Note: This is being reviewed and updated a bit in November 2022, after no additions being made since 2018. If you have a peer-reviewed item specific to loss in multiple birth, we’re glad to consider it for inclusion here – please let us know. We can’t guarantee that all of what is listed below is currently findable, but it’s a testament to how much good work was done by many people at the time when multiple births and their realities were becoming so prominent (and how much is still to be done).

This is the Bibliography for this site, and it also is a guide to what exists in print and online on many aspects of multiple birth loss. It is by no means complete – thankfully many more articles pertaining to multiple births, and directly or indirectly to loss, have appeared in recent years and it’s not possible to list all of them. You are encouraged to seek additional books, articles, and other resources, and welcome to suggest additions to this listing. Some of the books and articles listed here are not easy to locate, but that is all the more reason to give you the benefit of knowing that they do exist and so the chance to try to locate them if needed. Any opinions expressed in any of these items (other than those authored by CLIMB) are not necessarily those of CLIMB.

Books – General

Baldwin, Virginia J., MD, Pathology of Multiple Pregnancy (Springer-Verlag, 1994-ISBN 3-540-94011-1): 400+ pages of very detailed and comprehensive clinical information, with illustrations and some statistics, by a pathologist specializing for many years in the complications of multiple pregnancy

Blickstein, Isaac, MD and Louis G. Keith, MD (ed.), Iatrogenic Multiple Pregnancy: Clinical Implications (Parthenon, 2000): 300 pages of articles by experts on topics related to multiple pregnancies induced through fertility technology, and their risks

Blickstein, Isaac, MD and Louis G. Keith, MD (ed.), Multiple pregnancy: Epidemiology, Gestation & Perinatal outcome (Taylor & Francis, 2005, 2nd edition): 976 pages of articles by medical experts worldwide on many aspects of multiple pregnancy and birth

Mundy, Liza, Everything Conceivable: How Assisted Reproduction is Changing Men, Women and the World (Alfred A. Knopf, 2007): several chapters deal in depth with multiple births in relation to fertility technology, discussing the incidence, outcomes, and issues, including MFPR and ST

Newman, Roger B. and Barbara Luke, Multifetal Pregnancy: A Handbook for Care of the Pregnant Patient (Lippincott Williams, 2000): written for physicians but readable by others, with comprehensive information and statistics on multiple pregnancy and birth

Articles – General

American Society of Reproductive Medicine. Multiple gestation associated with infertility therapy: an American Society for Reproductive Medicine Practice Committee opinion (April, 2012): a very thorough review of the current situation in regard to multiple births

Anath, CV,, “The influence of obstetric intervention on trends in twin stillbirths: United States, 1989-99” (Journal of Maternal-Fetal and Neonatal Medicine, 2004, 14): concludes that cesarians and induction have produced a large decline in the rate of twin stillbirths

Blickstein, Isaac, “When and How to Deliver Twins?” (in the proceedings of the 2nd World Congress on Controversies in Obstetrics, Gynecology and Infertility): a comprehensive review

Cheung, Yin Bun, “Mortality of Twins and Singletons by Gestational Age: A Varying Coefficient Approach” (American Journal of Epidemiology, December 15, 2000): concludes that “the optimal gestational age for twins appeared to be 37-39 weeks according to neonatal and infant mortality”

Coetsier, T. and M. Dhont, (Gent) Embryo transfer and multiple gestation: Avoiding multiple pregnancies in in-vitro fertilization: who’s afraid of single embryo transfer? Human Reproduction vol. 13 no. 10 pp. 2663-2670, 1998

Cooper, Susan L. and Glazer, Ellen, “Loss in Multiple Pregnancy” (in Beyond Infertility: The New Paths to Parenthood, Lexington, 1994): a lengthy section on many aspects of multiple birth loss

Derom, R.,, “The risk of monozygotic twinning” (in Iatrogenic Multiple Pregnancy) (see Books section): one of the articles documenting the great increase in monozygotic (“identical”) twinning in twin, triplet or higher order multiple sets after in-vitro fertilization and micromanipulation, with sidebars by Drs. Blickstein and Baldwin on some of the risks to monozygotic (and monoamniotic) babies

