As per usual, start with the cons and move on form there.
Con: You didn't use the same coloring on her eyes as you did in previous pictures. It is lighter in your previous pictures.
Con: Her hand doesn't look like it is resting on her belly. It looks like its just hovering there. Some lines showing a bit of impact may have helped. (Like the ones along her side that show just how far out her skin has stretched)
Aside from that though, the picture is wonderfully done. The expression on her face works well for the embarrassment she must feel for breaking the 4th wall.
She must be carrying three or four kids at this point as I have never seen twins quite that active, however it is left to the imagination.
The best part of this picture for me was the shirt. The clever title you placed upon it is made of win and for that you deserve our accolades and 10% of all profits made from creating such shirts in real life.
Once again, excellent job. It was an impressive piece to see.