All About Pregnancy with Twins and Multiples

Double, triple, or quadruple the love! An overview of what to expect if you’re carrying more than one pēpi.

Around 2% of pregnancies in New Zealand are twins, 75% of which are fraternal and 25% are identical.

Fraternal twins occur when two separate eggs are fertilised at the same time. Fraternal twins may be the same sex or different.

Identical twins develop when one fertilised egg splits into two, resulting in two babies. Identical twins are always the same sex and will look very alike. They may share an amniotic sac and placenta or have their own.


LMC care

Pregnant people who are carrying twins (or more) are considered ‘high-risk’ so if you have already chosen a midwife or GP as your LMC, they must refer you to a specialist and transfer your care to this specialist doctor.

You may have mixed feelings about this change in care and understandably so, especially if you have had your midwife for a previous pregnancy or have built a good relationship with them already. In some circumstances, your midwife may be able to continue to provide some of your care in partnership with the specialist doctor – discuss this with them if shared care is an option that you’d like to have considered.


Additional screening

Due to being deemed ‘high-risk’, it will be recommended that you have more frequent ultrasound scans during your pregnancy with multiples than if you were carrying just one pēpi. Having these scans more often is important for monitoring the growth and development of your babies and to check for serious conditions, like Twin to Twin Transfusion Syndrome (TTTS).


Preparing for multiples

  • Planning for birth with twins (or more) looks different in every pregnancy. The choice between a planned C-section or trying for a vaginal birth depends on many factors. The healthcare professionals looking after you will discuss your options for birth to best provide a safe and healthy outcome for you and your babies.
  • Twins are often delivered early, sometimes from 26 weeks. Make sure you have packed everything you need well in advance… just in case!
  • You’ll need enough supplies for both (or all) of your babies, including a car seat each, nappies, clothing, cots, and a pram.
  • With double or triple the changing and feeding, having plenty of help on hand at home can make the adjustment that much easier. Ask friends or whānau to lend an extra hand in the weeks after birth.
  • If you’re having triplets or you already have a child or children and are having twins, you may be eligible for the Work and Income Home Help Payments to help with household tasks. Visit for more information.
  • It’s possible to produce enough milk to breastfeed twins or triplets – your supply adjusts to the demand. Ask your doctor or midwife for advice on preparing for breastfeeding with multiples.