Eberlein, Tamara, “Too Many Babies? The Dangerous Rise of Multiple Births” (Redbook, August 1996): one of the first articles to look comprehensively at the downsides of multiple births, including the realities of loss

Hartley, Rebecca, PhD, “Born too late: risky timing” (Twins Magazine, May/June 2002): an article for parents based on her study and her personal experience

Hartley, Rebecca, PhD, et al., “Perinatal mortality and neonatal morbidity rates among twin pairs at different gestational ages: Optimal delivery timing at 37 to 38 weeks’ gestation (American Journal of Obstetrics & Gynecology, Vol. 184, No. 3): a study based on 10 years’ data for Washington State. She devised the “pair method” of looking at mortality, so that – unlike in other studies – it can be determined how many losses after 20 weeks are of one twin and how many are of both, and therefore (for example) how many families are actually impacted by loss.

Hartley, Rebecca, PhD, and Jane Hitti, “Birth order and delivery interval: Analysis of twin pair perinatal outcomes” (The Journal of Maternal-Fetal and Neonatal Medicine, June 2005): an analysis of 5,138 twin pairs which concludes that if prompt vaginal delivery of twin B does not occur, the benefits of vaginal delivery for Twin A might not outweigh the risks of distress and low Apgar scores in Twin B and vaginal plus cesarean delivery for the mother

Kollantai, Jean, “The Context and Impacts of Multiple Birth Loss: A Peer Support Network Perspective” (in Twin Research special issue June 2002, “Loss of a Twin, Triplet or Higher Multiple – see below): an edited version of CLIMB founder’s talk at the ISTS 10th Congress Bereavement Symposium

Kollantai, Jean, Loss and Grief in Twin Pregnancy and Birth. International Journal of Childbirth Education, April 2012

Kollantai, Jean (May, 2012). Loss in Multiple Birth: A Literature Review

Kollantai, Jean, “Multi-realities: coping with the impacts of death in a multiple birth”, reprinted in Iatrogenic Multiple Pregnancy (see Books section): a summary of the major points

Kollantai, Jean and Lisa M. Fleischer, “Multiple Birth Loss and the Hospital Caregiver” / Décès lors d’une grossesse multiple, les professionnels de la santé: des alliés pour les parents / La muerte en nacimientos múltiples y el personal de los hospitales (1993): based on the experiences of CLIMB members

Kollantai, Jean, “Reaching a New Normal,” Twins Magazine, March⁄April 2004: comments on multiple birth loss and how others can be helpful

Machin, Geoffrey, MD, “Boy⁄girl twins not identical, but monozygotic,” Twins Magazine, March⁄April 2003: a twin specialist explains why so-called identical twins are actually monozygotic (same egg) twins, and how monozygotic twins may be unalike in many possible ways, even including gender. Dr. Keith and Dr. Blickstein’s book Multiple Pregnancy also contains articles on this topic.

Panza, Barbara, Guidelines for Supporting Grieving Parents of Multiples, (under “Patients” in the menu, then go to the section titled “Resources”), by a member of CLIMB

Pector, Elizabeth, MD, “Rebuilding A Life After Multiple Birth Loss”: a comprehensive look at grief issues for bereaved parents

Pector, Elizabeth, MD and Michelle Smith-Levitin MD, “Bereavement in Multiple Birth Part 1: General Considerations” and “Bereavement in Multiple Birth Part 2: Dual Dilemmas” (Female Patient, November 2001): another comprehensive look, oriented to caregivers

Pector, Elizabeth, MD, “How Bereaved Multiple Birth Parents Cope with Hospitalization, Homecoming, Disposition for Deceased, and Attachment to Survivors” (Journal of Perinatology, 2004, 24)

Pector, Elizabeth, MD and Michelle Smith-Levitin MD, “Mourning and Psychological Issues in Multiple Birth Loss” (Seminars in Neonatology, June 2002): includes some additional comments and resources

