Sam and Finn: Book Review

When Kate’s twin son, Sam, brother to Finn, died unexpectedly 12 hours after their births, she wanted to give Sam a voice and this book is Sam’s voice. Sam and Finn is a gentle exploration of twins who began life together in the womb and while life and a future awaited one little boy, the journey for his twin would very different.

Sam and Finn, Kate Polley, illustrations by Alex Latimer, The Oodlebooks Publishing Company Ltd.

Sam and Finn explores death and leaving as well as nearness and support for those left behind.  The illustrations are simple and will be appealing to parent and child, while leaving plenty of room for discussion as the young reader may wish to explore.

sam and finnAny child from 2 to 10 would appreciate this book and rather than feeling afraid, would feel comforted and no doubt wish to look for the sibling in all sorts of places around them.

Sam and Finn will be a great introduction for parents looking for a way to gently break the news to their child that they had begun life as a multiple.

Sam and Finn can be ordered at:

Loss in Multiple Birth

In spite of everyone’s best efforts, there is a chance that you may lose one, more or all of your babies. In an effort to assist you face this difficult time, to guide you when you have to make certain difficult decisions (e.g. whether or not to see or hold your baby(ies), taking pictures, funeral arrangements) and offer ideas on how to deal with others’ remarks, the following has been prepared. May you find some comfort from these suggestions.

Vanishing Twin (occurs by about 12 weeks gestation)

Vanishing Twin occurs when at least one embryo does not develop probably due to the fact the embryo was not able to properly attach itself to the uterine wall to get the maternal nutrition it needed to properly grow and develop.  The embryo dies and is reabsorbed by the placenta or the mother’s body.  Vanishing Twin is not anyone’s fault.

Miscarriage (occurs up to 20 weeks gestation)

If you have lost your babies through miscarriage, you may feel empty or angry with yourself and let down by your body. You may blame yourself, your actions or attitudes or even that glass of wine or cup of coffee. You may find that friends, family or hospital staff don’t acknowledge the pregnancy or the depth of your grief. Remember, this has been a very real pregnancy for both you and your paratner. You have visualized the babies, ‘taken them for a walk’, ‘bathed and dressed them’, amongst other things.

You might wish to try to find out why your miscarriage occurred. Be prepared for the fact that there might be no definite answers. Try not to feel guilty. Talk openly about your feelings and the babies with a caring person. If desired, maintain some contact with the your local twin and triplet support club until you feel ready to let go.

Stillbirth/Infancy (after 20 weeks gestation)

Prematurity is still the leading cause of death in a multiple birth situation. There is no guarantee against the early delivery of your babies. In spite of the best precautions, it can still occur.

Grief can occur on two levels: at one level, the loss of a unique type of parenting experience; and the other the loss of your baby(ies). The emotions experienced can be varied and sometimes not even feel as if they make any sense: “Did I prefer one baby over the other?”, “Did I really only want one?” Be sure and talk about your feelings with a caring person. You may experience inner struggles as you try to deal with the joy of the birth of one baby and the loss of another. You may wish to push all thoughts of the dead baby from your mind and concentrate on your living baby(ies). You may be subjected to thoughtless remarks from family or friends – ‘you couldn’t have handled triplets anyway.’ ‘At least you still have a baby.’ ‘You have some babies who need you, get on with it!’ It is helpful if you take time to grieve your loss. We cannot move forward until we have grieved what we have lost. Children are not interchangeable and we cannot ignore the death of one because others have survived. Don’t be shy about reminding others that you have lost a baby(ies) and have every right to mourn for him (them).

Some important feedback received from bereaved parents:

  • Name your baby(ies)
  • See your baby(ies) if you can. Hold them, touch them, bathe them and dress them. Take all the time you need. Such contact helps with integrating the fact that your baby is dead. We cannot say ‘good-bye’ before we have said ‘hello’. The majority of bereaved parents find solace, comfort and some healing in seeing their baby(ies). Some grieving parents do not want to see their baby(ies). Don’t be talked into anything that you do not wish to do or which does not feel right for you. Whichever works for you is right way to proceed.
  • Take photos. Take pictures of your babies together and alone, as you wish. The photos can be put away until such time as you feel you might like to look at them or, if you feel unable to take the photos yourself, have a hospital staff member or good friend take some.  Over time, some parents report the photos help acknowledge that their baby(ies) really did exist.  These photos can also become very important for the surviving co-multiple(s) in understanding about their beginnings.
  • Ask any questions of your doctor that you might have. Ask until you have answers that you understand. Be prepared, however, for the fact that some questions may have no answers.
  • Plan the funeral or memorial service as you wish.
  • Don’t keep feelings bottled up inside of you. Talk with a caring person whenever you need. Join a local bereavement support group. This is important for both Mom and Dad/Partner.
  • As the parents, try to spend set aside some time to spend together to share your grief and lost dreams.
  • Be prepared to have ‘set backs’ – this is normal. We are not the same people we were before the death. We need to get used to a new reality. The loss of child stays with us forever and we need to learn how to incorporate our grief into our everyday lives so that we can keep on living. Be prepared to have grief feelings triggered for no seemingly apparent reason. Don’t ignore them. It is only by going through these painful feelings that we can eventually begin to feel any peace.
  • You may wish to think about including older children in the funeral in a meaningful way:  draw a picture, pick out the burial outfit, and such.
  • Try to include the grandparents in some meaningful way in either the funeral or memorial service. They too have a lot to deal with. They have lost a grandchild(ren) and in addition, have not been able to protect their own children from such terrible pain.

There are many good books available on grief.  Check your local Library and perhaps the library of your local twin and triplet support Chapter. Many are available on line at  In addition, Multiple Births Canada has written two booklets on loss and they are available from their Business Office. Multiple Births Canada also has a Loss Support Network which issues a monthly e-newsletter (except December), has confidential e-mail connection between the members and can refer you to appropriate support persons. If you already belong to a member Chapter of Multiple Births Canada, there is no charge to join the Loss Support Network although a donation of your choice to help defray printing and web site costs is greatly appreciated.

Please don’t feel alone in your grief. There are many caring people available to assist you.

