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For many, pregnancy is an overall joyous time of looking forward to the future and what life is about to bring. However, it is no secret that with this incredible excitement also comes some discomfort, and even pain. This begs the question: is the level of pain within a twin pregnancy greater than that which is experienced in a single-fetus pregnancy?
Twin pregnancies do come with greater instances of pain, such as back pain, heartburn, and muscle cramping. A mother carrying twins has twice the number of babies within her uterus as a mother carrying a single baby. With this in mind, it is no wonder that there may be added difficulties (and joy) to a twin pregnancy.
Increased pain experienced during twin pregnancy often includes back pain, indigestion, fetus movement, muscle cramping, ligament pain and emotional distress. Some good news: the increased pain is temporary and often treatable. Keep reading to learn more about these uncomfortable symptoms and ways to help alleviate suffering.
Why is Twin Pregnancy More Painful?

With two babies to carry, expecting mothers of twins often have double the instances of various forms of pain compared to expectant mothers carrying a single fetus. Categorized below are some of the types of pain that can occur.
Back Pain
During twin pregnancy, mothers can gain upwards of 30 to 50 pounds of weight. This weight gain alone can cause a significant difference in back pain experienced by expectant mothers. The heavier weight is not only more for the body to carry, but also adds difficulty to maintaining a healthy posture. Additionally, the expansion of the uterus to accommodate the growing fetus’ creates a shift in the body that puts more pressure on the spine, causing increased pain and potentially misalignment of the spine.
Some common tips to help with back pain include wearing comfortable and supportive shoes, practicing specific stretches and exercises, trying various sleep positions, and using support bands or other products to help carry the added weight.
Indigestion
Indigestion, also known as heartburn, is a common symptom of pregnancy in general, but is more frequently found in twin pregnancies. While this feeling of burning in the chest is not life-threatening, it can be very uncomfortable and downright painful.
Why does heartburn occur so frequently in twin pregnancy? Due to the increased size of the uterus to hold two babies and the pressure that this adds against other organs, stomach acid can be sent back up to the esophagus instead of continuing into the proper trajectory. Adding to the likelihood of experiencing heartburn, the increased release of the hormone progesterone allows for easier access of stomach acid back into the esophagus.
Ways to alleviate heartburn include eating smaller meals, wearing comfortable clothing, and limiting foods such as tomatoes, spicy food, caffeine, greasy food and drinks with carbonation. With these tips, the experience of heartburn should decrease in occurrence and severity.
Fetus Movement
For many women, experiencing the first movements of their child is a magical and beautiful moment. As time goes on, however, these kicks, punches, and elbows may become uncomfortable and painful, especially for twin moms who have twice the amount of movements to contend with! While the uterus does expand, there is still limited space for the wiggles of a fetus. With twins, the space is even more limited due to the needs for movement being multiplied by two.
When a fetus moves, their limbs and other body parts are actively hitting the organs and other internal body parts of the mother. These blows can range from a slight butterfly feeling to a sharp, unexpected pain. For some moms, speaking softly, listening to music and even softly rubbing their bellies can help soothe and minimize movement to a certain degree or area.

Muscle Cramping
We have all experienced muscle cramps at some point in our lives, if not regularly. For pregnant women, muscle cramping can cause added stress and pain when the body is already going through so much as it is. Because of the extra weight being carried within a twin pregnancy, muscles may cramp more frequently for expectant mothers. Some causes of cramping may include dehydration, overuse, compression of nerves, blood circulation issues, or depletion of minerals/vitamins within the body. To combat these issues, it is important to drink plenty of water, stretch frequently and take the vitamins suggested to you by your physician.
Ligament Pain
While we are all familiar with the stretching of the uterus during twin pregnancy, you may want to also pay special attention to the ligaments that surround the uterus. These ligaments help support the uterus in its important job of carrying twins, but they can also be a source of pain for women throughout pregnancy. Like the uterus, the ligaments surrounding the uterus (particularly, the round ligament) stretches. This stretching is a natural response to the pregnancy process.
When movement occurs, either from the mother or one of the twins, the round ligament may tighten very quickly- causing a sharp pain to occur in the lower abdomen. This can occur at anytime throughout pregnancy but is most frequently felt in the second trimester. Even a slight sneeze or laugh may cause an instance of round ligament pain. Doctors may allow certain pain relievers to help, if necessary, but otherwise various exercises and hip flexing are common remedies.
Emotional Distress
Pregnancy can be wonderful and a dream come true for many individuals and couples. However, it should not be discounted that women also experience many stressors during this time in their lives, sometimes made more difficult due to hormonal shifts from pregnancy. During twin pregnancy, hormones change even more rapidly and dramatically than within a single fetus pregnancy. This change can create havoc on a woman’s emotions and overall mental health.
Some of the stressors that may come along with twin pregnancy are worries about finances, housing, family, health (of baby and mom), employment, the future, etc. Each of these categories can cause an individual to feel overwhelmed and being pregnant may make these challenges feel even more out of one’s control. During twin pregnancies, this distress is often multiplied due to needing to house and care for two babies versus one. This distress is not only harmful and emotionally painful, for the mother, but it is also dangerous for the unborn babies.
To improve mental health, professionals recommend:
- Having a supportive network of friends and family
- Talking with your loved ones
- Talking with a mental health professional
- Mentioning your stress to your OBGYN
- Practicing meditation, or something similar
- Eating healthy and exercising when advisable
Additional Avenues for Pain Management During Twin Pregnancy
During twin pregnancy, you will likely see an OB-GYN (a doctor who specializes in women’s reproductive health during pregnancy), a midwife, or other medical professionals. With whichever route you choose to take, make sure to communicate your worries and feelings with these individual/individuals. These professionals will become your team and are there to support you with the knowledge that they have gained through extensive schooling and experience.

In conclusion – twin pregnancies may be more uncomfortable, but speak with your doctor for advice specific to you
Pain management is a common topic within the overall theme of twin pregnancy. It is important to realize that there are many techniques available to help you through your pregnancy, and that it is okay, and maybe even necessary, to be creative with your pain management path. With so many techniques to try, there is hope that a solution exists for you.
While twin pregnancy comes with many challenges that may sneak up on you, the end results of this tremendous time in your life are topped off with the addition of two new family members. When you look into the eyes of these two new little infants, all of the pain and distress will have been worth it. The world begins again and eventually, the pain is long gone. Up next is the incredible journey of motherhood.