have arrived quickly enough for little Eli.

I got to see my baby one more time before he was taken to the regional NICU for suspected infection. He was hooked up to so many horrible tubes and the oxygen and he was lying in a bili bed, his eyes covered. It was horrifying. We stood there and just cried.

They figured out what his problem was pretty much immediately. He had a condition called tracheoesophageal fistula with esophageal atresia. Basically, that means his esophagus came from his mouth and ended in a blind pouch and the end coming from his stomach attached to his trachea instead. The crap he'd been coughing up was colostrum that sat in the pouch awhile and came straight back up. That's why he never digested any of his amniotic fluid. That's why I was so big.

They were able to do Eli's lifesaving surgery on his fifth day of life, and though he spent over two months in the hospital, he is home now, eating like a champ, and very happy.

But if we'd ignored the signs, if we'd figured he was just a big baby or twins or whatever, and if we had been planning a homebirth, things would have gone very badly and very wrong for poor Eli. He would, to be honest with you, he would be dead today.

I tell you all this just to give you and your husband a very, very big reason that you need to go get an ultrasound and see what's going on. You need to check on things. It could be nothing, or it could be twins, or something, but this sounds so familiar to me, and if you have another Eli, I want him to be safe. I want him to be lucky. Please, please, please, for the sake of your little one, make sure everything is okay.
sunshine28's Avatar sunshine28 04:18 PM 10-30-2012

With one of my babies, we did not hear a HB at 20 weeks, and there was no mvmt. and my extremelly experienced OB sent me for an U/S. Turned out the placenta was based in the front, and covered the whole area, so it was impossible for me to really feel things then. Later in the pregnancy, when the baby was bigger, I felt more.


Good luck!

Adaline'sMama's Avatar Adaline'sMama 09:36 PM 10-30-2012


I know you are wanting to avoid an ultrasound, but at this point in pregnancy I really, really think your midwife should be able to tell you if you are pregnant with twins regardless of dopplers or ultrasounds. Personally, Im not trained how to tell which baby parts are which at all and my babies are big enough for me to feel around in my uterus and know that something is in there besides just one baby. One of my friends is a midwife and she could feel exactly where both babies were two weeks ago (when I was 23 weeks. She felt right before I went in for a ultrasound just to see if she was right about location), so your midwife should be able to do the same thing at this point in your pregnancy.  The fact that she isn't concerned about it is a bit strange for me. Im glad you are seeing her in a few days, but if she doesnt order an ultrasound for you at that appointment, I strongly suggest you seeking a second opinion. 

Aside from issues you could have that pp's have mentioned even if it isnt twins, if you do have twins you will want to make sure that there is no TTTS or any other issues. There are more risks associate with twins, especially with mono-mono or mono-di twins, which you have no way of knowing without ultrasound.  It just seems like your midwife is taking this "wait and see" approach a little too far in my opinion and I worry that either you or your bab(ies) will be at risk because of her neglecting to attend to the issue. 


I'm also still beside myself as to why your husband is okay with a doppler but not an ultrasound. Is it just that he doesnt want to pay for one, or is he opposed to the act of getting one?

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