More and more women today are pregnant with twins or higher order multiples. Delayed childbearing and techniques to treat infertility have brought an increase in multiple births – and with multiple babies comes special care for the expectant mom.

A multiple birth automatically puts a pregnant woman in the "high-risk" category, but that doesn't necessarily mean there will be problems during pregnancy. Obstetricians will watch for potential complications such as preterm labor, hypertension, gestational diabetes, loss of one or more babies or other difficulties. With conscientious prenatal care, both Mother-to-be and Babies can thrive.

Keep Your Eyes on the Goal
When Laci Mulick of Omaha, Neb., found out she was pregnant with twins, she was already 18 weeks along. "I didn't have time to worry,” she says of her successful delivery of two healthy babies at 35 weeks. “I was in shock for so long that it was time to deliver before I knew it."

If you are pregnant with multiples, you will see your doctor more frequently than a mother carrying one baby. This close monitoring of you and your babies will help a physician detect potential problems and help to ensure you carry your babies as long as possible.

"The most important thing we watch for is preterm delivery," says Dr. Michael Pluvial, physician of maternal-fetal medicine at Brown Medical School’s Women and Infant's Hospital in Providence, R.I. According to Dr. Pluvial, if moms-to-be of multiples deliver at 32 weeks or later, the babies have a greater chance for survival and fewer complications in general. The goal is to reach 36 weeks for a twin pregnancy, 34 weeks for a triplet pregnancy and 30 weeks for a quadruplet pregnancy.

Prenatal Care Guidelines
Although multiple pregnancies are considered high risk, it's not a good idea for moms-to-be to add the stress of worrying about possible complications. Instead, focus on taking good care of yourself and carrying your babies to term.

Kimberly Clayton of Jamesburg, N.J., gave birth to healthy twins in March. "I was very worried about having a high-risk pregnancy,” she says. “You never know what to expect when you're pregnant with multiples, and I think losing one of the babies or going into labor too soon were probably my biggest worries.”

This is why prenatal care is so crucial, says Clayton. Prenatal care allows for close monitoring of you and your babies. "The rate of birth defects, miscarriage, preterm delivery, placental abruption, gestational diabetes, pre-eclampsia, fetal growth restriction and amniotic fluid abnormalities is increased in multiple gestation," says Dr. Plevyak. While some of these conditions may not be entirely preventable, proper nutrition, hydration, rest and consistent prenatal care are vital for a healthier pregnancy.

Basic guidelines for women carrying multiples include monitoring weight gain. You should add at least 300 calories per day to your diet. If you are carrying triplets, gaining 10 pounds more per baby is a good rule of thumb. Prenatal vitamins are a must, and most doctors will increase iron and folic acid intake as well.

It’s also important to drink at least 2 quarts of water a day. Dehydration can cause contractions, which can lead to premature birth. Rest is another important factor: About half of all women carrying multiples will spend part of their pregnancy on bed rest. Depending on your job, your physician also may prescribe some time off from work. "I feel the risk of delivery may lessen with decreased activity,” says Dr. Plevyak. “I often take a mom out of work if they are a waitress, but not if they have a desk job." Making a conscious effort to rest frequently may decrease the likelihood of bed rest.

Prenatal Tests
As a mom of multiples you will probably have more prenatal tests than during a singleton pregnancy. Don't be alarmed. These tests are done as a precautionary measure to identify complications or monitor your iron or glucose levels.

Tracie Madden, mom to twin boys in North Hills, Calif., had an ultrasound at every prenatal appointment with her OB/GYN and perinatologist. A perinatologist is an OB/GYN who has additional education and practical experience in the area of obstetrical, medical and surgical complications of pregnancy.

Although Madden had no additional risk factors, her OB/GYN encouraged her to see a perinatologist regularly. For Madden, it was exciting to watch her twins grow. "I have a photo album documenting their growth during pregnancy," she says. Madden’s ultrasounds also showed formation of the twins’ internal organs, checked placenta placement and revealed the babies’ positions. Moms-to-be of multiples also can expect periodic blood tests to detect possible complications.

Donna Wheeler of Norcross, Ga., is 35 and expecting twins. Because of her age and because she is carrying multiples, she is at a higher risk for complications. After talking with her doctor, Wheeler made the decision to have an amniocentesis, a sampling of amniotic fluid obtained through a needle inserted into the womb, which is then tested to determine the health and genetic constitution of a fetus.

"We want to be fully prepared to deal with any problems the twins might have when they are born," says Wheeler. Knowing the results of an amniocentesis, says Wheeler, will allow her and her husband to enjoy the pregnancy, to get proper medical treatment if necessary and to prepare themselves for parenthood.

If you are a woman carrying twins, triplets or more, the seemingly endless tests may seem daunting – but they are worth it in the end. The best advice from moms who have been there? Keep your eye on your delivery date goal and the beautiful babies you'll soon love and cuddle.

Want to see more?

• The Home Stretch: Surviving the Last Trimester With Twins
• The Bed Rest Blues: Moms Share Their Tips on How to Survive
• Keep Those Babies in There: Avoiding Premature Delivery With Twins
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