for when… one baby dies in a multiple pregnancy during the first trimester

You have discovered in these early days that you are pregnant with multiples. Now, so quickly into this special time, you have discovered that one of the babies has not survived and you must continue through the remainder of the pregnancy for the sake of the other baby or babies. We send our heartfelt sympathies and encourage you to seek out all the support you can.

With the introduction of ultrasound scanning, it is becoming increasingly apparent that more pregnancies begin as more than one but by the end of the first trimester (the first 12 weeks), a great many of these pregnancies have become singleton pregnancies. There may have been a bleed or loss of some tissue but in many cases the only clue to a twin pregnancy was the early scan which clearly showed more than one baby.

This phenomenon has been described as “vanishing twin syndrome”. While these babies may appear to physically vanish, they do not vanish from being and the early loss of a twin affects the survivor in ways that researchers are only just beginning to acknowledge and understand. For families themselves there is grief for the loss of a child and for the loss of the “twin” experience. The remainder of the pregnancy may be an anxious time as parents await the birth of the remaining baby with concerns for its well being plus the thoughts and grief for the baby who was lost.

Following are some experiences of families who have suffered the loss of a twin in this way. We hope that by sharing their stories with you, you will be able to begin to work through your own story.

Julie writes after the discovery that her twin baby Megan had died at around 15 weeks gestation:

Mentally, the rest of the pregnancy was extremely difficult. It is very hard to reconcile the joy and hope you have for one baby and the overwhelming sense of grief and loss you have for the other baby. Those emotions were two extremes, exact opposites, yet I had to live with them simultaneously. For the remainder of the pregnancy I had fortnightly sonograms to monitor both babies. At each one Chris would scan Thomas, explaining things as we went along. And he would always ask me if I wanted to see my other baby and I’d always say yes. It was comforting to see Megan still there with us. I would drink in those images of her trying to imprint them on my memory not knowing if this would be the last time I would see her. Whilst I grieved so very deeply for Megan, I also felt that for Thomas’s sake I had to focus on him and keep on daring to hope he’d keep growing as he should and make it to term.

The 37 week sonogram confirmed that I still had both babies to deliver. Both babies’ sacs and the separating membrane were still intact although Megan’s body appeared to be fragmented. It was always very reassuring for me to see the separating membrane because I knew that while it stayed intact, each baby would remain safe and sound in their own sterile environment.

After the birth Julie writes:

The hardest part of the pregnancy was grieving Megan’s death and anticipating her birth. It was estimated that Megan had died at 14 w 6d gestation, approximately 10/12/2000 and by the time of delivery she had been dead for approximately 23 weeks. It was one of the big unknowns of the pregnancy, whether Megan would stay with us to the end of whether Thomas’s placenta would incorporate her sac/bady, the so-called “vanishing twin syndrome.

The following morning I got a message from the birthing unit to say the placenta was in storage so that I could come down and view it whenever I wanted. The midwife took me into the room containing the sterilising units and there on the bench was a kidney shaped bowl with my placenta in it ,covered with paper and my name written on top. She said she didn’t know what we were going to see as she hadn’t inspected the placenta prior to my arrival. I couldn’t glove up fast enough and ended up with the gloves on/half off in my haste. we fingered our way through the placenta. That was fascinating in itself but you can imagine my elation when I saw what looked like figure eight imbedded in the membrane. The top part of the figure eight had a black dot in it. The bottom part of the figure eight had a telephone looking cord coming away to the left and I said, “do you know, that to me looks like a head, an abdomen and the umbilical cord” and she agreed that it could well be. By this time another midwife had come to join us so I passed my camera over for her to take a photograph. Unfortunately, when developed this photograph didn’t really represent my memory of what I saw. Then I asked if it were possible for us to cut away the membrane so that I could better see the baby and she did. Again the other midwife took a photo. That was the last photo on the roll so I ripped off my gloves, changed films and asked if we could lay the body on the green paper. It was a painstaking process but she respected every request I made of her and slowly but surely she laid Megan’s body out for me to see. Megan’s head was facing to the left with her little arms crossed over her chest and her little legs tucked up, just as I saw in the 17 week sonogram. we were able to separate one arm and both legs from the foetal position. Megan’s form was not much longer than a paddle pop stick, quite flat from where Thomas’s placenta had compressed her against the uterine wall and she was kind of doughy looking. We could clearly see the slits where the fingers and toes had once been, her right eye that I had seen through the placental membrane and the umbilical cord. We turned Megan’s body over and we could see her left ear, the vertebrae and her rib cage. I was just amazed how perfectly formed she was.

I guess they were wondering how I would react to all of this but I would have to say I was elated and in my excitement I took more photographs. Then other midwives came in to see Megan’s body and they kept on saying, “look at this, you’ll never see this again, it’s a once in a lifetime thing”. They used the clinical term “foetus papyraceous” and they were all abuzz with excitement. I just kept on saying over and over, “she’s such a miracle, she’s beautiful to me.” In many ways I could have spent all day there just looking at her but I knew I couldn’t.

Another mum writes after finding her twin baby had died earlier at 13 weeks:

As February approached, my amniotic fluid level dropped so my doctor decided to induce me a bit early. Our daughter was born healthy and happy. Her twin was delivered with the placenta. That’s all we saw, and that was okay for us. Our baby’s spirit was in heaven and in our hearts, not inside that sac. (I never liked that name “vanishing twin syndrome”. Our twin didn’t vanish, physically or spiritually.)

Kirsten writes about the birth of her babies after discovering that one had died at around 12 weeks gestation:

I had a scan at 36 weeks which showed no sign of Jo (the other twin) which was very hard on me, but it meant my midwife would allow me to go through a home birth again. On March 2nd I went into labour and Regan was born and before and before the placenta came out there was a second bag of water which broke. I chose to believe that Jo was with us in spirit at least until that moment as we all thought that there was going to be nothing left. we could also see the remains of Jo and the placenta which means we had something to bury after all. We have buried Jo and the placentas with a pohutakawa tree which one day I will give to Regan.

The loss of a baby is always significant no matter how early the loss happened. In the cases of very early loss families may not be left with any physical evidence of a baby but ways can always be found to acknowledge this dearly loved baby and the grief it’s loss brings. Many have found it helpful to talk to others who have lost twins and survived this bittersweet time and so we encourage you to be in contact with us anytime about anything. Take care and do seek out the help you can find at this time.