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Resources Centre / Twins Tips Introduction / Twins Tips / Loss of a Twin/Triplet in Multiple Pregnancy & Birth
Loss of a Twin/Triplet in Multiple Pregnancy & Birth
The birth of a child is one of life's greatest celebrations. Especially during a multiple pregnancy. parents fantasise about their babies. about taking them out. showing them off to friends and family. trying out names and how they sound. When the outlook is positive. those close to the couple share in the journey as excitement and anticipation mount.

In spite of everyone's best efforts. there is a chance that you may lose one. more or all of your babies. Yet when one. more or all of the babies dies by miscarriage or stillbirth. parents at times are encouraged to consider a miscarriage or stillbirth as something less than a "real" death. People around you often want to help. but find it difficult to understand the special circumstances of your loss. Information mentioned in this article and from other resources can assist them say and do things that are helpful and avoid those that are hurtful.

If you do lose one. more or all of your babies. you may wish the birth and/or death certificates to reflect the fact that your baby(ies) was part of an appropriate multiple birth set. i.e. loss of one triplet does not make it a "twin birth". loss of two quadruplets does not make it a "twin birth" and so on. You may need to be vocal about your wishes as some hospitals may record only the surviving baby(ies) and not your accurate multiple birth.

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.

Miscarriage
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 husband. You have visualised 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 your local twin and triplet support club until you feel ready to let go.

Stillbirth / Newborn Death / Loss in Infancy
Prematurity is still the leading cause of death in a multiple birth situation. There is no guarantee against the early delivery of your babies. Even in spite of appropriate and timely intervention by hospital staff. a loss of one. more or all of the babies may still occur.

If such is the case. you will no doubt be:
  • grieving for your baby(ies);
  • grieving the loss of a unique type of parenthood;
  • feeling shocked. empty and alone with disappointment. anger. sadness and grief;
  • wondering how this could happen and fear that you might not have other children.
The loss of one baby from the multiple birth set. can present complicated emotions to deal with:
  • Why this baby and not the other?
  • Did I resent or fear the thought of looking after two. three or four babies and thereby cause this to happen?
  • Did I "wish" one or more babies "away" and cause this to happen?
  • Did my preference for one sex cause this baby to die?
  • How will I tell the survivor(s) about her sister and when?
While these thoughts are normal. they also increase the burden of guilt and grief. Don't leave these feelings bottled up inside of you. Talk to a bereavement counsellor. good friend. hospital staff. your partner or religious support person. in order to assist you in putting your feelings into perspective.

You may experience inner struggles as you try to deal with the joy of the birth of one baby and the loss of another. It is imperative that 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 possibly 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).

Losing one. more or all of your babies leaves the parents and those who care about them to deal with complicated issues. Some of these issues are:
  1. Not only have you lost a baby(ies). but you have also lost a unique parenting experience. Seeing other people with their multiples is a painful reminder of your loss. and may trigger feelings of envy. anger. failure or sorrow. In addition. when there is (are) a surviving child(ren). it can be difficult to resolve the conflict between the two extreme emotions that you are feeling - that is. the joy of the birth of a baby(ies) and the sorrow of the death of a baby(ies).
  2. Your feelings may include rage. shock. numbness. guilt. panic. being out of control. powerlessness. confusion. and/or denial. You are adapting to a new reality and it takes time to adjust. In fact. we are never the same after the death of a child(ren). We adapt and go on. but we are not the same. Grief is a journey. not a destination. Expect powerful feelings to resurface at different times as you walk the rocky road. It is healthiest to allow yourself the neeed time to experience them as they arise. rather than suppressing them.
  3. You may not wish to be touched or held for a period of time after your loss because of a fear of losing control of your emotions. At work or in social situations. you may not wish to discuss your children or your loss. afraid that you will break down in tears and be unable to stop the flood. It helps to tell family. friends and co-workers what you do and don't want to talk about. Every parent is different. While some want and need to talk about their distress with anyone who will listen. others wish to keep their personal pain separate from their social responsibilities. It helps to tell family. friends and co-workers what you do and don't want to talk about.
  4. You may find that people pay more attention to the live baby rather than the fact that one (or more) died. They may feel that dwelling on the dead baby may make things more uncomfortable for you. Feel free to speak up if you wish to speak of your dead child(ren). Others will be more open about their thoughts if they know you are happy to hear your dead baby's name and consider him or her to be a special part of your family.
  5. On the other hand. you may wish. yourself. to push all thoughts of the dead baby(ies) out of your mind and concentrate on your surviving baby(ies). You might wish others would stop reminding you of the baby(ies) you have lost. You need not feel guilty about this normal reaction. Parents can only cope with so much at once. With newborns. especially when they are premature or ill. it is common for parents to devote their energy to their living children and delay grief until a later time. In due course. you will find the right way to acknowledge the child who died.
  6. Parents often hear inappropriate comments that are meant to comfort them but in fact. do exactly the opposite. To hear "It's not the same as losing a baby. this one never drew breath." or "You are young. you can have other children" is devastating. even if the comment is well intentioned. "At least one survived." I am truly grateful. but one crib is still empty. "It's God's will. They've gone to a better place." There is no better place for babies to be than with their parents! "It's for the best. she/he would have been disabled. Death of a child is not "good" and not necessarily easier to handle than disabilities. "You have a healthy baby. just forget the other and get on with your life." You have 2 legs. If one was amputated. how would you feel if I said "you have one healthy leg. forget the one you lost and move on?""You could never have handled quadruplets." Death of a child is not easier to handle than mounds of nappies or huge shopping bills!
  7. Communication is important. and a counselor may help bereaved parents avert losing relationships with family or friends. People often call two surviving triplets or quadruplets "twins". They need to know what you want to call them. Likewise. one mother reported one of her twin daughters was born very ill and died in the hospital after a short life of two months. Her mother-in-law focused on the surviving. healthy baby. sending the parents a card congratulating them on the "birth of their daughter". The dead sister was never mentioned. even though she lived for two months. was named and given a funeral. A rift developed between the mother and mother-in-law. with hurt. anger and hostility at the lack of acknowledgement of one grandchild's birth and death.
  8. Recognize that you will have limits. Your pain may be so intense that you will have nothing to give to the rest of the family or spouse. Be honest and let them know when you need some space for the time being.