Pector, Elizabeth, MD, “Views of the Bereaved Multiple-birth Parents on Life Support Decisions, the Dying Process, and Discussions Surrounding Death” (Journal of Perinatology, 2004; 24:4-10): based on an e-mail survey of 71 bereaved parents of multiples

Pector, Elizabeth, MD, “What I wish I’d known and what I’m glad I didn’t know” (Our Newsletter, April 2005) reflections 8 years after her own loss experience

Ramsey, Patrick S. and John T. Repke, “Intrapartum Management of Multifetal Pregnancies” (Seminars in Perinatology, February 2003): a review of information and issues related to timing of delivery, labor management, anesthesia options, and choice of type of delivery

Sairam, Shanthi, MD, et al., “Prospective Risk of Stillbirth in Multiple-Gestation Pregnancies: A Population-Based Analysis” (Obstetrics & Gynecology, October 2002): concludes that “multiple gestations at 37-38 weeks have a risk of stillbirth equivalent to that of a post-term singleton pregnancy”

Taylor, Holly, “Rolling the dice in the game of life” (Albany Times Union, March 9-12, 1997): a week-long series which takes a close look at realities of fertility technology, multiple conceptions, selective reduction, and risks of multiple pregnancy, featuring CLIMB members, including a family of 4 survivings quints with physical challenges

TTTS Foundation, Mary Slaman Forsyth, “Compassionate Deliveries” (1994) when one or more of the babies is stillborn

Twin Research, the bi-monthly journal of the International Society for Twin Studies (, is a rich source of current scientific research on many topics related to multiples, sometimes including loss-related ones

Online – General


The Twins Trust in the UK has a really extensive and informative update to the bereavement booklet of TAMBA (the national multiples organization), by Dr. Erika Fraser, “Bereavement Support Group Booklet: For parents who have lost one or more babies in a multiple birth”. “Pub Med”, the National Library of Medicine an organization with information and support for a number of conditions which do or may affect multiples (Twin Transfusion Syndrome, TRAP and others)

Loss of Both or All

CLIMB, Inc., “The Death of Your Twin or Triplet Babies” / La muerte de bebés gemelos, mellizos o trillizos / La perte de jumeaux ou de triplés (1995)

CLIMB, Inc., “The Loss of Both Twins, All Triplets or Higher” (collections of stories from Our Newsletter through 1995)

CLIMB, Inc., “The Loss of Twins in the 3rd Trimester” (a collection of stories from Our Newsletter)

Fifield, Donnali, William & Wendell: a family remembered (Times Two Publishing Co., San Francisco, 2000, her experience of the deaths of her twin sons at different times from prematurity, in the context of being a twin herself, the suicide of her other brother and death of her father, being a survivor of childhood sexual abuse, and being gay. She comments on religion (and absence of religious beliefs) and the limitations of conventional psychotherapeutic models in relation to parental grief.

Howser, Christine, A Different Kind of Mother (1stBooks, 2001) : her account of her loss of her twin sons Timothy and Steven from prematurity, a week apart, “…tragedy, intense grief, depression, a supreme test of faith, a glimmer of hope in the darkness…a glimpse of the crawl back from the brink of despair…” (written from a Christian worldview).

Kollantai, Jean and CLIMB, Inc., “The Death of Twin Babies: Some Comments for Grief Counselors” (1995): based on the experience of CLIMB members.

Mieszkowski, Katharine, “Born too soon,” (, July 25, 2009): an interview with Vicki Forman, whose twins were born at 23 weeks gestation. One of them survived as a super-preemie with severe disabilities, then died suddenly when he was 8. Ms. Forman is the author of a new book, titled This Lovely Life: A Memoir of Premature Motherhood.

Moorhead, Susan, “Double vision: Life After Their Death” (Brain Child, Spring 2001): a short story about the stillbirth of her twins near term.

Novak, Monica, The Good Grief Club (Inkwell Productions, 2008): the story of the members of a SHARE support group over the years since their losses, including the story of a CLIMB member coping with the loss of her triplets

Pector, Elizabeth, MD, “The Loss of Both Twins” (in Twinsworld) comments for a couple who lost their twins, and suggestions for remembering them

Loss of a Twin

Bryan, Elizabeth, MD – please click here for a listing of her articles and book chapters on the loss of a multiple. The late Dr. Bryan was a pediatrician in England deeply involved in multiple births and the founder of the Multiple Births Foundation in the UK.