Other Support Contacts:

Vanishing Twin

In March of 1995, I began having cramping and experiencing pain in my lower abdomen beyond the norm.  I was 24 years old and turned 25 in June and did not know that I was pregnant.  I went to the doctor to try and determine what was going on.  I was seen by a Nurse Practitioner.  She was very kind and attentive.  I also had a low grade fever, and just did not feel “right”.  She determined that I had a “vaginal bacterial infection.” In addition, she did a pregnancy test which came back negative.  She prescribed an antibiotic and sent me home.

A couple of weeks later, I was still experiencing the same symptoms and continued to feel like “something just  wasn’t right”.  I returned to the Nurse Practitioner and she ran another pregnancy test (among other tests) and this time it was positive…I was pregnant!  WOW!!!  Because I was experiencing pain and cramping, she felt that there was an urgent need for me to have an ultrasound.   There was a Radiology department on site so she called down for me to be seen immediately.  I was in shock…I was happy, excited, and terrified all at once.  I was not married at the time, however, I was engaged and knew that my fiancé was going to be very happy.

Before the day was over, I was to be in even more shock, even more happy and excited, and even more terrified.  I was seen by the ultrasound tech as soon as I arrived.  I was eager to see what “my baby looked like”…knowing that it was early on and I would not be able to see much…the anticipation was tremendous.  As is usual, the tech had the screen turned away from me during the first part of the ultrasound.  So, I was just lying there waiting, watching her, being lost in my thoughts, and then I saw a change in expression on her face.

Her rather emotionless face turned very serious.  At first, I wandered what was wrong. When I asked what was happening, she said she wanted to “take some more measurements and get some additional pictures.  She said she had not been doing this for very long and that she wanted to let the Radiologist take a look at things.  She could see that I was worried and assured me all was okay.  She stood up and said that she needed to go get the Radiologist.  I knew it was common practice for the Radiologist to look over “the films” later.

The Radiologist came into the room, introduced herself, and told me that she wanted to do an ultrasound herself.  She said that she wanted to take a look at a few things and then would fill me in on what was going on.  I was nervous.  Listening to them, talking and pointing things out, I was beginning to figure out what going on.  The Radiologist had only been looking at the pictures for about 30 seconds, but it felt like minutes, when she turned the screen toward me and asked if “I would like to see my babies”.  Wow!  “Do you have a history of twins in your family?”  I immediately got tears in my eyes.  It was amazing!  There they were…”my two babies”! You could see two very little hearts beating…it was totally amazing!!!  The Radiologist and the tech were so excited themselves.

The Radiologist continued the exam just to make sure all was okay.  Everything seemed perfect.  I was about 8 to 10 weeks pregnant.  The babies, she said, had a due date of December 10th.  As the news spread through the department, I was congratulated over and over. It was wonderful…so exciting.  I was assured that everything was great…both babies looked really well…and right were they should be.  However, since I had been having some cramping and pain, they wanted me to come back for another ultrasound in two weeks to just follow-up.  They also wanted for me to “take it as easy as possible”.  I was not “on bed rest”…but was just advised to stay off of my feet as much as I could.  I made my appointment and headed for home.

My mind raced and was in a thousand different places on my 45 minute drive home.  I arrived at home and laid down on the bed.  I was exhausted, overwhelmed, so, so excited.  My fiancé arrived home about 15 minutes after I did.  He looked at me and immediately knew something was going on.  I told him…”We’re pregnant”.  The look on his face was that of both shock and incredible excitement.  Then, I told him:  “oh, and by the way, we’re having twins”.  He was shocked and beaming.  I was beginning to really absorb it all.  Yes, I was really excited; however, at the same time, reality was setting in and I was overwhelmed by it all.  He was so happy.  He actually started jumping up and down on the bed.  We were in tears together.  They were, at this time, tears of joy!  We agreed that we would not tell anyone yet.  Though, I knew that it was going to be very difficult for both of us. The excitement of the moment was something we really wanted to share. However, we decided that we would wait until we were a little “further along” and knew that all was truly okay.

I returned for the second ultrasound two weeks later.  I was greeted by the receptionist with “Hi Mommy…how does it feel to be carrying twins?…has it set in yet?…I know you guys are so excited”.  Of course everyone in the waiting area overheard her and it began a big topic of conversation…many questions, etc.  It was so fun to listen to everyone to tell me how wonderful it was that I was having twins…strangers…so happy for me.  I came out of the ultrasound with additional reassurance that all was okay.  The pain and cramping had gotten much better.  With the exception of the morning sickness, EVERYTHING was wonderful.  I was beginning to allow myself to really be excited.  The feeling of being overwhelmed was “vanishing” with each day.  I was having twins…wow…it was wonderful!

My fiancé and I had decided that we would not tell anyone else until I was 3 months along.  Things seeming to be going wonderful.  My fiancé had not had a chance to “see the babies” yet.  He had not been able to make it to the two previous ultrasounds because of work.  My third ultrasound was scheduled on his birthday in mid-May.  He was definitely not going to miss this one. What an awesome birthday present to see his babies for the first time!  We really thought that we had passed the time were we should have any reason for concern.  Since my last visit, I had changed to a facility that was closer to where we lived and I would be able to deliver at a hospital that was a little closer to our home.  So when we walked into the reception area that day, there was not the same excitement and greetings that I had experienced at the previous facility.  I found out at the end of my appointment, they not even have my medical records yet. I had no idea that the tech did not have any idea that I was expecting twins.  I was just another expecting mom-to-be in for a routine ultrasound.  I laid there while she performed the ultrasound, my husband and I eagerly waiting to see the babies.  The exam seemed uneventful.  The tech just went about her “business” very quietly…moving the probe around, taking the measurement and clicking on the keyboard.  My fiancé had asked during the exam how everything looked and she said “great…I’ll be able to give you a look as soon as I get a few more measurements”.  When she was done, she turned to screen towards us and pointed saying  “you can see your baby right here”.  She began to point out the head, arms, etc.  We looked in amazement!  She clicked a button and printed some pictures for us.  We just sort of sat there still and silent as she told us that was all she needed for today and everything looked great.  I couldn’t make words come out of my mouth.  My fiancé said “well what about the other baby???”…”aren’t you going to show us pictures of it as well???”.  The tech looked at us with complete bewilderment.  A terrible knot sunk into my chest.  She asked him what was he talking about.  He said “we’re having twins!”  In a seemingly cold tone, she blurted out:  “I don’t know where you got that idea…you just have one baby in there.”  My fiancé, became very upset and insisted that she sit back down and look for the other baby.  In her still seemingly cold tone, she said that she had done a thorough exam and there was no need to do a further exam.  She told me to get my clothes back on and make another appointment at the front desk for 20 weeks.  That was that…she walked out of the room.

