HEDI - Multiple Pregnancy

Sometimes pregnant people suspect early on that there is more than one baby on the way. For example, severe morning sickness may be a sign of a multiple pregnancy. Your doctor will tell you for sure how many babies you are expecting. A multiple pregnancy can be clearly detected during the first ultrasound examination. A distinction is made between identical and fraternal twins. The pregnancy usually proceeds in the same way in both cases. But it is important to find out if the fetuses share a placenta. This is only readily apparent in early pregnancy. For this reason, gynaecologists recommend that the first ultrasound examination should be carried out between the ninth and twelfth week of pregnancy.

Multiple pregnancies are high-risk pregnancies

Any multiple pregnancy is classified as a high-risk pregnancy. This means that the probability of an irregular course of pregnancy is increased. But that's nothing to worry about. The result of this assessment is just that you are particularly well taken care of. However, it is important that a multiple pregnancy is detected as early as possible so that it can then be determined whether twins are sharing a placenta, for example. If this is the case, one of the things that will be paid more attention to is making sure that each baby has enough nutrients and an adequate blood supply. Otherwise, there is a danger that one will remain very small and the other will become very large. Problems with the babies’ cardiovascular systems can then also occur. Regardless of the number of fetuses, check-ups happen more often with multiple pregnancies. Up to the 28th week of pregnancy, they are performed every two weeks, then weekly from the 28th week of pregnancy on.

Possible complications

Your body is under a lot of strain with a multiple pregnancy. Due to the particular hormonal situation, you may experience more severe pregnancy symptoms. This includes severe morning sickness. Elevated blood pressure is also a common problem. It is also one of the signs of pre-eclampsia. This issue used to be called ‘pregnancy poisoning’ in German. But it is actually a disorder in which the body has difficulty adapting and which is associated with high blood pressure and water retention. Sometimes pre-eclampsia becomes eclampsia. Then, in addition to the problems described above, there are other severe symptoms, including headaches, seeing auras or shapes in your field of vision, and seizures. Eclampsia is an emergency and must be treated immediately.

Your pregnancy will be particularly well observed

Your babies will be watched especially closely during pregnancy so that if they are undernourished, a quick response can be taken. There is an increased risk of miscarriage, especially during first trimester. Sometimes an embryo dies, in many cases even before the multiple pregnancy is discovered. The other baby or babies can still go on to develop normally. The loss of a baby, even at an early stage of development, is difficult for many people to cope with. If you are affected, be sure to reach out to trusted people. You can also talk to your doctor or midwife. They can also recommend points of contact where you can talk to trained counsellors about your painful experience.

Giving birth to multiples

The greatest possible safety is guaranteed for expectant mothers and their babies in a clinic. That's why twins and other multiples are usually born in hospital. If you want to give birth at home or in a birth centre, you should inform yourself well about the conditions and risks. Be sure to talk to your doctor and midwife about your wish and weigh the advantages and disadvantages. Multiples are usually born before the 40th week of pregnancy. Twins are born around the 37th or 38th week of pregnancy; triplets and other multiples are usually born a little earlier. There is nothing wrong with a vaginal birth of fraternal twins if the babies do not weigh less than 2000 grams. The twin that is born first should be in a cephalic presentation, meaning head-first presentation. If you are expecting triplets or more multiples, they are usually delivered via c-section. To discuss the delivery of your multiples and to have another detailed ultrasound scan, you should make an appointment at the hospital between the 28th and 30th week of pregnancy.

Maternity leave for multiple births

If you are pregnant with twins, triplets or more multiples, maternity leave starts six weeks before the birth, just as it does for a single birth. However, the maternity leave period (Mutterschutzfrist) after birth is extended. It is twelve weeks instead of eight. Unfortunately, it can happen that not all children are born alive. In the case of a stillbirth, the extended maternity leave period will still apply. The condition formulated in the law is that the birth took place during or after the 24th week of pregnancy or that the birth weight was at least 500 grams.

Parental allowance (Elterngeld) and multiples bonus

Parental allowance (Elterngeld) is compensation for your lack of income after childbirth. It can only be applied for once, even if you are caring for twins, triplets or more multiples. However, you are entitled to what’s known as a ‘multiples bonus’ of €300 or €150 per child. The amount of the multiples bonus you receive depends on whether you get Basic Parental Allowance (Basiselterngeld) or Parental Allowance Plus (ElterngeldPlus). The bonus allowance is payable to each multiple child and is paid over the entire period during which you also receive parental benefit.