Jump to ratings and reviews
Rate this book

When You're Expecting Twins, Triplets, or Quads: Proven Guidelines for a Healthy Multiple Pregnancy

Rate this book
When You’re Expecting Twins, Triplets, or Quads by Dr. Barbara Luke & Tamara Eberlein is the revolutionary, nutritionally based prenatal program for the growing number of women pregnant with multiples. Revised and expanded for an era when multiple births are on the rise, the third edition of When You’re Expecting Twins, Triplets, or Quads includes updated diet and exercise recommendations for the postpartum mother as well as twenty-five new recipes.

512 pages, Paperback

Published December 28, 2010

238 people are currently reading
255 people want to read

About the author

Barbara Luke

15 books1 follower

Ratings & Reviews

What do you think?
Rate this book

Friends & Following

Create a free account to discover what your friends think of this book!

Community Reviews

5 stars
390 (34%)
4 stars
449 (40%)
3 stars
217 (19%)
2 stars
46 (4%)
1 star
17 (1%)
Displaying 1 - 30 of 156 reviews
Profile Image for Meredith.
4,114 reviews73 followers
October 12, 2018
When you're expecting twins, triplets, or quads, expect to be frightened if you read this book. The overall impression that this book gives is that if you're having a pregnancy with multiples, you should expect to have serious complications, will need a high risk specialist even if you're having twins rather than triplets or beyond, and better unquestionably and blindly obey your doctor's orders or else you are jeopardizing the lives of your unborn children. Anecdotes have been proven to trump statistics and medical evidence every time, and this book is loaded with anecdotes to support the authors' every statement.

Although this book does seem to contain some good information from a supposedly authoritative source, it does a lot of fear mongering under the guise of informing mothers-to-be. ". . . now that you're pregnant, you must hand over control to the people best qualified to make the decisions about your care: your obstetrician and other health care team members." (page 185) These type of statements are not only paternalistic and condescending, but they show a blatant disregard for the legal requirement of obtaining informed consent. Any medical treatment conducted without a patient's informed consent is unethical by professional standards in addition to legally being considered to be assault. In order for a patient to give informed consent, the clinician must make every effort to be sure the patient understands the purpose, benefits, risks, and alternatives as well as provide the opportunity for the patient to ask questions and discuss all options with family members and/or other medical professionals. If the patient is expected to simply comply without being informed of the reasons behind a course of treatment, the benefits, the risks, and any alternatives, which include waiting or doing nothing, then that patient cannot legally consent.

It also contains some glaringly questionable advice, which casts a doubt on all of the "proven" guidelines laid out in the book. For example, Dr. Luke recommending fast food as a good source of calories especially for women on bedrest due to complications (pages 100 to 101). Recommending food that is excessively high in sodium, cholesterol, and saturated fats for pregnant women who are at an elevated risk of problems such as high blood pressure and gestational diabetes or who are already suffering from complications, really?! In one of the patient testimonials, one of Dr. Luke's patients tells how Dr. Luke brought her an Egg McMuffin and hash browns from McDonald's every single morning when she was on mandatory hospital bedrest (page 163). Apparently, the doctor did not trust the hospital's dietitian when it came to her patient's diet.

Another questionable bit of advice is the edict not to try to bargain with your doctor but to do whatever s/he says is in the best interest of your unborn children. Again, demanding that patients obey all physician orders without question flaunts informed consent. Dr. Luke includes asking your health care provider to agree to a vaginal birth (in case of twins; all other multiple pregnancies are automatic c-sections) as an example of unreasonable bargaining. It is in no way unreasonable to ask your doctor to commit to allowing you to attempt a vaginal birth of twins. The guideline from the American Congress of Obstetricians and Gynecologists recommends allowing the vaginal birth of twins as long as Baby A is head down and neither twin show signs of distress. If a doctor is unwilling to deliver twins vaginally regardless of their positions at the onset of labor or if Baby B is breech, mothers carrying twins will need to know as soon as possible, so they can switch doctors if they wish to attempt a vaginal delivery as is deemed acceptable by ACOG, the governing body for American Ob-Gyns. Most ob-gyns won't accept new patients who are over 25 to 30 weeks pregnant, so this is something that women need to have disclosed to them as soon as a twin pregnancy is diagnosed.