We sat there motionless and in shock…it felt like a bad dream…literally.  I sat up on the table, tears were beginning to roll down my cheeks.  I was shaking.  I looked at him for an answer…”what is happening?”  He told me not to move and he would be right back.  I could hear the discussion from the hallway.  He was insistent that a radiologist was going to come into the room immediately and do another ultrasound.  The discussion went on for several minutes.  He returned to the room and said the doctor would be in soon.  We sat there together for what seemed an eternity…it was probably only minutes.  The door opened and a very nice, but perplexed, Radiologist introduced herself to us and said that she “understood that we had some sort of confusion going on and that she was going to take a look at things”.  She asked me what I had been told previously and explained that they had not yet received my records from the other facility.  She performed the ultrasound and spent about 5 to 8 minutes “taking a look at things.”  When she finished, she stated that she “did not know what we had seen previously…but that I was only pregnant with one baby.”  She made me feel like I was crazy…there was no explanation…no anything…just “you have one healthy baby…everything looks great…see you back at 20 weeks”.

My fiancé and I sat there angry, confused, numbed…we did not know what to think.  There was no mention of a vanishing twin and we had never heard of it before…we really didn’t know what to think.  We tried to go upstairs to the OB/GYN Department but it was late in the day and none of the doctors were there.  We left a note with the receptionist attempting to explain what was happening and we were assured that we would receive a call the next day.  I did not go to work the next day.  I did not know what to do.  I was feeling devastated.  I did not know what was happening…was I in the process of loosing both of the babies?…should I be at the hospital?…I did not know what to think or do. I attempted to call several times and kept getting the main call center.  They said that they would call both of the facilities that I had used and someone would call me back as soon as possible.  I wanted to get in touch with the Nurse Practitioner I had originally seen.  I was told that they would contact her and have her or someone else from there contact me.  I was insistent that I needed to talk to someone immediately.  Finally, I was put me through to a nurse.  She was virtually no help.  She listened to what I had to say and advised me that as long as I was not in severe pain, cramping, or bleeding significantly that I was “okay”.  She said that she would contact someone at both of their facilities and have someone call me back.

The following afternoon, a Midwife from the second facility called me.  She said that she did not have my records yet and that the Nurse Practitioner that I had seen at the other facility was no longer with them.  Basically, she could not tell me anything until she received my records which she felt that she would have by the next day. She, too, reassured me that if I was “not in severe pain, cramping, or bleeding significantly that everything was okay”.  She made an appointment for me for two days later to make sure that would have my records and to call if anything changed.  I know now that I and my remaining baby were in no danger…however at the time,  I was terrified and confused.  Two days later, when we went in for my appointment, we were assured that everything was fine.  There was a brief, sympathetic explanation of what had “happened”.  We were devastated. And regardless of the “reassurance that everything was alright”, we were still scared that we might loose the other baby.  The internet did not exist [11 years ago] as it does today and there was no way to go home and “Google” it.  When we asked: “Where was our other baby?”, we were told that it was more than likely absorbed into my body.  We really were not given much information.  It was just confusing and sad.

We continued our 1 month visits and were seen around 21 weeks for our “regular 20 week ultrasound”.  Everything was great – they said.  We were able to find out that we were expecting a baby boy.  Based on the ultrasound, he now had a due date of December 20th.  We were excited. Things felt good.  We tried to let “the missing baby” drift into some secluded…forgotten  place in our minds.  We were focusing on having a healthy baby boy and fairly confident that we were safe.  We happily began to spread the news of Baby Boy due on December 20th to friends and family.  Other than morning sickness, the pregnancy was going great.

At 33 weeks, I informed by doctor that I was having some contractions that would come and go.  They didn’t feel too strong…just noticeable.  It made me nervous.  However, since “each contraction” would come and go, I was not terribly worried.  After telling my doctor what was happening, she decided to do an internal exam.  To both of our surprise, I was 3 cms. dilated.  I was prescribed Brethine.  I was allowed to continue working…I had a desk job. I was told to stay off my feet and on bed rest as much as possible.  The contractions continued off and on.  However, I did not dilate further than 3 cm.  Then at my 36 week check-up, my doctor noticed that my cervix had “thinned” significantly and the baby had dropped.  She felt like it would not be long.  Two days later, the contractions came back and this time they were different.  They were painful!  We went to the hospital around 10:00 pm on November 17th.  They were able to stop the contractions and sent me home the next morning…again take it easy stay off your feet.  The following Sunday, we drove about an hour and a half away to my Baby Shower.  The contractions returned.  I just couldn’t sit down.  I would sit down or lie down and then get back up and walk around.  I was not in terrible pain…I just couldn’t get comfortable. The “uncomfortableness” continued through the Baby Shower.  We drove home that evening.  I was really exhausted.  We went to bed around 10:30 pm.  I was awakened around 12:30am (Monday) with terrible pain like I had never felt before.  Somehow, over the next 5 hours, I walked around, would lie back down, showered in repetition…feeling like I was in some kind of dream.  It was really strange.  I finally woke my husband up around 5:30 am telling him that something is really wrong or maybe this is it.  I hung on for about another hour or so before calling the nurse.  Then, the contractions just stopped…it was bizarre!  The nurse said that since they had stopped, I should just come in to see the doctor when they opened at 08:30 am.   We left for the facility which was about 45 minutes from where we lived.  On the way, it all started again.  It was pretty painful.  We got to the facility, signed in, were told to wait and they would call us back in a few minutes.  While waiting, it all stopped again. I felt a significant amount of pressure but no contractions.  Strange.  The nurse said that they were going to do “A Non-Stress Test”.  She hooked me up and sat there waiting to see the contractions I had described.  There was nothing…nothing for over 15 minutes.  She looked at me like I was nuts.  I felt nuts!  She said that she was going to get the doctor to do an exam just to check things out and then they would probably let me go home.  In the 10 or so minutes that she was gone, I had 5 contractions…big ones!  When the nurse and doctor came back into the room, they looked at the strip and looked at me with astonishment.  When she checked me, I was 8 cm.  No one could believe it.  The hospital was about 25 minutes away and with the morning rush hour traffic, it could take an hour or more!  I had a ride to the hospital in an ambulance for fear that I could possibly give birth on the way as the labor started and stopped, again and again.  Our beautiful baby boy was born at 12:22pm after pushing for about 45 minutes.

