30 Aug Vanishing Twin and Multifetal Pregnancy Reduction: New Reproductive Technologies, New Losses
There are two types of losses which, in my opinion, are often overlooked, not only by family and friends, but also by many professionals, including medical practitioners, therapists and grief counsellors. Those two losses are Vanishing Twin and Multifetal Pregnancy Reduction. For reasons which can be understood, although debated, one can see why they might be marginalized (it’s an early loss…, “you hadn’t yet had time to bond with your child(ren)” or “at least you still have one [two]”). However judging by the number of e-mails I receive from families with questions, disbelief, concerns and aching hearts, I think, as a society, we need to take a hard and long look at how we are supporting (or seemingly not supporting) families experiencing such losses.
Vanishing Twin (VT) is a surprisingly common situation, certainly judging by how many questions I receive (it’s the most hit-on article on my site). Even as a young girl, I can remember a couple of my Mom’s women friends saying something like, “It’s the strangest thing; I’ve been bleeding but the doctor tells me I’m still pregnant.” In hindsight and prior to the advent of ultrasound, I bet some of these women experienced VT. Not knowing that they did might indeed be their story, and they continued on with their lives, thankful for their healthy baby.
In the messages I receive, parents narrate their stories, desperately looking for hope regarding the empty sac and asking “over time will there be a baby in it?” Then there is the worry about the effect of VT on the health of the remaining embryo(s). Because ultrasounds are regularly performed at 5-8 weeks, we learn very early that we are pregnant and with how many. Hence, to learn by 10-12 weeks the situation has changed dramatically is devastating to many families. Doctors, ultrasound technicians, grief counsellors, friends, family all need to realize that the loss of these much-wanted children is two-fold: first there is the loss of a baby, and then there is the loss of unique parenting experience. Passing off an early loss as “at least you still have one” is not the way to comfort anyone and only adds to the confusion and disappointment these parents feel while also depriving them of a right to safely talk about their feelings.
Multifetal Pregnancy Reduction (MFPR) is very complicated and in a recent 10-day period, I was contacted by six families facing reduction or who had just gone through it and were comfortable with their decision, and one who deeply regretted the decision and felt pressured to reduce or chance losing the whole pregnancy. Here too, anyone coming in contact with families facing reduction needs to be in tune with the emotional strain, possibly lasting a life time, of having to decide to reduce. Yes, a reduction offers a better chance to having healthy survivors; yes, a reduction improves the physical stress on the mother, and yes the brain tells us a reduction makes rational sense in so many instances. None of this can be repudiated, but it isn’t just the brain making this decision; the heart is very much involved too and will not be ignored. The heart is already in love with the babies within and wants desperately to believe that the pregnancy will continue to deliver healthy 3, 4 or 5 infants.
In some cases, it will and things work out, and sometimes things don’t work out so well for one or more of the babies. There is the emotional strain of the decision: Am I a killer of my baby(ies)? How will I ever tell the others? When do I tell them? Do I tell them? My babies are already bonded in utero, how will a reduction affect the survivors? All difficult questions and parents need informed guidance and support in finding solutions which will work for them.
MFPR is not a topic that can be easily discussed with family or friends. The decision is usually made by the parents in conjunction with professionals and peer strangers who are located on the internet (e.g. other families experiencing or looking at reduction, caring support people and organizations who guide them along the rocky path). Parents can feel very isolated, frightened and alone in making a decision which bears such significant and life altering impact. If the discussion to reduce does include family members or friends, then it is no longer a “secret” and telling the kiddies of their origins takes on a new urgency so that parents have control over how and when the children are told.
There are no easy answers but one thing is for sure and that is these grieving families need society’s support, comfort, and understanding in a non-judgmental way. They are mourning their losses and like any grieving individual, deserve a safe place to do so, with caring people all around them who do not minimize or de-legitimize their loss. It is the least we can do.
Lynda P. Haddon (613)267-6754
Multiple Birth Educator
Multiple Birth: Prenatal Education & Bereavement Support
Chair, Loss Support Network
Multiple Births Canada