When the doctor discusses weight gain, she does give the useful fact that multiples gain weight more slowly in the second half of pregnancy because they run out of room more quickly than a single baby, but her recommendation to gain as much weight as possible as early as possible is not fully explained. That would make the fetuses run out of room sooner, but does that just benefit them because presumably they're going to be very premature? How does rapid early weight gain not contribute to intrauterine growth restriction? And Dr. Luke also doesn't explain how a mother can make sure that she is gaining weight because the unborn babies are growing and not because she's simply getting fat, which will increase her odds of developing many complications for which she already has a higher risk of developing simply because she's having a multiple pregnancy. And the doctor's flippant comment that "You probably need to gain more weight than you imagined" (page 56) is extremely ignorant. Many women gain the 75 lbs that is the max healthy gain for triplets when having a singleton pregnancy; providing this license for uncontrolled overeating can endanger a pregnancy that is not high risk. It is reckless to recommend this type of behavior for a high risk one. Rather the doctor should have stressed the guidelines for a healthy weight gain and paid more heed to healthy food rather than singing the praises of McDonald's and other highly processed commercial fast food. This encouragement of unhealthy eating greatly troubled me.

Another minus is the structure of this book, which lumps all multiple pregnancies into the single category of "multiples." This hurts the quality of advice since pregnancies with twins, triplets, and quads can vary dramatically. Someone pregnant with twins or even triplets reading this book will receive descriptions of the worst case scenario that might only apply to quads and beyond, and the authors seldom offer any insights or guidelines specific to each type. It would have been more helpful to provide a chapter on optimal twin pregnancies and their specific needs, concerns, and challenges, optimal triplet pregnancies, optimal quadruplet pregnancies, etc . . ..

There are a few very good points, which is why I gave this book two stars. The descriptions of all the potential complications for pregnancy -- especially how to recognize symptoms preterm labor -- are good information to have although the stress on everything that could go wrong accompanied by the ominous emphasis that it is inevitable that some severe complication to happen during a multiple pregnancy is unnecessarily scary. The chart showing the breakdown and expected outcome for premature birth clearly shows the condition of the unborn babies and what outcome the parents-to-be can expect at six different stages of pregnancy. This is scary but necessary, and it is something that all parents should know at the beginning of any pregnancy (multiples or not) to prevent them from being blindsided in the event of a premature birth.

The sections on what to expect in the NICU and typical complications and health problems for preemies are very good although the chart for cost of hospital stays for preemies shows 1991 prices. This edition is from 2004, so there is no reason why the prices for a preemie's medical care was not updated to reflect prices from 2000 or later.

The tips and dietary requirements for women nursing multiples are good if the reader ignores all the free advertising for fast food. The lists of what equipment and whether you need an item for each baby or if the babies can share a single item are also helpful.

There is a newer third edition is available, but my public library does not own a copy of it. It may have corrected some of the flaws in this edition. This review speaks only to the 2nd edition.
Profile Image for Jill Urie.
985 reviews1 follower
October 31, 2022
This was such a great book. All the practical advice and nutrition info was really helpful. But the thing that I appreciated the most was that they talked about the process of grieving that many women go through after they find out that they are pregnant with twins. (This is more applicable to women who are unexpectedly pregnant with twins). And while I love my children and I am excited to have more, it has been difficult to wrap my head around for a number of reasons:
1. I know it's going to be hard. At this point I'm pretty good at handling singletons (I have had three) and I know how trying it can be at first, to care for one newborn, let alone two at a time.
2. I grieve the loss of myself. This pregnancy has been quite difficult and I am not myself right now. I don't even recognize me right now. I just hope I come back sometime....
3. Am I ever going to leave the house again? The logistics of getting one baby out the door are maddening enough, but with two? Oh, and the three other kids I already have (ages 7,5,3 when the twins come). I might be a hermit by necessity. And I don't care for that prospect.
4. What is this going to do to my body!?! Diastasis recti, stretch marks, etc.