Memories
It can be very helpful for parents to see. hold and touch their dead baby or babies. I feel very strongly that we cannot say "Good-bye" until we have said "Hello." No parents have ever expressed to me their regret at having seen and held their babies. but several have expressed regret that they did not. Sensitive and caring hospital staff can encourage parents to hold their baby(ies). and bathe them if they wish. You can take photos of the deceased babies separately and together. with any surviving babies from the multiple birth. and with other siblings if you desire this. Hospital staff are often exemplary in supporting families at this difficult time. making it as easy as possible for you. although they cannot change the tragic reality of death. Parents are often given specially designed Memory Boxes. one per baby. which may include: the blanket the baby was wrapped in. a lock of hair when possible. plaster hand and foot prints. an outfit the baby wore. hospital bracelets and several photos of each baby. Such special items are cherished as tangible evidence of the reality and value of a baby who did indeed live. even if only in dreams.

There are companies and artists who can create drawings of your babies. or unite separate photos of babies with computer imaging to create a group picture. These tasteful and precious photographs or sketches can provide parents with much comfort. As one Dad put it ".it the photograph proved to the world that our son was real."

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.
  • 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 Mum and Dad.
  • As 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.
  • 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.
Vanishing Twin Syndrome
It is not uncommon for families with vanishing twin to experience feelings of sadness. grief and loss as they had anticipated and looked forward to a multiple birth.

With ultrasound. it is now possible to know as early as five or six weeks that you are pregnant. However. with these first trimester. early ultrasounds an interesting side effect has occurred. The early ultrasound confirms two or more fetuses and a subsequent ultrasound reveals the 'disappearance' of at least one of the fetuses and an empty sac may be visible. This 'disappearance' is called Vanishing Twin. It is not clear why one (or more) fetus fails to develop and is either miscarried or reabsorbed into the mother's system. See more details in our article on Vanishing Twin Syndrome.

Please don't feel alone in your grief. There are many caring people available to assist you. Below you will find some support contacts both here in the UK and abroad. Books and leaflets on bereavement are available as well as many articles and personal stories that you may find helpful.

Resources : Lynda P Haddon Multiple Births Families www.multiplebirthsfamilies.com
Support Contacts:

UK Support :
Twins and Multiple Births Association (Tamba)
Bereavement Support Group
2 The Willows
Gardner Road
Guildford
Surrey
GU1 4PG
T: 0870-770-3305

The Multiple Births Foundation
Hammersmith House Level 4.
Queen Charlotte's & Chelsea Hospital.
Du Cane Road. London.
W12 0HS
T: 0208 383 3519

SANDS (Stillbirth & Neonatal Death Society)
http://www.uk-sands.org
The Miscarraige Association
International Support :
Multiple Births Families - Lynda P. Haddon
Location : Ottawa. Ont. CANADA

Multiple Births Canada
Loss Support Network

Centre for Loss in Multiple Birth (CLIMB). Box 91377. Anchorage. AK 99509
e-mail: climb@pobox.alaska.net



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