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• Contractions that occur every 15 minutes or closer (for more than 1 hour). Or, last from 20 seconds to 2 minutes each, or come closer together as time goes on.
• Sudden gush of vaginal fluid (your “bag of waters” breaks)
• Change in vaginal discharge. This discharge could be blood, water, or mucus.
• Pressure in your pelvis, back, or in the insides of your thighs. It feels like the baby is pushing down.
• A dull backache below your waist.
• Cramps like you get with a menstrual period.

Self-Care

• You will need more prenatal health care visits than with just one baby. You will need extra blood tests and blood pressure checks. Your provider will need to make sure each baby is doing well. Call your provider whenever you have questions during your pregnancy.
• Eat healthy foods.
• Eat smaller meals more often. This helps ease things as your growing uterus presses on your stomach.
• Take your prenatal vitamins (vitamin pills) every day. They should include iron and folic acid. They will supply other needed vitamins and minerals, too.
• Don’t smoke, drink alcohol, or take drugs.
• Exercise only with your health care provider’s consent. Women carrying more than one baby tire more easily. In later pregnancy, avoid any activity that takes a lot of energy. Avoid any activity that could injure you or your babies.
• Lie on your left side. This helps blood flow to the babies. It may help keep blood pressure down, too. It also makes you more comfortable. Don’t lie on your back.
• Reduce stress in your life. Stress can lead to early labor.
• Get quality sleep.
• Follow your health care provider’s advice on rest during the day.
• Get help with daily tasks, like caring for other children. If you can, take time off from your job after the 24th week.
• Watch for signs of preterm labor. Your provider may have you wear an electronic monitor. It senses contractions of the uterus.
• Choose a well-equipped hospital. Do this with your health care provider’s help. The hospital should be well suited for births of more than one baby. Choose one with a neonatal intensive care unit (NICU). This has special staff and equipment for babies born too early.