I could go on but these are the big ones. And so yes, I have experienced grief. And this book let me know that it's ok. That I'm not a terrible person or mother. I'm basically just trying to let go of how I thought things were going to be. And this doesn't mean I won't love and value these babies. It's just an adjustment.
Profile Image for jess.
859 reviews82 followers
February 26, 2013
I have not actually read every page of this book, but I have read a lot of it. This book is awesome if you are expecting multiples, as the title implies. It is based on long-term research about what behaviors produce the best outcomes with multiple pregnancies. There are a ton of charts and graphs about nutrition and weight gain. It can be overwhelming, but is fine to come back to it in digestible portions. I love that Dr. Luke is so matter-of-fact like, yes, your pregnancy is inherently high-risk and here are the 1 million stressful things singleton preggos don't really have to think about. But she is reassuring, she has science, and there are anecdotes from real mothers of multiples that contextualize it in real life.

A lot of her recommendations reflect a perfect dream scenario that does not exist for most people: eating 175 grams of protein a day for twins, gaining the perfect amount of weight at the perfect rate, laying down for naps at least twice during your 8 hour workday. stopping work at 24 weeks. not standing up for more than 30 minutes at a time. and so on. So, you know, like everything in parenting, just do your best.
Profile Image for Emily.
244 reviews10 followers
April 22, 2018
My impression of this book was that it was somewhat overly alarmist. The authors seemed to overly emphasize certain things like weight gain to the point where the impression you were left with was “if you don’t do this, your babies will have horrible outcomes.” I feel grateful for my extensive knowledge base of birth / professional background to be able to take some of the book with a grain of salt. Moreover, the book was published in 2011, and there is some slightly outdated information (and possibly more that I was less informed of); for example, crib bumpers are NOT recommended!

On the other hand, I learned a lot of interesting facts about multiples, and found some of the postpartum advice to be informative. And if you’re into nutrition/recipe advice, this book has that up the wazoo!
Profile Image for Mandy.
397 reviews
February 18, 2013
This book is great. Being pregnant with twins, I really needed the dietary advice and meal plans that are offered within. I also really needed to hear a lot of what she had to say about slowing down, resting, not pushing yourself too hard. I'm notorious for stubbornly forging ahead when I should be resting. This book made me think twice about that and I began to realize how serious the consequences could be when she discussed preterm labor symptoms in great detail. It's also got a very informative section on birth, NICU, breast feeding multiples, and getting your multiples into a routine once you get them all home. It is a well written, informative, serious book. I will keep it out and refer to it throughout my pregnancy and I would highly recommend it to anyone pregnant with multiples. You NEED to read it, as most of the dietary advice out there for pregnancy is not intended for a person pregnant with multiples.
Profile Image for Emi Yoshida.
1,651 reviews99 followers
July 14, 2011
To be honest, I read the earlier version and do think this revised edition is better. But when I was pregnant in 2007 the earlier version had me in tears. I didn't suffer morning sickness or any nausea at all despite being pregnant with twins; I also didn't really have crazy cravings, just an overall increased hunger that I fed sensibly. However, the weight I gained was no where near the insane weight Barbara Luke was calling for, and she had me frightened that I was endangering my babies by not eating enough fast food and milkshakes (she literally espoused those specifically). One of my unborn twins was diagnosed IUGR, or intrauterine growth retarded (another improvement since my pregnancy, now referred to as "restricted") and this book had me convinced it was my diet causing her tininess, despite our perinatologist assuring me otherwise.



Profile Image for Colleen Jayroe.
12 reviews4 followers
September 28, 2019
HANDS DOWN the best pregnancy book I read! This book contained lots of helpful, science based information without being over complicated. I felt like everything in this book was relevant. I especially enjoyed all the talk about diet and the role it plays in a successful pregnancy. This book includes lots of recipes, charts, graphs. It’s just the best! I was thrilled when I met a newly pregnant mother of twins today so I could tell her about it and suggest she reads it!
Profile Image for Elena.
55 reviews10 followers
November 22, 2009
I love this book. Definitely a must-read for a multiple pregnancy. I wouldn't go as far as to claim to give this book credit for helping me carry these babies to one day shy of full term, but it is definitely educational and very resourceful.
Profile Image for Katherine Parker.
48 reviews6 followers
March 31, 2010
This is for my doula continuing education, not for personal use. Luke runs a Multiples Clinic in Michigan and has lots of strategies for helping grow healthy, term multiples, or at least giving higher order multiples the best shot at getting as fat and developed as possible before they have to be born. She really emphasizes nutrition, starting in the first trimester, and also emphasizes slowing down and taking excellent care of yourself, something that is hard for go-getter mamas to do. Luke has very comprehensive nutrition information, including information on weight gain based on your BMI, meal plans for each trimester, and 50 recipes for healthy foods to eat when gestating multiples. One thing she points out is that the mother's weight gain before 28 weeks is the best predictor of fetal weight gain after 28 weeks, so mamas need to eat right from the start!