Centering Corporation, “Death of an Infant Twin” (1984) a 2-page pamphlet written by parents and others that was the only one in the U.S. at the time of Jean’s loss

CLIMB, Inc., “The Death of Your Twin or Triplet Baby” ⁄ Perdre un jumeau ou tripletLa muerte de su bebé mellizo o trillizo (1995)

Cuisinier, M., M. DeKleine et al., “Grief following the loss of a newborn twin compared to a singleton” (Scandanavian University Press, 1996): a relatively large study based in several hospitals in the Netherlands

Davis, Denise, Baby Nathan (Publish America, 2007) : her account of the loss of one of her identical twin sons, who was stillborn and the survivor in the NICU, by a mom who is also a social worker

Doerr, Maribeth Wilder, “A Special Kind of Grief – The Miscarriage of One Twin” (Shattered Dreams, 1991): one mother’s experience, and her comments

Feldman, Rozlyn, “When You Don’t See Double Anymore” (1983): by a mother who lost one of her identical twins to SIDS, it’s still the only thing we’ve seen on the challenges of the loss of a baby who is identical

Fleischer, Lisa M., “When One Twin Dies” (in Bittersweet…hellogoodbye, National SHARE): describes the many things her family did to say goodbye to their twin son who died after birth, including many ways in which the whole family was involved

Fukushima, Rhoda, et al. “Faith and Grace” (St. Paul Pioneer Press, November 22, 2001): a CLIMB family’s experience of the the loss of one twin daughter in-utero from Twin to Twin Transfusion Syndrome, along the birth of the twins and the homecoming of their survivor

Hander, Jennifer, A Place of Peace (iUniverse, 2007): her account of the loss of one of her identical twin daughters and their premature birth, along with her search for meaning, written from a Christian perspective

Hathaway, S., et al. “Loss of One Twin”, in What to Expect When You’re Expecting (4th ed. 2008), pp. 528-529

Inglis, Kate, Notes for the Everlost: A Field Guide to Grief (Shambhala Publications, to be published 2018): based on the author’s experience of losing one of her twin sons when they were born extremely prematurely after undiagnosed Twin Transfusion Syndrome

Kollantai, Jean, ” The Death of a Baby Twin: Some Comments for Grief Counselors” (1995)

Lee, Kelley E. Critical review of the literature: Parental grief after the loss of a multiple. Journal of Neonatal Nursing (2012) 18, 226-231. Twin Research and Human Genetics, August, 2009, pp. 394-401

Lewis, Dr. Emanuel, “Coping with the Death of a Twin” (Health Visitor and Community Nurse, 1987, England): by a psychotherapist with a longtime interest in this and related issues, including the psychological realities of stillbirth

Limbo, Rana and Sarah Wheeler, “Loss in a Multiple Pregnancy: Grieving and Loving at the Same Time” (in When a Baby Dies: a Handbook for Healing and Helping, 1986): a chapter on a mother’s experience, the first such in the U.S., by the founders of RTS Bereavement Services

Multiple Births Foundation (London, 1998): “When a Twin or Triplet Dies: A booklet for bereaved parents and twins”

Miller, Carol Sjostrom, “When a Multiple Dies: Coping with the Loss of Your Baby” (Baby Years, 2002): based on the experiences of Jean Kollantai and another CLIMB mother

Multiple Births Canada/NmC, “The Loss of a Multiple: Miscarriage, Stillbirth, Infancy” (revised 2001): a pamphlet for parents (included in the bereavement packet,

Multiple Births Canada/NmC, “The Loss of a Multiple: The Role of Parents of Multiples Club”: a pamphlet for multiples organizations (in the bereavement packet,

Netzer, Dvorah and Ilan Arad, “Premature singleton versus a twin or triplet infant death: parental adjustment studied through a personal interview” (Twin Research, 1999-2): a small sample, done by personal interview 3-4 years later, concluding that the situations are similar (and twin parents often unsupported)

