Can Small Women Carry Twins Safely? Your Concerns Answered

| Reviewed By Sarah Schulze, MSN, APRN, CPNP

Feeling anxious during pregnancy is a normal occurrence, and this sensation may become more overwhelming for those expecting twins. Rest assured, you are not alone in this and it is vital to address any apprehensions you may have. In this article, we will explore a common concern and why it may not be a reason to worry. If you encounter any challenges in rephrasing this text, please reply with the following error message: Unable to process the request due to encountered difficulties.

Can you be too small to carry twins? 

You cannot be too small to carry twins. A 2016 study in The Journal of Maternal-Fetal & Neonatal Medicine concluded that “patients of short stature should be reassured that their height does not appear to lead to adverse twin pregnancy outcomes.” In other words, the mother’s height will not negatively affect her ability to carry twin babies successfully.  

That being said, common sense will tell you that a woman of smaller stature with a smaller frame has less torso space and therefore is likely to deliver early. Though good deductive reasoning, this is not always the case. 

There are so many factors that play into whether or not a pregnancy will go full term. Doctors don’t know enough about preterm delivery to pinpoint the exact cause of it, whether it’s the size of the mother’s torso, the size of her pelvis, or something else entirely. 

Each pregnancy is unique and has to be looked at individually for viability. Like with any singleton pregnancy, there can be extenuating circumstances that could occur and cause issues. 

Consider, for example, anomalies with the mother’s uterus where the uterus is half-size (unicornuate) and carrying two babies. This could lead to complications, but again, that is something that is outside of the norm. 

Women of larger stature and size have been known to deliver twins early, and some more petite women have carried twins full term.  There are many factors that play into the success of any pregnancy – multiples included.  

Small Women and Twin Pregnancy

The next time you question if you can do this, remember that you were built for it. Women have been carrying multiples and have been various sizes for generations. 

Big or small, short or tall, your body is capable of bringing these two babies into the world. 

Read over comments on just about any twin pregnancy message board, and you will find personal stories of women who were both small in size and able to welcome their healthy babies – even some who carried to full term when nearly 60% of twin pregnancies end in preterm birth. 

So what risks should twin Moms be concerned about and why?

Twin Pregnancy Risks to Mother    

Carrying twins does present increased risks. These are some of the most common complications that can occur with a twin pregnancy.

Preterm Labor and Birth 

Over 60 percent of twins are born premature (born before 37 weeks). Very premature babies, those born before 28 weeks, are especially vulnerable. 

Many of their organs may not be ready for life outside the mother’s uterus and may be too immature to function well. Many multiple-birth babies will need care in a neonatal intensive care unit (NICU).

Gestational Hypertension 

Twin mothers are at a higher risk for developing Gestational Hypertension, also referred to as Pregnancy-Induced Hypertension (PIH). This condition is characterized by high blood pressure during pregnancy and can lead to a serious condition called Preeclampsia, also referred to as Toxemia. 


Anemia is more than twice as common in multiple pregnancies as in a single birth.

Cesarean Delivery 

Twin mothers may require a c-section delivery if the leading baby is in an abnormal position.

Postpartum hemorrhage

According to Cleveland Clinic, the large placental area and over-distended uterus place a mother at risk for bleeding after delivery in twin pregnancies.

Does a Small Frame Mean High Risk?

No, having a small frame doesn’t mean that your pregnancy will automatically be problematic or defined as high risk, but carrying twins does. Women carrying multiples have a higher chance of developing complications like the ones listed above, and for that reason, twin pregnancies are considered high risk. 

“High Risk” can sound alarming when you don’t have a good understanding of what it means. The American Pregnancy Association defines High-Risk Pregnancy as a pregnancy that requires “extra care” to be successful. 

With twins, you will have more frequent prenatal visits because a twin pregnancy simply has more things to keep an eye on, and your doctor will want to monitor you more closely.

Can Smaller Women Carry Twins Full Term?

“Wow, you’re pregnant with twins. . . Where will they fit?. . . You’re so tiny!”

People love to comment on pregnant women’s bodies, but you can reassure them that, yes, you are more than capable of carrying twins. 

While it may be possible that you will deliver early, being a woman on the smaller side isn’t the deciding factor in whether or not you will carry your babies to term. 

Women carrying twins who are more petite or who were underweight before conception may want to look into the correlation between appropriate weight gain and the delivery of healthy twins. 

In their book, When You’re Expecting Twins, Triplets or Quads, Proven Guidelines for a Healthy Multiple Pregnancy, Dr. Barbara Luke and Tamara Eberlein state that the “rate and pattern of maternal weight gain has a strong influence on the rate of fetal growth and ultimate birthweight.”

Put more simply, they assert that delivering healthy twins has a lot to do with the mother gaining the appropriate amount of weight during pregnancy, and in their book, they outline specifically how much to gain week by week based on BMI. 

When To Stop Working When Pregnant With Twins?

If you are working and pregnant with twins, you may be wondering if you should take leave early. Keep in mind that a little more than half of all twin pregnancies deliver preterm (before 37 weeks), with most of them delivering between 32 and 38 weeks. 

The Family & Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave. It can’t hurt to ask for a little longer from your employer since you will be welcoming not one but two babies home, but there is no guarantee that they will make any accommodations. 

It’s a personal choice, but you may want to consider taking leave somewhere in the window between 32 and 38 weeks. Keep your employer looped in as things progress, and make changes as needed. 

Twin Pregnancy Care Tips

Taking care of yourself during your pregnancy is the best way to take care of your growing babies. Here are a few twin pregnancy care tips: 

  1. Weight Gain/Healthy Diet: Eating the right amount is important for any pregnancy but especially so when you are supporting not one but two growing babies.
  2. Staying Hydrated: Drinking plenty of water during pregnancy can help fight fatigue, keeps your body from overheating, and helps your body absorb essential nutrients.
  3. Exercise: Yes, we realize that you are pregnant with twins, but even so, staying active is important. Talk to your healthcare provider about safe ways to keep active during your pregnancy.

Related Questions:

Is Bed Rest Required for Twin Pregnancy?

Bed rest is not required for twin pregnancies but may happen due to complications in the pregnancy. Some of the complications that may lead to bed rest are preeclampsia, incompetent cervix, premature labor, vaginal bleeding, gestational diabetes, or placenta issues.

Are Twin Pregnancies Always High Risk?

Women carrying multiples have a higher chance of developing complications, and for that reason twin pregnancies are considered high risk. “High Risk” can sound alarming when you don’t have a good understanding of what it means. 

With twins, you will have more frequent prenatal visits because a twin pregnancy simply has more things to keep an eye on, and your doctor will want to monitor you more closely.


Many factors play into the success of any pregnancy – multiples included.  Simply being smaller in stature or more petite is not a determining factor for whether or not you will successfully carry your twins to term. 

Women of all sizes and shapes have been carrying twins for generations. Caring for yourself properly by eating the right amount of food, staying active, and attending regular prenatal visits are all great ways to help keep potential complications at bay and have a successful pregnancy.