Remembers Karen Jahnke, who has a 12-year-old, a nine-year-old, and a four-month-old in addition to her one-year-old twins, "I started to spot early on, which my doctor said was more common when carrying multiples. My hormone levels continued to rise even while I was spotting, alleviating any fears of miscarriage."
Dr. Warhus confirms, "Occasionally spotting may be a sign of [multiples]. Early on, there is a somewhat higher chance of miscarriage. But even if no miscarriage occurs, early twin pregnancies may spot more than early singleton pregnancies."
Abnormal Test Results
Many women opt to have the AFP (alpha fetal protein) test midway through their pregnancies to check for fetal abnormalities, and it may be at this point that a multiple gestation is suspected.
Warhus notes that, "Mothers with twins often have abnormal AFP results. The AFP test is typically done between 15 and 18 weeks gestation, often before an ultrasound. The hormonal laboratory parameters are designed for one baby. So if you have two or more and you don't know it, but have the AFP test anyway, there is a good chance that the results will come back abnormal. Fortunately, the first thing you do when you get an abnormal AFP result is get an ultrasound, and in the case of [multiples], you'd have your diagnosis right there."
Many women's hormone levels are off the charts early on. Doctors often put two and two together and opt to do an early ultrasound, at which time they discover a multiple gestation. This was the case for Jahnke, who, after multiple bouts of spotting and higher than normal hormone levels for her estimated week of gestation, was given an ultrasound. It was at that point that the cause of her spotting and elevated lab results was determined.
Years ago, many parents didn't find out that they were expecting more than one baby until they got into the delivery room. These days the diagnosis is most often made long before that blessed event. Thankfully, this allows parents much more time to adjust, not to mention decorate a nursery that is fit for a king (or two).