Noble, Elizabeth, Having Twins – and More (3rd edition, Houghton Mifflin, 2003): includes a chapter on twin loss

Ong SS, Zamora J, Khan KS, Kilby MD. Prognosis for co-twin following single-twin demise. BJOG 2006 113(9): pp. 992-998

Pector, Elizabeth, MD, “Twin Death and Mourning Worldwide: A Review of the Literature” (in Twin Research special issue June 2002, “Loss of a Twin, Triplet or Higher Multiple – see below): a summary of beliefs and practices impacting the death of a twin

Richards, J., et al., Mothers’ perspective on the perinatal loss of a co-twin: a qualitative study (BioMed Central Pregnancy & Childbirth, 2015)

Schulz, Lynne, The Diary (Clever-clogs Independent Publishers, 1998, 83 pages) (⁄index.htm): a book written (from a Christian view) by an Australian mother whose twins were born in 1990 at 39 weeks, 7 weeks after her daughter had died in-utero

Swanson, Kristen, PhD, RN, “There Should Have Been Two: Nursing care of parents experiencing the perinatal death of a twin” (Journal of Perinatal and Neonatal Nursing, October 1988): one of the first and most comprehensive articles for medical caregivers

Swanson, Patricia B., et al., “How Couples Cope With the Death of a Twin or Higher Order Multiple” (Twin Research and Human Genetics, volume 12, number 4, August 2009): a study by an Australian psychologist of grief in 52 couples who experienced the death of a twin or higher-order multiple.

Sychowski, Sandra M. Perfect, “Life and Death: In the All at Once” (Mother Baby Journal, January 1998): by a long-time NICU nurse, using a phenomenological approach in looking at the experiences of some CLIMB mothers

Tracy, Amy, “A Silent Sorrow” (Twins Magazine May/June 2000): based on the experiences of Beth Pector, Jean Kollantai, and several other mothers

Vasilescu, C., Garel, M., & Caeymaex, L. Experience of parents after the loss of a newborn twin in the NICU: A qualitative study 3 years after the death. Arch Pediatr, Mar. 1, 2013

Woodwell, William H., Jr., Coming to Term: A Father’s Story of Birth, Loss, and Survival (University Press of Mississippi, 2001): a straightforward account of his experiences with the birth of their twins at 24 weeks along, and the death of one of them

Wong, B.D., Following Foo: (the electronic adventures of the Chestnut Man) “A true story about intensive caring” by the well-known actor. He and his partner were expecting surrogate twins, identical boys who were born three months early from TTTS and one died after birth.

“Loss of a Twin, Triplet or Higher Multiple”, a 250-page special issue of Twin Research, the journal of the International Society for Twin Studies (June 2002): presentations from the first Bereavement Symposium at 10th Congress of the ISTS July 2001 – plus a literature review, several scientific papers, personal experiences, book reviews, website and organizations listing

Loss of a Supertwin(s)

Bryan, Elizabeth, MD, “Loss in Higher Multiple Pregnancy and Multifetal Pregnancy Reduction”, in Twin Research (special issue, Loss of a Twin, Triplet or Higher Multiple) June 2002 (see “Loss of a Twin, Triplet or Higher Multiple,” above)

Chasen, S.T., “The natural history of high-order multiples” (in Iatrogenic Multiple Pregnancy, see Books section)

CLIMB, Inc., “The Death of Your Higher Multiple Baby” ⁄ La muerte de un niño trillizo, cuatrillizo, etc…

Newman, Roger, MD and Barbara Luke, “Perinatal Significance of Multiple Pregnancies” and “Management of Triplet and Other High Order Multiples” (in Multifetal Pregnancy, Chapters 1 and 10, see Books section)

Pector, Elizabeth, MD, “Ethical Issues of High-order Multiple Births“(Newborn and Infant Nursing Reviews, June 2005)

Pons, J.C., “Management of triplet and higher-order pregnancies” (in Multiple pregnancy: Epidemiology, Gestation & Perinatal outcome, see Books section

