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 Amazon.com  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 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.

By Lynda P. Haddon, Article copyrighted.

Multiple Births Canada
www.multiplebirthscanada.org