There were some issues…as he was a month early.  Surprisingly, he weighed 6 pounds 12 ounces.  However, he did not have the eating thing down pat and we would find out in the next few weeks that his lungs were not quite developed. We had a few medical ups and downs early on.  However, today, he is a thriving almost 11-year old.  We have not yet told him of his “Lost Twin”.  It will happen soon.  We wanted to wait until we thought that he was mature enough to understand and handle it.  I think about his “Lost Twin” what feels like every day.  I wonder whether or not it was a boy or a girl.  I try to imagine two of him.  It is sad to think about at times.  However, we are so very blessed to have him.  We have been blessed again two times.  When he was 9 months old, we got pregnant again…this time with only one.  He has a gorgeous 9 year old sister.  Then, when they were almost 5 and 3 1/2, we were blessed with another beautiful baby boy.  They are now almost 11 (in 3 weeks), 9, and almost 6 (next week).  My husband and I have a truly beautiful family!



Miscarriage is the unplanned ending of a pregnancy before the 20th week of the pregnancy. 15 to 20% of all pregnancies end with a miscarriage. 75% of miscarriages occur within the first trimester (12 weeks) for several possible reasons: improper attachment to the uterine wall, imperfect fetus either genetically or more usually, by a chance mutation of cells at the time of conception. 25% of miscarriages occur during the 13th to 20th week. Usually the fetus is normal but there may be other problems: improper attachment of the placenta, uterine difficulties or an incompetent cervix.

There may be several reasons for a miscarriage as discussed above or a mild virus, more serious disease or infection may be the cause. Environmental facts and malnutrition of the mother are two more possible causes.

Many times there are no definite reasons for a miscarriage and we, who prefer answers, may have some difficulty in coming to terms with that fact.

If you lost one more or all of your babies through miscarriage, you may feel empty, angry or let down by your body. Even worse, you may find that family and friends don’t properly acknowledge the pregnancy or the depth of grief. In fact, society tends not to think of miscarriage as a real loss. People tend to think that because you didn’t know the baby, you shouldn’t feel too sad. The loss is downplayed and the parents are often advised to “try again.” If parents are to have any hope of healing, many of those whom have dealt professionally with pregnancy loss or studied it, agree that parents need to grieve their baby’s loss if they are to heal.

If it is possible to see your child, ask the hospital staff in this regard. They are best suited to advise you. Even if the baby can’t be viewed, it might be wrapped in a blanket and brought to you to hold. The physical sensation of holding your child gives you tangible memories of the baby’s real existence as a part of your family. Other mementos, such as copies of early ultrasound photographs of the multiple pregnancy with all fetuses intact, are cherished by many families.

If it is not possible to see the baby due to the miscarriage at too early a stage, it still may be possible to arrange formal burial or cremation with the cooperation of the hospital and a funeral home. If this is not an option for you, it is helpful for many families to hold a memorial ceremony, either officially with religious involvement or personally with only family and friends. You might decide to plant a tree(s) in a special location in memory of your child(ren).

It is important to find a safe place to grieve your loss. You may join a bereavement support group, see a therapist who specializes in pregnancy loss issues, find a caring friend or relative to share your feelings and emotions. Research has shown that parents who do not talk about a tragedy pregnancy take much longer to resolve their grief.

Women usually will grieve longer than men and want to speak of the miscarriage for weeks or months afterwards. Mothers may be receiving adequate care and attention afterwards, but bereaved fathers are sometimes overburdened and overlooked. Not only must they console the mother who just suffered a loss and who may be seriously ill herself, but they must also deal with their child(ren)’s death and memorial arrangements while also juggling household duties and possibly a job as well.

This article was written with grateful input and assistance from:
Dr. Elizabeth Pector, Illinois, U.S.A.


Bereavement in Multiple Birth, Part 1: General Considerations, Elizabeth Pector, MD; Michelle Smith-Levitin, MD, The Female Patient, Vol. 27, November, 2001
Miscarriage, pamphlet prepared by Canadian Mental Health Association, Windsor, Ontario, Canada
At a loss, article by Kimberly Pfaff, printed in The Walking Magazine, September/October, 2001

Reading Resources

Twins, Triplets and More, Elizabeth M. Bryan, M.D., St. Martin’s Press
Guidelines for Professionals: Bereavement, Bryan, EM; Hallett F, Multiple Births Foundation, London England
Living Without Your Twin, Betty Jean Case, Tibbutt Publishing
Bereavement in Multiple Birth, Part 2: Dual Dilemmas, Elizabeth Pector, MD; Michelle Smith-Levitin, MD, The Female Patient, Vol. 27, May, 2002
The Worst Loss: How Families Heal from the Death of a Child, by Barbara D. Rosof, Henry Holt
Empty Cradle, Broken Heart: Surviving the Death of Your Baby, Deborah L. Davis, Fulcrum Publishing
Men & Grief, Carol Staudacher, New Harbinger Publications
Trying Again: Guide to Pregnancy After Miscarriage, Stillbirth and Infant Loss, Ann Douglas and John R. Sussman, M.D., Taylor Trade Publishing
Empty Arms: Coping with miscarriage, stillbirth and infant death, Sherokee Ilse, Wintergreen Press

Other Organizations

One is Alive, One is Not

Please note that the information contained herein is general in nature and does not cover every possible situation.  If you have concerns about any aspect of your pregnancy, please consult your doctor.

For many months, you have delighted in carrying your precious babies beneath your heart.  They are very active and your belly grows almost daily.  Beating hearts have been visible on the ultrasound screen as perhaps have legs, arms or spines, depending upon which way they are lying.  One of the babies though is smaller (usually referred to as small for gestational age) and a little weaker than his co-multiple(s).

Then the unthinkable happens: the smaller one has passed away.  It is still early enough  in the pregnancy that it needs to continue for several more days, or even weeks, to give the survivor(s) the best chance at survival outside the womb.

This unbelievable and devastating situation is almost too much to absorb, let alone comprehend.  Shock as well as many questions leap into the parents’ minds in an attempt to understand what has occurred and why.  Following are some frequently asked questions:

Q: What is going to happen to my surviving baby(ies)?