Sainsbury, Mary Kay, “Grief in Multifetal Death” (Acta Genet Med Gemellol, 1988): by a nurse who lost one of her quads, by a nurse who lost one of her quads: probably the first study of bereaved parents of a (higher) multiple

Siladi, Heather, “Helping Multiples Cope With Loss, and Lessons My Twins Taught Me Along the Way” (Twins Magazine, March 2006): by a mother who lost one of her triplets, written two years later

Selective Reduction (MFPR and Selective Termination)

A Heartbreaking Choice: a longtime website for parents who have made the decision for termination or selective termination in a wanted pregnancy, with resources for those involved in the decision-making process

Allen, Arthur, “Too Many Babies” (Glamour, November 1998): subtitled “when fertility technology works too well,” it goes into the situation in regard to higher order multiples and MFPR, with personal experiences and some statistics.

Bergh, Christina et al., “Obstetric outcome and psychological follow-up of pregnancies after embryo reduction” (Human Reproduction, vol. 18 no. 8, 1999): a small study in Sweden

Berkowitz, Richard L. MD, “The current status of multifetal pregnancy reduction” (Am. J. Obstet.Gynecol., April 1996): a comprehensive review that also touches on the issue of major handicaps in surviving premature higher multiples

Bryan, Elizabeth MD, “Loss in Higher Multiple Pregnancy and Multifetal Pregnancy Reduction” in Twin Research (special issue, Loss of a Twin, Triplet or Higher Multiple) June 2002 (see Articles section): her very comprehensive presentation at the bereavement symposium of the International Society for Twin Studies conference in June 2001, along with some other presentations touching on MFPR

Carton, Barbara, “Multiple Pregnancies Are Often Pared Back in ‘Fetal Reduction'” (Wall Street Journal, Nov. 21, 1997): includes comments and experiences of a number of CLIMB members

Chitkara, Usha et al., “Selective Second-Trimester Termination of the Anomalous Fetus in Twin Pregnancies” (Obstetrics & Gynecology, May 1989): one of the earliest reviews of these pregnancies and their outcomes

Cooper, Susan and Ellen Glazer, “Multifetal Reduction” (in “Loss in Multiple Pregnancy,” see Articles section above): quotes and comments (with CLIMB’s assistance) on the emotional aspects of MFPR in the context of infertility struggles

Craigo, Sabrina D., MD, “Triplet pregnancy and multifetal reduction: a rational review of the data” (Contemporary OB/Gyn, April 1999): just as the title indicates

Davis, Deborah, Ph.D., “The Emotional Aspects of ART” (in Our Newsletter)

Coping With Your Feelings About the Septuplets” (in Our Newsletter)

Evans, M.I. et  al., “Multifetal pregnancy reduction” (in Iatrogenic Multiple Pregnancy, see Books section): a current review by one of the physicians who developed MFPR. (Other articles by Dr. Evans are in print also.)

Finkel, David, “What Kind of a Choice Is That?” (front page Washington Post, March 21, 1999): on the dilemma of those who conceive higher order multiples, based on the experience of a CLIMB member who lost her quintuplets

Garel, M., et al., “The Psychological Effects of Multifetal Pregnancy Reduction” (in Multiple Pregnancy, see Books section above): a summary of some of the studies which have been done

Grisaru, D. and S. Lipitz, “Selective termination of the anomalous fetus” (in Iatrogenic Multiple Pregnancy, see Books section): as mentioned above

Hathaway, S., et al. “When multiple fetuses aren’t thriving”, in What to Expect When You’re Expecting (4th ed. 2008), pp. 518-519

Kollantai, Jean, CLIMB, Inc., “Selective Reduction: Food for Thought” (1995-2001)

McKinney, Mary, Ph.D., et al., “The psychological effects of multifetal pregnancy reduction” (Fertility and Sterility, July 1995): a study of 42 patients, one year later (by telephone interviews)

Minnick, Molly et al., “Selective Fetal Reduction” (in A Time to Decide, A Time to Heal, Pineapple Press 4th edition, 1994): stories of parents (including some CLIMB members) who decided on MFPR or selective termination

Multiple Births Foundation, “Fetal Reduction” (London, 1997) a booklet for those making a decision about MFPR