Tamara Eberlein birthed premature twins at 31 weeks, and her stories interspersed throughout provide a cautionary tale of what not to do, and why you should not be blase or think, "Oh, I can work until I am 35 weeks along," or, "I can just carry these water jugs up two flights of stairs. It's not a big deal." Well, cumulatively, it IS a big deal. They also have stories from many women who were under Luke's care and carried 2, 3, or even 4 babies and grew them into healthy children, though often not without time on bedrest or time in the NICU for the infants.

I would highly recommend this book for anyone carrying twins or more, and consider it your mandate for taking it easy and letting somebody else do the heavy lifting for the coming months. You only gestate these babies a short time, and it's important to let go of your independence and be waited on in order to keep them in as long as possible!
Profile Image for Rhonda.
178 reviews3 followers
April 27, 2014
This is by far the best book that I've read during my twin pregnancy!
Every other book I've read had like a chapter, if that, dedicated to twin/multiple pregnancies and the information was not thorough whatsoever. This book gave clear, precise information about milestones and goals during a multiple pregnancy and I must say that it really made me feel empowered! The authors are medical experts in the specific field of multiples so it made me very happy to get advice and guided learning from people with so much experience. The nutrition and practical tips were invaluable and I really have faith that the education provided in this book will help me go longer in my pregnancy and grow big, strong babies! Thank you for writing this book! Anyone that says that this book presents "scary facts" needs a reality check because science is not all rainbows and sunshine. It's better to be educated than to be oblivious to any possible negative outcomes. A must-read for anyone expecting multiples!
*update - I went full term, 37 weeks with my twins and this book genuinely helped me do it!
24 reviews3 followers
April 3, 2015
I agree with many of the others who wrote that Dr. Luke used fear mongering to promote her beliefs regarding twin births. I was really disappointed with this book because she body shamed women who didn't gain an excessive amount of weight early on. She also tried to scare you into thinking that if you didn't gain a certain amount of weight by 24 weeks, then your babies were severely at risk for all sorts of negative outcomes. Interestingly, her research is the only published work to support this idea and anecdotally - I've met and spoken with many mothers of multiples who did not gain 24lbs by week 24 and went on to deliver healthy 6+ lb babies. I stopped reading this book after she suggested to start eating fast food to pack on fat - something no other doctor would recommend for a health pregnancy.

Profile Image for Heather.
13 reviews
July 20, 2007
I'm so happy I received this book. The authors' position is that food is the most important factor (within your control) in order to carry your babies full term. I didn't follow their diet exactly, but I came close, and I ate an extraordinary amount of food. I never would have eaten that much on my own. My twins were induced at 39 weeks and weighed 6lbs 12oz and 7lbs 13oz. One of my little girls had a birth defect and needed surgery when she arrived. Her weight and general good health convinced the doctor to try it thorascopically. She recovered in two weeks instead of a possible six week recovery time with the conventional surgery and she barely has a scar. I know the diet in this book was not the only reason for such a good outcome but I'm sure that it had a very positive influence.
Profile Image for Shannon.
424 reviews3 followers
September 4, 2012
I actually took notes when reading this book! After losing twins to premature death in April 2008 (born at 24 weeks), I am taking no risks with this twin pregnancy. The book may seem alarmist to some but to me it emphasized that gestating twins is hard work, and that a twin pregnancy does carry a high risk label (something that our OB shrugged off in the first pregnancy).

I didn't read the last two-thirds of the book yet as it focuses on what to expect when you bring your babies home. Mentally, I need to get through this pregnancy before I can begin to think about the beauty and wonder of those moments.