The death of a multiple before 16 weeks of pregnancy generally creates no increased risk for the remaining baby or babies.  An after 16-weeks death of a multiple with a separate placenta from the other(s) is also not too likely to cause any problems.  When a deceased fetus’s placenta is shared with a co-twin (monochorionic), there is some risk of problems for the survivor, but not always.  With the death of a fetus when there is a survivor(s), the mother can expect to be closely monitored until birth. Your doctor can discuss your particular situation and explain a management plan for your pregnancy until birth.  While the mental strain can be very taxing, many women continue their pregnancy and have a healthy survivor(s).

Q: Will my dead baby hurt my living baby(ies)?

If the surviving multiple(s) is healthy itself, there will be no affect on the living baby(ies).

A deceased baby’s body begins to be broken down in utero and is reabsorbed by the mother’s body and/or the survivor’s placenta.  Depending upon how long after death it is delivered, depends upon what its appearance will be like when it is delivered.   Delivery can be expected to be earlier than previously planned if the babies share placentas and/or sacs.  Mom is carefully monitored until birth, so that the doctors can make timely decisions if needed.

Q: Did my baby ‘kill’ his sibling?

No, one baby didn’t ‘kill’ the other.  The deceased fetus usually has substantial health problems through no one’s fault (e.g. anomaly within a larger organ such as the heart). Through ultrasounds, it is sometimes possible to diagnose that one baby is weaker and has a compromising health problem(s).  In twin-to-twin transfusion syndrome (with monozygotics), for example, the mother is closely monitored to try and prolong the pregnancy as long as possible in order to give both (or all) babies the best chance.  With some medical issues within the womb, however,  it isn’t always possible to successfully intervene and one baby dies.   Sometimes the death cannot be explained until the baby and the placenta can be examined after birth and even then, the reason for the death may not be identified.   Depending on when a fetus passed away and how many days or weeks later the mother gives birth, it is not always possible to identify the cause of death due to deterioration of the fetus and/or placenta.

Q: How is this going to affect my own health and emotions?

Physical complications for the mother after one multiple dies in the womb are uncommon. Careful monitoring of both mother and surviving baby(ies) during the rest of pregnancy can detect any signs of concern.   Delivery may occur earlier than previously planned because of this changed situation.

Emotionally the situation can be quite different.  Some women report feeling fear, isolation, confusion, devastation or horror.  Some report feeling particularly close to their dead multiple because they know this is the only time they will have him/her. They report a great sadness through the rest of pregnancy, unable to find any joy in the approaching birth because they will need to give up that baby. Others push grief aside, fearing it will harm the remaining child(ren) or cause preterm labor. They dedicate their energy to hopeful thoughts about the survivor(s).  Some hang on to a belief that there has been an error and at delivery, there will be two (or more) healthy and alive babies.  All of this is normal.

Q: What will the delivery be like?  What will happen?

Your doctor, hospital staff and grief counselors can help you plan a birth experience that honors your deceased child while meeting the medical needs of your living baby.   Depending upon at which stage the baby died, you may need a death plan as well as a birth plan.  Communication with your doctor about the delivery will help clarify what will happen and how things will proceed.  Don’t be afraid to discuss with your doctor your needs and fears.

Q: What will our dead baby look like at delivery?

Your baby’s body will be small (as compared to its co-multiple[s]) but recognizable as a baby if death occurred after the 14th week of pregnancy. There will likely be some distortion of features and discoloration (bruising).  Discussion with your healthcare provider or a grief counselor can sensitively prepare you for your baby’s appearance, and help you choose whether to view him/her after birth or not.   Some families choose to view their baby regardless, some don’t want to view the baby.  Don’t be pressured into doing anything that you don’t feel comfortable doing.  Whatever you decide to do is what is right for you.  You may wish photos to be taken either by yourselves or ask the staff to take them for you, should that be easier.  Photos can be an important consideration as this is the only time both (all) multiples will be together, should you wish to do so.   The baby can be wrapped in such a way as only a foot or feet, hands or face is visible for the photos.  The hospital staff will be able to guide you.  You may chose to have the photos taken, but put them away and not look at them until a later date when you feel more comfortable viewing them.  Sometimes one parent will wish to see the baby and/or photos and one will not.  People do not all grieve in the same way so understand that your partner may make a different choice from yours.  There is no right or wrong way to proceed, only the way that works for you.

Q: Can we spend some time with our baby?

Yes, you can spend time with your deceased baby, if you want to.  Be sure and let the staff know ahead of time if this is what you want to do.  Have a note written in your file indicating that this is what you wish to have happen.   You can take as long you want or need to take with your baby.  In addition, some parents have hand and foot prints taken as a keepsake if it is possible.

Some options to consider for the remainder of your pregnancy: 

  • If you do not wish to view the deceased fetus(es) during ultrasounds inform the technician.   The monitor can be turned to another direction.
  • Doctor’s appointments may be booked when no other parents of multiples will also be present.  If this is better for you, then you can request it.
  • More frequent doctor visits and/or testing will occur in view of your situation. This may be reassuring to you.
  • Talk with your doctor if you have any fears about the surviving baby’s health.
  • You can see your baby(ies) at delivery should you wish to do so.  If you do not wish to do so, that is OK too.  The hospital staff, at delivery, can help you with the decision, if that works for you.
  • If you do not wish to view your deceased baby, you still can hold him/her, usually wrapped in a blanket. This relieves the aching arms felt by some grieving parents.
  • If you wish an autopsy to be performed discuss it with your doctor.
  • You may need or wish to make plans for burial, cremation or hospital disposition of your baby’s body.
  • Consider if you have photos taken, they may also be important for your surviving multiple(s) to view and to help you begin the discussion of how he/she began life.
  • In any photos you may wish to include yourselves and any older siblings so you have a record of the whole family together.  For some families photos confirm that they truly gave birth to multiples and reduce later feelings of confusion.
  • Computer programs can create a combined photo from two or more separate images.  Some parents who did not take photos of the babies together, can thus create a combined photo.
  • Ask for the survivor’s birth certificate to clearly state that the child was one of the original number of babies conceived. The death of a triplet does not create twins.
  • Some hospitals offer an honorary birth certificate for the child who died.  Ask for one if you would like one.
  • Children are not interchangeable and you do not have to listen to such comments as “As least you still have one” or “You couldn’t have handled three.”   Feel free to inform the speaker that such comments are painful and only add to your grief.
  • Contact Multiple Births Canada’s Loss Support Network which offers a monthly e-newsletter, Forever Angels.  You are not alone.  Other families have gone through the same thing and it can be very helpful to connect with them.


