For many moms, the more babies, the merrier the household. Multiple pregnancies mean more joy and yes, twice (or even three times) the work of a single pregnancy. For that reason, many parents want to find out as soon as possible if they are going to have more than one child. While only an ultrasound will tell you for certain, there are other signs of a pregnancy with multiples.

High Hormone Levels

As soon as the fertilized egg burrows into the lining of the uterus, your body starts kicking out high levels of progesterone. In addition, the developing embryo starts producing a hormone called human chorionic gonadotropin. This is the hormone that is detected by pregnancy tests. Higher-than-normal levels of progesterone and to a greater extent, hCG, can be an indicator of a multiple pregnancy.

Larger Uterus

Pregnancies where there is more than one embryo cause the uterus to expand more rapidly and be much larger than in single pregnancies. Women who carry multiples often “show” much earlier than women who are carrying only one baby. A pregnancy with multiples is often suspected if your fundal height — the distance between your pubic bone to the tip of the uterus — measures large for your gestational age, or the number of weeks you are pregnant.

More Than One Heartbeat

Dopplers are used to bounce sound waves off of a baby. The heartbeat of the baby disturbs the sound waves, creating a noise the mother-to-be can hear. If the Doppler returns more than one heartbeat, this is a good indicator that there may be more than one baby. Note that this can be deceiving, however, as a single baby’s heartbeat can sometimes be heard all over the mother’s abdomen, according to the MayoClinic.com website.

Severe Symptoms

Nausea, breast tenderness and fatigue are all common symptoms of pregnancy. In a pregnancy with multiples, these symptoms may be more severe than usual. Nausea may last all day, and the mother-to-be may experience extreme tiredness. While these are not certain indicators of a multiple pregnancy, they can lead a doctor to do an ultrasound to check for more than one baby.