The Third Trimester of Twin Pregnancy

Let’s start off by diving into the first trimester of a twin pregnancy – what you can expect for yourself, what your babies’ development looks like, and how you can set yourself up for a healthy, comfortable pregnancy.

Third Trimester of Twin Pregnancy
Any expecting mother entering her third trimester is starting to anxiously anticipate the arrival of her bundle of joy. If you’re expecting twins, you’re about to experience this twofold! If this is your first time carrying a multiple pregnancy, you may be wondering what you should expect and how this type of pregnancy may be different from a singleton pregnancy.

Last Trimester with Twins: What to Expect

As your twins are growing rapidly and getting ready to be able to survive on their own outside the womb, you’ll continue to experience belly growth up until your due date. For this reason, you may find that the fatigue, achiness, and weight gain you noticed in the second trimester continues or intensifies. 

Many mothers carrying twins in the third trimester experience swelling in the feet, legs, and hands, as well as backaches from the weight of the babies. Just make sure to keep your doctor updated on all of your symptoms, as some common pregnancy experiences, like swelling extremities, can also be symptoms of pregnancy complications. 

As you’re approaching the end of your pregnancy, your nesting instincts will start to kick in at full force. If you weren’t already feeling the urge to clean your home and get your babies’ living areas ready for them, you’ll certainly start to feel it now! 

Nesting is a normal part of the third trimester in any type of pregnancy, but it’s important to make sure you’re not overextending yourself. Get plenty of rest according to your doctor’s recommendations.

Stages of Twins Preganancy

Twin Pregnancy in the Third Trimester: Week by Week

Let’s learn a bit more about your babies’ growth and development during the third trimester on a week-by-week basis.

28-32 Weeks


The first half of the third trimester brings increased abilities for your twins. They will be able to open and close their eyes, their brains will be developing rapidly, and they will start to shed the fine hair that’s been protecting their bodies for the past several weeks.

33-36 Weeks


Your twins will continue to gain weight in the final weeks of your pregnancy, preparing them to support life outside the womb. However, it’s important to note that most twin newborns are smaller than singleton babies at their heaviest, with average weights of around five pounds at birth. Additionally, their lungs are getting ready to breathe on their own.

How to Have a Safe and Healthy Pregnancy in the Last Trimester with Twins

Balance Bed Rest and Activity


Carrying a multiple pregnancy can be exhausting to the body, which is why many mothers pregnant with twins may need more bed rest than singleton mothers. Ask your doctor how much you should be resting each day and whether some activity might actually improve your fatigue.

Watch for Pre-Eclampsia


Pre-eclampsia is a pregnancy complication that is related to sudden high blood pressure in pregnant mothers. Symptoms include swelling, excessive weight gain, blurred vision, and headaches. Most obstetricians will put their patients on bed rest if they’re showing early symptoms of pre-eclampsia.

Learn How to Spot Early Labor


You will likely start to experience Braxton Hicks contractions, or false contractions, as early as the second trimester. However, you may be going into early labor if you notice abnormal bleeding, more than four or five contractions in an hour, or cramps similar to menstrual pain.

Frequently Asked Questions

Sleeping on the left side often makes women who are pregnant with twins the most comfortable. This positioning optimizes your babies’ circulation and helps to reduce lower back pain.
The best way to avoid preterm labor is to take as many steps as possible to have a healthy pregnancy. This includes avoiding alcohol and drugs, eating a balanced diet, managing stress, and managing weight gain or loss during pregnancy.
Twin fetuses will generally gain around a quarter of a pound to half a pound during each week of the third trimester. At birth, twins tend to be around five pounds each at their healthiest.
Most mothers carrying twins should expect to gain 1 to 1.5 pounds per week in their third trimester. Multiple pregnancies usually come along with more weight gain, as the mother is supporting the development of more than one baby.
If you’re opting for a Cesarean section for your twins over vaginal delivery, the process will look very similar, if not identical, to the process of delivering a single baby through a C-section. Your doctor will make a small incision of five to six inches into your abdomen and uterus, which will allow your medical team to safely remove your babies.
Cramping during the third trimester of twin pregnancy can be caused by the weight of the babies, but it can also be caused by Braxton Hicks contractions or even preterm labor.

Mothers carrying multiple babies in the third trimester should expect fatigue, swelling of the extremities, and back pain as the babies continue to grow in size. Make sure to alert your doctor of any abnormal or uncomfortable symptoms.

Some common items included in hospital bags for twin deliveries include:

  • Nipple cream for breastfeeding or pumping
  • Nursing pads
  • Toiletries
  • Lotion
  • Comfortable clothing for both mother and partner
  • Pads with extra absorbency
  • Nursing bras or sports bras

Ask your doctor or nurse at your next checkup if you should include anything else for your specific needs.

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