Bereavement in Multiple Birth, Part 2: Dual Dilemmas, Elizabeth Pector, MD; Michelle Smith-Levitin, MD, The Female Patient, Vol. 27, May, 2002

Reading Resources

  • Twins, Triplets and More, Elizabeth M. Bryan, M.D., St. Martin’s Press
  • Guidelines for Professionals: Bereavement, Bryan, EM; Hallett F, Multiple Births Foundation, London England
  • Living Without Your Twin, Betty Jean Case, Tibbutt Publishing
  • Bereavement in Multiple Birth, Part 1: General Considerations, Elizabeth Pector, MD; Michelle Smith-Levitin, MD, The Female Patient, Vol. 27, November, 2001
  • The Worst Loss:  How Families Heal from the Death of a Child, by Barbara D. Rosof, Henry Holt
  • Empty Cradle, Broken Heart: Surviving the Death of Your Baby, Deborah L. Davis, Fulcrum Publishing
  • Men & Grief, Carol Staudacher, New Harbinger Publications
  • Trying Again: Guide to Pregnancy After Miscarriage, Stillbirth and Infant Loss, Ann Douglas and John R. Sussman, M.D., Taylor Trade Publishing
  • Empty Arms: Coping with miscarriage, stillbirth and infant death, Sherokee Ilse, Wintergreen Press

Support Organizations and Web Sites

A story of birth and loss

I was in quite a bit of pain that whole weekend. I really didn’t get anything done. Not even any laundry for the week. I went in to my usual weekly appt. with the OB. I was 36 weeks that day. I walked in and was taken right back. The appointment was going as usual. The doctor came in and measured me. I was measuring 52 cm. I was so uncomfortable that when he was talking about inducing me in 2 weeks I just started crying. He said I know that you are uncomfortable, let’s check you.

He checked me and said Oh, you’re at 5 cm, looks like you are going to have these babies today. I want you to go over to L&D.

I called my boyfriend and my sister and proceeded to go to the hospital. When I got there they laid me down and hooked me up. I just stayed like that with my regular mild contractions. They came in to do the US to check positions of the babies and Irene was still transverse but she was spine up. The doctors talked to me and I then decided that I was more afraid then I thought I was of C sections. I decided to try vaginal and hope for the best.

They checked me again at like 6 o’clock and I was at a 6cm dilated. They doctor decided to come over and break my water for baby A. That was horrible because Fernando Jr was trying to grab the doctor’s hand. SO they had to push up from the vagina and down on the fundus. OUCH!!! After that things started to pick up. At about 8 o’clock they decided on starting pitocin. I have had Pitocin before and decided that before they started that I would like to get my Epidural. It took 3 tries to get it in, but it was a really great Epi. When it was time to push they wheeled me down to the OR and we started to push after a couple of minutes.

Fernando Rueben Hernandez Jr. was born at 18 inches long weighing 4lbs and 14 oz. They made me wait between pushes while they saw what Irene did. After a couple of contractions they started to push her head down. After getting her into place, two pushes later Irene Amelia Hernandez made her début screaming her head off. She was 17 inches long and 4 lbs and 11 oz. They were taken to the reg nursery, but only lasted an hour and a half before being taken over to the NICU for some O2. They were in the NICU for the longest 10 days of my life. We have now been home for 2 days. I am so happy. 🙂 The sweetest babies and an easy delivery. I feel so blessed.

Now I will tell you what happened the night of March 1st. My little boy Fernando had been sick with a cold for a couple of days. I took him to bed with me to Breast feed at about 11:30 at night. This was my first day back at work. When I woke up a little over an hour later, he was gone. After an investigation they ruled his death SIDS. I am devastated. I feel horrible, I feel guilty. I miss my little boy so much. He will have been gone for 6 months tomorrow. As his sister grows she is now 7 ½ months old. I remember not only him, but think of how they would be interacting now. They would be laughing at each other and maybe even fighting. I feel bad; I don’t want to overshadow my daughter’s life with her angels. Maybe his whole purpose was just to bring her to me. I will never know. I will always be a twin mom, but feel cheated out of the joy of seeing them grow up together. I love all four of my children so much.

Thank you,

Sara L.M. NE, USA

The death of my identical twin sister

Hello, My name is Marsha Sherly, identical twin to Marilyn Sharon, who killed herself two years ago. I am 57 now. We had a triplet-like sister born a year after us. We were all born in the month of August. That sister killed herself when she was 27. Our parents did not want to have triplets, or kids for that matter.

I would love to meet triplets or twins or twinless or tripletless people. I never met a triplet in my life and really do want to.

I live by the beach in California and love to paint pictures of twins and triplets. I deal with the death of my twin through painting. I paint for a chiropractor and he gives me my treatment for free. Marilyn and I were (each) born with serious back problems.

I am very friendly and would love to meet you. I belong to the twinless twin club. I met a twinless twin named Monica and talk to her every day.

Thanks for listening. I am suffering a lot without my twin. We did everything the same for 55 years. I feel brain dead without her.

Marsha Harris

Growing Up Twinless

Hi, I wanted to take the opportunity to share my story of what it’s like to grow up twinless. The few accounts I’ve read of before echo thoughts and feelings I have had and have helped me to replace some of the confusion with understanding. I hope that my sharing is able to help someone in some small way such as I’ve been helped.

My story begins around my sixteenth birthday when, for some unknown reason, I seemed to have hit a crisis point. I think it was the thoughts of suicide that really brought me to a point that things were as bad as they seemed. All I knew was what I told my mother on those many evenings when I would seek her out in the hopes that she might help me out of my pain. She would usually be ironing or doing some other household chore when I would enter the room and make my presence known. That’s about all I seemed able to achieve because when I tried to say something, the words wouldn’t come out. There were a couple of times though when in between the tears, I’d say “Mom, I don’t think I was made for this world.” I hadn’t found out yet that I had been one of twins and that my brother had died while still inutero. I could feel that I was creating an awkward situation for my mother. She told me later that she felt deeply for me, but just didn’t know of anything to say or do to make me better. Often, I would become angry with her.