Overall, this book is a great resource written by practitioners with real experience!
Profile Image for Leah.
22 reviews4 followers
September 11, 2008
This book was so helpful while I was pregnant with my twins. I feel like it was a big reason why my twins stayed inside me for 38 1/2 weeks and weighed 6 1/2 and 7 pounds! This book is definitely "pro"-gaining weight, which is exactly what I did. I gained exactly what the book said (more than any of the other twin pregnancy books and more than my doctor recommended)and had perfect healthy babies and lost ALL my baby weight three weeks after they were born! I'm a strong believer that it's better to gain too much that too little...better safe than sorry...I PIGGED OUT and this book made me feel good about it.
Profile Image for Jeanette.
555 reviews4 followers
December 21, 2020
I learned a lot from this book but i did a lot of heavy eye rolling.

1. Not everyone who is pregnant with twins has a husband (or wants one!) Cqn we step out of the dark ages?

2. Vegans do NOT need to add any eggs or dairy into their diets. Stop already.

3. Please explain to me how a pregnant person who has any sort of life can take 6 hours every single day to nap.

There’s more, but a lot of the book i skipped because it was just so stereotypical.
Profile Image for Wendy Cantu.
125 reviews4 followers
April 10, 2014
Fantastic book...when it comes to making you feel that unless you quit your job and live on a steady supply of Big Macs, your twins will be born early and severely underweight.

There was some useful information here, but it came with a huge dose of fear mongering. Definitely NOT what you want to read as a first time mom who just found out she's having twins.
Profile Image for Jackie.
29 reviews
May 25, 2014
Being the only person in my family to have identical twins, I was so glad I found this book! It gave great nutrition information and recommendations on how to get the babies here safely. I really feel following the advice in this book helped me make it to 37 and a 1/2 weeks, full term for my mono-di identical twins. I recommend this book to every mom expecting multiples!
5 reviews1 follower
June 29, 2010
I suppose this is an announcement of sorts to my goodreads friends :) But nothing on facebook please, we'll be announcing on there in a couple of weeks, after one more good ultrasound...
Profile Image for Erin.
7 reviews
April 19, 2020
Overall great information, though somewhat patronizing at times.
Profile Image for Anne.
123 reviews1 follower
Read
July 21, 2024
I've read two other books on multiples pregnancies and a handful that primarily focused on singleton pregnancies. This was my favorite out of all of them. It starts with a very intense (somewhat intimidating) focus on nutrition and how critical early weight gain is in multiples pregnancies. It breaks down the nutritional needs for each stage of pregnancy and has a section on why fast food is great for multiples pregnancies, especially as a supplement to meals involving whole foods. Basically, since there will be so little room for food later on, you gotta pack it in early. We love to see it. God knows how many of the other pregnancy resources I read basically said there was no need for extra calories until later in my pregnancy. Also, this book has a section on how multiples pregnancies will affect the stamina you have for exercise (especially in hot weather!!!!!!) I really thought something was wrong with me--so many other pregnant people I know are/were able do relatively high intensity workouts through the second and third trimesters, and I can't even run a mile without feeling like I am going to pee my extra-stretch bike shorts. Everybody is different, but multiples changes the game for a lot of things.
Profile Image for Shannon Mitchell.
177 reviews
December 24, 2024
I hated reading every bit of it, it scared me to death. I skipped the NICU chapter until the very end, the book cautions you not to do that. I begrudgingly read it and it scared me even more, but definitely prepared me for my 6 month NICU stay when my boys were born. So, yes- I’m very grateful I read this book.
Profile Image for Katie.
175 reviews129 followers
July 20, 2015
This book is like a 'What to Expect' for multiples, the 'bible' of twin, triplet, and quad pregnancies. Early on in my twin pregnancy, I was frustrated that most books, including 'What to Expect,' barely touched on multiple pregnancies and high risk topics, and much of the advice (exercise, working, bed rest, breastfeeding, labor, NICU, etc) wasn't applicable to me. When someone recommended Dr. Luke's book, I immediately checked it out from the library...and renewed it over and over again! Especially informative are the chapters on nutrition. Unlike a singleton pregnancy, eating healthy is not the primary goal, calorie consumption and weight gain are the focus. The book provides useful weight gain charts along with suggested timeframes, and the author explains in detail how momma's ideal weight gain is positively correlated to a longer gestational period and therefore bigger and healthier multiples. Dr. Luke provides ample encouragement and even suggests eating burgers and milk shakes if that's what it takes to meet the weight gain goals. If you are expecting multiples, don't bother with the 'other' pregnancy self-help books, this is the only book you'll need.
Profile Image for Christina.
499 reviews17 followers
September 21, 2012
I had to take a break from this book because of its fear-mongering pressure combined with unrealistic advice. Take two naps a day. Don't do ANY housework. Eat at least 3500 calories a day. And if you don't follow this advice, your babies will be born at 26 weeks and likely DIE.
Maybe I'll come back to it and try again, this time taking everything with a grain of salt. I started reading it right after I found out my surro pregnancy is a twins and it really stressed me out.

