32 to 35 weeks pregnant with twins or multiples

Twins are probably still going to be developing in the womb a while longer, but the parents of triplets and other higher-order multiples may be getting close to the end of their pregnancy journeys now! This can happen in the form of spontaneous labor, but is also often prompted by a doctor’s evaluation of the pregnancy, and their assessment that it’s safer to have a C-section now than to continue to carry the pregnancy.

In order to make this evaluation at the right time, your doctor may have recommended in the last few weeks that you see them more often, and that you continue these more frequent visits up until delivery. This is the best way for doctors and healthcare providers to detect complications as early as possible. Multiples born around this point in time or later on tend to do very well, are much less likely to have lasting medical complications, and may spend much less time in the NICU when they’re born before they’re ready to go home.

Twin and multiples growth at 32 weeks

So if many babies that are born around this point do so well, what developmental steps are your little ones still working on in there? Well, the closer babies can get to gestation before they’re born, the more developed their lungs tend to be at birth. This means that the longer they gestate, the less likely they are to need help breathing when they’re born. The added weight and growth that happens in the coming weeks helps newborns regulate their own temperatures, too. In the last weeks, babies also start getting ready to open their eyes on their own.

This is also the point when twins or multiples’ development may start to differ from the development of single babies. Since twins and multiples are competing with each other for nutrients and space, their growth from this point on may start to level off a little sooner than it would for singleton babies. This may play a part in why twins and multiples tend to be smaller than singleton babies, although the biggest reason for this is still that twins and multiples are much more likely to be born before their due date than singletons are.

In general, doctors will try to prolong gestation in a twin or multiple pregnancy for as long as possible to give the babies as much time to develop as they can. However, if your doctor recommends scheduling a C-section for a certain point before your due date, it will be because they’ve detected a medical reason why it’s safer for you and your babies to have your pregnancy end earlier.

Sources

• American College of Obstetricians and Gynecologists. “Multifetal gestation: Twin, triplet, and higher order multifetal pregnancies.” National Guideline Clearinghouse. U.S. Department of Health and Human Services, May 2014. Retrieved January 25 2018. https://www.guideline.gov/summaries/summary/48025/multifetal-gestations-twin-triplet-and-higherorder-multifetal-pregnancies.
• Stephen T. Chasen, Frank A. Chervenak. “Twin pregnancy: Labor and delivery.” UpToDate. Wolters Kluwer, December 2017. Retrieved January 25 2018. https://www.uptodate.com/contents/twin-pregnancy-labor-and-delivery.
• Richard A. Ehrankranz, Mark A. Mercurio. “Periviable birth.” UpToDate. Wolters Kluwer, December 2017. Retrieved January 25 2018. https://www.uptodate.com/contents/periviable-birth-limit-of-viability?search=viability%20milestones&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2.
• William Goodnight, Roger Newman. “Optimal nutrition for improved twin pregnancy outcome.” Obstetricians & Gynecologists. 114(5): 1121-1134.
• Atsushi Kuno, Masashi Akiyama, Toshihiro Yanagihara, Toshiyuki Hata. “Comparisons of fetal growth in singleton, twin, and triplet pregnancies.” Human Reproduction. 14(5): 1352-1360. https://academic.oup.com/humrep/article/14/5/1352/766210.
• http://www.mfmsm.com/media_pages/MFM-Optimal-nutrition-for-improved-twin-pregnancy.pdf.
• Kenneth J. Leveno, J. Gerald Quirk, Peggy J. Whalley, Robert Trubery. “Fetal lung maturation in twin gestation.” American Journal of Obstetrics and Gynecologists. 148(4): 405-11. March 1984. Retrieved January 25 2018.
• Mayo Clinic Staff. “Twin pregnancy: What multiples mean for mom.” Mayo Clinic. Mayo Clinic, December 13 2014. Retrieved January 25 2018. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/twin-pregnancy/art-20048161.
• “FAQ: Multiple pregnancy.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, July 2015. Retrieved January 25 2018. https://www.acog.org/Patients/FAQs/Multiple-Pregnancy.
• “Tracking your weight, for women who begin a twin pregnancy at a normal weight.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Retrieved January 25 2018. https://www.cdc.gov/reproductivehealth/pdfs/maternal-infant-health/pregnancy-weight-gain/tracker/twins/normal_twin_weight_tracker__508tagged.pdf.
• “Twin pregnancy obstetric care guidelines.” Brigham and Women’s Hospital. Brigham and Women’s Hospital, June 28 2016. Retrieved January 25 2018. http://www.brighamandwomens.org/Departments_and_Services/obgyn/Services/twin-pregnancy/twin-pregnancy-obstetric-care-guidelines.aspx?sub=6.