For years, when I seemed to reach bottom, I would seek her out or someone else I thought that might be able to help me. I saw ministers, counselors and even tried to talk to a few friends, but I often walked away feeling more frustrated than anything. I did have this Sunday School teacher named Carol, who incidentally was a twin, whom I really bonded with. My own mother oftentimes became jealous and said many painful things that would keep me home in my room, alone, rather than with Carol. Though, as with the others, I couldn’t talk to Carol, I did feel something akin to a soothing effect around here.

The series of events that led up to me learning about my twinship began when a friend of mine suggested that I go to see this lady who was a psychic. Having come from a very religious home, I at first felt like this wasn’t an option for me, but I was desperate for someone to help me and so any hesitation I had soon melted away. I took my friend’s offer up and copied the lady’s phone number down. From a pay phone, I called her up to schedule a sitting and she gave me the day, time and place. I hung up, not placing very much hope in what I might encounter, but then a little hope was better than none.

I showed up at designated place and time and have to say that my first impression of things wasn’t a very good one. I could’ve just left, but I thought ‘I have nothing to lose’ so I stayed. And just in case she
might actually be psychic, I told her on our way back to her kitchen that I didn’t want to know anything about my future.

After I sat down opposite her at the kitchen table, she took out a set of regular playing cards with alot of marks on them. I didn’t know what the marks meant, but wondered for a minute where I could get a set 🙂 She had me separate them and then she shuffled them and laid them out into groups. She asked if I was going to become a minister, to which I replied “My parents would like me to.” She moved on to describe my parents and did a pretty good job, but still, I felt that she could have gathered all this from my demeanor and what had transpired from the moment I walked through the door.

Then… She told me that I had died near the beginning of my life. I was shocked! How could she know this? I knew that 8 hours after I was born my lungs collapsed and I had a near death experience that lasted 4 1/2 minutes. I confirmed her claim and listened on. She then stated that my mother was in labor for almost two weeks after I was born. I never heard of this and so I couldn’t confirm or deny it so she asked that I check with my mother and get back to her. Next, she asked if I had a twin. Again, I told her that my mother never said anything about a twin and again, she asked me to check with my mother and get back to her. She said that she was going to continue despite my uncertainty. What follows was her telling me that I did have a twin and that originally, I had been the one that had died and he the one that lived to be born and then undergo that near death experience I mentioned earlier. She told me that we were both there when the doctor was resuscitating him and that he had let me come into the body. Everything she said seemed to turn my world topsy turvy, but yet it was a world [which] resonated with me.

That night, I had dream. I was lying in my bed and feeling so alone as I usually did when I felt this brush against my arm. I didn’t need to look over because I could feel him. The only way to describe the experience was of everything that moved in me, all my feelings of lonliness and confusion, came to rest. This image came to my mind of this necklace with two pieces that had been broken into shards had come back together.

I rolled over and used my arm to raise my head as I looked at him. I asked “Who are you?” He replied “You know who I am.” I laughed. “yeah, I know who you are.” I said. I asked “How long have you been here?” He said “I’ve always been here.” I responded “Yes, I think I knew that.” Just then I yawned and he said “you’re tired. you should get some sleep.” I said “oh no, if I close my eyes, you’ll go away.” He said “No, I’ll always be here.” I did end up falling asleep by his side and then while still dreaming, time had passed so that it had become morning. My mother came into to wake me up, but in the course of the night I had fallen off of the bed leaving him to be the one she woke up. When I had heard her come in, I had stayed low so she couldn’t see me. After she left, we laughed that she had confused him for me and then the scene changed again and it was getting dark suddenly. I found myself out on our front porch looking down at my watch. The dream scene began to fade and I heard his voice saying “I’ll be back.”

While I was afraid during the first day to ask my mother about the things the psychic lady wanted me to, after the dream, I just had to know the truth and so, during a car ride to my grandmother’s house, I asked her.

I began with the question “Mom, were you in labor after I was born?” She jerked the staring wheel sending us off onto the birm as she turned to look at me in the back seat. “Who told you?” she asked me. I said “This lady.” She said “Yes, I was in labor, for almost 2 1/2 weeks.” “After you were born, the doctor had left the afterbirth in me,” I spoke over what she had said next as I then asked “Did I have a twin?”

She answered in the affirmative telling me that after being rushed to the emergency room because she couldn’t walk anymore, the doctors had removed the afterbirth and later reported to her that there had been a second baby, fully formed, but [whom] had stopped growing.” She told me that she never told anyone, not even my father about my twin. I came clean then about having visited this psychic lady who told me this and rather than getting chastized, was meant with a response that was more like awe and wonder about who this lady was.

Over the next 18 years (I’m now 34) I would have my mother repeat the story of my and my brother’s birth because it all still feels so unreal. Yet, I can feel its truth in my heart and over the years have come to make sense of much of my feelings and thoughts that seemed alien to me before. For instance, since I first encountered a black rose and its significance (age 11), I had alway requested one for my birthday. It was just one more thing that confirmed my grandmother’s statement that I was a strange child. I also had/have the habit of buying two pairs of shoes, two shirts, all two of the same. Even knowing what I know today still isn’t enough to squelch it. There’s also my odd habit of oftentimes referring to “we” rather than to me. I don’t really seem to be aware of this until it is brought to my attention by others. When I was around 12 years old, I remember reading this book called “Sybil” about a woman with multiple personalities and I would then go around telling people I had multiple personalities. Actually, I didn’t bear any of the symptoms of the disorder, but there was this one thing that Sybil reported and that was that she felt double. It was the only way I knew then to express how I felt. Of course, this too would startle my parents and relatives who just thought I was overly imaginative and had odd interests. Fast forward to when I turned 32. Since finding out at 16 years old that I had a twin brother, I found some measure of peace and understanding say for instance, of why I was always seeking out some other guy to bond with (an attempt to find a surrogate) or spending my last dime to buy a second pair of something that I didn’t need a second pair of.

It was at 32 though, that a lot of unrest came back to me. I could see that over the previous 10 years I had been struggling with issues of identity and career. And then there was this feeling, a pulling that was always present and would intensify whenever I wasn’t doing anything. So I would keep busy, but I could still feel it there dimly in the background. I knew what it was and it brought up all these thoughts and feelings. On one hand, I would ask myself if my twin were here, would he approve of me and what I did? What would it be like if he were here now or if he had been here instead of me? On the other hand, I wanted to deny him. How could someone I never knew have so much of an impact on me? I get angry and I don’t understand this. Yet I still have my mother recount the words she spoke so many times before “the doctor said there
had been a twin but..”