*several months later*

Ok, finally finished this because I felt I needed to know a little something about what twin birth is like. And now that I'm 31 weeks along I feel more confident in the pregnancy and can take the author's tone with a grain of salt.

So, overall, I think it was a useful book to read. There aren't many books out there that focus on multiple pregnancy. But I think the advice needs to be read with a skeptical eye (something difficult for me to do at the beginning of this pregnancy).
Profile Image for Kerry.
203 reviews2 followers
November 17, 2014
I highly recommend this book to anyone who is pregnant with twins, triplets, or quads. It is written by a doctor who has a clinic for multiple pregnancy. All of the information is supported by research she has completed or studied. It gives you information on how to have a healthy multiple pregnancy, including nutritional advice, warning signs of pre-term labor, information about NICU, etc. Some of the recommendations are pretty extreme (she recommends eating something like 170 g of protein a day...I don't even know how to get that much in without it being the only thing I consume), but I feel it is a good model to base your behavior on. The most important thing she emphasizes is how a multiple pregnancy is NOT the same as a singleton pregnancy and should be treated that way. Even though twins are more common now, it is still high risk. I think it is really important to remember that and treat yourself and your pregnancy that way.
Profile Image for Sharon Anderson.
53 reviews6 followers
July 20, 2016
This was the only book I could find that addressed the issues of the mother as well as the babies for a multiple pregnancy. It seems other titles highlighted either the mother or babies, never both and NEVER regarding a multiples scenario. I delivered twin girls without complications on April 3rd, 2001, and I think my success had a bit to do with the information I gathered from this book. The "regular" books had only a page or two mentioning multiple pregnancy issues; this quickly became my bible. I had "What to Expect ...", and I continued to follow that for it's great timeline format, but I always follwed it up with research from this title. I especially liked the week-by-week information on fetal development -- growing head circumference, survival rates, weights, etc.. It made that last month bearable knowing that each extra single day in the womb made a huge difference in the viability of my babies.
If you know you're having twins or more, this is the book you need.
Profile Image for CMT-Michigan.
287 reviews
July 23, 2015
I'm expecting twins so I decided to read this. There are some scary parts, but this book is meant for people expecting more than one baby and there MAY be risks, and if there are, you want to be prepared!

What I appreciated was the data. Studies have shown that following their recommendations for diet will give the babies a better chance. Lots of protein. Lots of dairy. Etc. This was helpful. My doctor is not treating me any different from a singleton pregnancy, and while I appreciate that in many ways, I also want my babies born healthy so they can come home with me.

This book is giving me the confidence to realize that many problems that pregnant moms of multiples face are PREVENTABLE problems.
Profile Image for Nolan.
23 reviews
January 6, 2010
Lots of good info you won't find anywhere else about being pregnant with multiples. A little scary, but definitely motivates you to eat, eat, eat and let the babies grow! One of the perinatologists that I saw had actually worked with Dr. Luke and said her diet works. I just couldn't make myself eat that much food! But my girls were born full-term and at 5.5 and 6 lbs...had I followed the diet more closely, I think they would have been bigger but I credit the book for getting us to that point.
Profile Image for Sarah.
45 reviews3 followers
January 15, 2010
Tons of information and good advice for parents expecting multiples. Learned so much about diet requirements and that milk shakes and takeout can be your friend during pregnancy and that no doctor should be cautioning a multiple mom to watch her caloric intake during pregnancy. Those babies need all they can get. Also that I was more than justified in seeking out secondary expert care. My friend, Kim, gave this to me and I am so grateful.
Displaying 1 - 30 of 156 reviews

Can't find what you're looking for?

Get help and learn more about the design.