Can you tell early?
If you’re newly pregnant and feeling more intense symptoms than expected, you might wonder — could you be carrying twins? Is it just normal pregnancy fatigue and nausea, or something more?

Though the only certain way to confirm a twin pregnancy is through an ultrasound, there are several early signs that may hint at having more than one baby.

Are there early signs of twin pregnancy?


Pregnancy brings hormonal shifts and physical changes from the very start. Some of these may feel more pronounced if you're expecting multiples.

While some people have a gut feeling they’re carrying twins, for many others, it’s a complete surprise at the first scan. Below are common symptoms that could indicate a twin pregnancy during the early weeks.

Nausea and Morning Sickness
Morning sickness can start around week 4 of pregnancy. It may be triggered by rising levels of the hormone hCG. While the name suggests otherwise, nausea can happen any time of day.

When expecting twins, some people experience more severe or longer-lasting nausea. If you’re still dealing with morning sickness past the first trimester, or if it’s intense, this could be a sign of multiples — though it could also point to a condition called hyperemesis gravidarum. Always speak with your doctor if nausea affects your daily life or leads to weight loss.

Extreme Fatigue
Feeling tired early in pregnancy is common. Hormonal changes, increased blood production, and disrupted sleep can leave you feeling worn out even before a missed period.

With twins, fatigue might feel even more intense. If you’re struggling to stay energized, try adjusting your schedule to allow more rest and talk with your healthcare provider about ways to manage your energy levels.

Elevated hCG Levels
hCG, or human chorionic gonadotropin, is a hormone produced during pregnancy. While home tests only confirm its presence, blood tests can measure how much hCG is in your system.

Higher-than-average hCG levels may suggest a multiple pregnancy, especially if monitored closely in fertility treatments. However, high hCG can also occur in single pregnancies, so this alone isn't enough to confirm twins.

Detecting a Second Heartbeat
A baby’s heartbeat can often be detected by a fetal doppler between weeks 8 and 10. If a healthcare provider suspects a second heartbeat, they may recommend an ultrasound for confirmation.

Larger Belly Measurements
Healthcare providers typically start measuring your belly after 20 weeks. Measuring larger than expected may prompt your provider to check for multiple babies. While some people show earlier in twin pregnancies, body type and previous pregnancies also play a role.

Feeling Movement Early
Fetal movement is usually felt between weeks 16 and 22. In some twin pregnancies, people report feeling movement a bit earlier, but this is more common in those who’ve been pregnant before.

Faster Weight Gain
Weight gain tends to be slow in the first trimester. On average, people gain 1–4 pounds in the first 12 weeks. If you’re gaining weight more quickly, it could be due to twins — or simply normal variation.

Guidelines from the CDC suggest the following total weight gain during twin pregnancies, depending on your BMI before pregnancy:

  • Underweight (BMI <18.5): 50–62 lbs

  • Normal (BMI 18.5–24.9): 37–54 lbs

  • Overweight (BMI 25–29.9): 31–50 lbs

  • Obese (BMI ≥30): 25–42 lbs

If you’re concerned about how much or how little weight you’re gaining, your doctor can provide personalized guidance.

Ultrasound Confirmation


Despite possible symptoms, the only way to know for sure if you’re carrying twins is with an ultrasound. This may be done between weeks 6 and 10 to confirm the pregnancy or rule out concerns.

Even if you don’t have an early scan, a routine anatomy ultrasound around 18–22 weeks will confirm the number of babies you’re expecting.

How Likely Is a Twin Pregnancy?


According to CDC data, about 32.6 out of every 1,000 births in the U.S. are twins. Certain factors — such as older maternal age, family history of twins, or fertility treatments — can increase your chances.

Final Thoughts


Being pregnant with twins can be exciting, but it also comes with unique health considerations. Whether you’re expecting one baby or more, early prenatal care and regular checkups are key to a healthy pregnancy.

If you’re wondering whether your symptoms could mean twins, the best approach is to stay in touch with your healthcare provider and schedule recommended ultrasounds. Take care of your body, stay informed, and enjoy the journey — no matter how many little ones are on the way.