Last year, after a particularly difficult weekend, my mother had returned from a trip so excited to see me because of something she had wanted to share. She had been unaware of my depression the night before, of wondering what life would have been like if he had survived. She told me that in a dream she had the night before, that she and my father were returning from the casino when she was entering into the restaurant at the hotel when she was told that a table was being held for her. As she walked over to where it was at, she saw this guy from behind and when she got nearer he turned. She gasped she said because here was this guy who looked exactly like me, yet sheknew that I was not there because I had to work. She asked him “who are you?” and he smiled (she said she has my smile). He said his name was Nathaniel. She told him to wait right there while she went to get me, but as she walked away she woke up. Upon hearing this, I got this strong sense, as if he is somewhere living his life and though we are apart, we are each living out our lives to their completion until the day we won’t be separated again ever.

Today, I live day by day. With the help of Twinless Twins and opportunities to share my story I find some quieting of the pulling within me. It’s a compulsion I have to share with others, my twinship, not letting people miss this very important part of who I am despite the fact they might not be able to see otherwise. Sometimes, I feel as if I am leading two separate lives. Currently, I work as a dorm parent at a boarding school, but during the summers, spend an inordinate amount of time in Quebec volunteering.

There is the “French” me and then there is the “English” me. Though it can be exhausting at times, it feels natural and right. Yet there is still something that doesn’t seem quite right. When I come to think of a wife and children, which I feel my life incomplete without with, I can’t imagine any other person in my life meaning as much to me as my twin.

Because of this, I seem to be frozen in the feelings I come to have for others.

What the future [will] hold for me, I’m not sure. But despite my many struggles, including my struggle to believe in an afterworld and an existence beyond physical death. I hold onto the last words I heard in that dream before I awoke. “I’ll be back.”

Co-Multiple story of loss and unanswered concerns

As a co-multiple who has lost his twin, I’m looking at your site and have decided to attempt to connect, although I’m getting very frustrated in my efforts to learn about my own loss and how it has affected me. My identical twin was killed in a car wreck 40 years ago when we were 18.

Rather than grieving, I just went forward with the momentum of my life. I was smart, athletic, engaged. Life went on. My two remaining brothers and my parents did not share our grief and our family began to drift apart.

In my 20s, I dropped out of college, protested the draft and the war in Vietnam, found a passionate interest in woodworking (it runs in the family). I was willing to live on nothing for several years while I learned on my own. Was this struggle to do it on my own a sign of trouble? I also began to become very frustrated at my difficulty forming a good intimate, long lasting love relationship. I was experiencing more and more loneliness as my crowd slowly drifted into their careers and families.

I finally fell in love, got married at 40, bought a home, had a child, and spent the last 18 years fighting to do my craft, build the home and garden, be a very involved dad, and support my wife at home. It’s been an exhausting struggle, but I felt happy and fulfilled. Until my wife announced that she was leaving, last January, siting “my abusive anger”.

This has rocked my whole world. I was not very aware of my anger. I figured we had normal marital conflicts and thought we’d eventually work it out. Except that my wife was getting more and more distant and unwilling to have serious talk about our issues. So now I’m alone, working very hard to understand what has happened, and always coming back to all the grief and loneliness I feel in missing my twin.

My woodworking seems to be at a dead end, my family is still in conflict and can’t be relied upon, and I feel distant from my community no matter how hard I try to engage. I’ve slowly lost all the good Buddies I had to share my interests with, although I have many good friends, they just don’t seem to be there for the closeness I crave.

I’ve been trying to look into the twinless groups, but have been unable to find anyone who can share knowledge or experience about how being twinless may be causing me to loose all those I feel close to and to always end up feeling so desperately alone. I am looking for answers more than just sympathetic support.

Yours, Richard

It Should Have Been Her – A Surviving Co-Multiple’s Story

The cold words were a sharp slap across my face. This wasn’t what I needed or wanted to hear. I craved the warm, welcoming softness of a mother’s embrace – not these cruel words of betrayal.

Hiding in the garden within the shadows of the trees, I reminded myself that I had always walked in my twin brother’s shadow, trying to siphon off some scraps of the love that Mother showered him with. Why had I expected it to be different now?

Mother had never seen us as pair. My brother had always been her shining glory – I was just an unwanted extra that tagged along in the shadows. To the World, we had been two. But knowing that we were really one had given me the strength to stand firm.

But now he was gone. My mother had lost her favoured son, the one through whose eyes God smiled for her, and I had lost a part of my very self.

I tried hard to be quiet as I crept back into the house and upstairs. I didn’t want anyone to see “The One” as she had put it – the cursed one who had lived.

The events of the last few days swirled before my eyes. My brother was ill. I’d crept into his room and squeezed his hand.

“Let me share. We can fight it together,” I had chanted over and over trying to absorb his pain, trying to get him to wake up. He had tried to squeeze back, I know he had. Deep in my heart in the golden chamber that belonged to both of us – I knew!

But as I sat beside him, in walked our mother and she shoved me out of the bedroom. Her jealousy of me I had never understood. There was a constant wall between us and I had grown weary of trying to climb it. Mother resented the fact that my brother and I were a part of each other, co-multiple. She had always wanted him all to herself.,

He had hated her cloying love. His eyes mirrored his pain, when she pushed me aside. But we were children, powerless the way children are at that age.

Snorting and hiccuping, I crept into my twin’s room, which Mother had always shared with him. She had never allowed us to share a room in all of our ten years together. She had always tried to come between us. And now someone else had won. He had gone and I had no one with whom to share my hour of grief.

There on his bed lay his favourite green sweater. I picked it up and held it close. But is was just a piece of clothing – no warmth, not unconditional reassurance in its fibers. It was then that I knew that I was alone, so very alone and that my mother hated me.

The years have gone by and now I am fully grown and my mother his still never acknowledged my grief, as if to punish me for somehow being responsible for his death.

Mother had sent me away during the funeral. I never got to say goodbye. Never again got to squeeze his hand and let him know that I was there and that I loved him.

At sixteen, I ran away from home and have been alone ever since. I have no wish to put down roots and sometimes, when the loneliness is particularly overwhelming, I take out my most precious possession – a faded green sweater. A reminder that I, too, once belonged.

Vinda (pen name), survivor of a childhood disease which claimed her twin brother, British Columbia, Canada