Multiple Births Foundation, “Selective Fetocide” (London, 1997): a booklet for parents having to decide about selective termination

Mundy, Liza, “Too Much to Carry?” Washington Post May 15, 18, 20, 2007, on some MFPR experiences and the procedure in the practice of an MD in New York

Newman, Roger, MD and Barbara Luke, “Multifetal Pregnancy Reduction and Spontaneous Fetal Death” (in Multifetal Pregnancy, Chapter 4, see Books section): as mentioned above, information on both MFPR and selective termination

Owens, Anne Marie, “The Selective Reduction Debate” (Multiple Moments, Multiple Births Canada, issue 4, 2004)

Pector, Elizabeth, MD, “Ethical Issues of High-order Multiple Births” (Newborn and Infant Nursing Reviews, June 2005): includes an impartial review of some of the information about higher multiple risks and reduction

Rapoport, Tal, Psy.D., “The Dilemma Within a Miracle” (self-published 2000): based on her doctoral project, it is a supportive booklet for those having to consider MFPR.

Redwine, Fay O. and Patricia M. Hays, “Selective Birth” (Seminars in Perinatology, January 1986): one of the first articles on the facts and issues surrounding selective termination

Roberts, Martha, “Having a twin is a bittersweet experience” (The Daily Mail, Feb. 2, 2009): the experience of a mother who conceived twins after IVF and learned that one of them had a very serious problem.

Smith-Levitin, M., “Reduced and non-reduced twin pregnancies: are they the same?” (in Iatrogenic Multiple Pregnancy, see Books section): a review of MFPR and the outcomes of pregnancies after MFPR

Smith-Levitin, M., et al., “Selective reduction of multifetal pregnancies to twins improves outcome over nonreduced triplet gestations” (Am.J. Obstet.Gynecol. 1993, 60(3) ): based on her review of then-available data

Scheiner-Engel, Patricia, PhD, et al., “First-trimester multifetal pregnancy reduction: Acute and persistent psychologic reactions” (Am. J. Obstet. Gynecol, February 1995): a study of the first 100 to undergo MFPR at one institution where it was pioneered in 1986

Wegner-Hay, Martha, Embracing Laura (Lulu Publishers, available through Amazon): the experience and thoughts of a mom who underwent selective termination after prenatal diagnosis of Trisomy 21

“Selective Reduction,” a fact sheet by Multiple Births Canada⁄NmC

(see also some comments and citations in Lee, Critical Review (in the Loss of a Twin section above)

Accessing at⁄pubmed and searching for “multifetal pregnancy reduction” will result in citations of most of the peer-reviewed studies of the medical and psychological aspects of MFPR. Most of the citations include abstracts, and a few include the full article.

If You’re Pregnant Now

Loss In-utero

Ainsworth, Claire, “And Then There Was One” (New Scientist, London, 20 October 2001) and on the current state of knowledge regarding “the vanishing twin”

Boklage, C.E., “The frequency and survival probability of natural twin conceptions” (in Multiple pregnancy–Epidemiology, Gestation and Perinatal outcome, see Books section)

Burley, Vicky. How to Survive When One Twin Dies: one woman’s journey through twin loss during pregnancy

Hodge, Amy, “Doula care and twin loss,” International Doula, vol. 2 issue 3: the experience of one family, it includes their birth plan

Kollantai, Jean, “The Emotional Impact of Stillbirth in a Multiple Pregnancy” (WiSSPERS newsletter, Vol. 1 No. 3, Spring 1994)⁄wissp⁄wisspers⁄spring97.htm

Landy, H.J. and B.M. Nies, “The Vanishing Twin” (in Multiple pregnancy– Epidemiology, Gestation and Perinatal outcome, see Books section)

Lopez-Zeno, J.A. and Navarro-Pando, J., “The intrauterine demise of one fetus” (in Multiple pregnancy–Epidemiology, Gestation and Perinatal outcome, see Books section)

Malinowski, Witold, et al., “The Case of Monochorionic Twin Gestation Complicated by Intrauterine Demise of One Fetus in the First Trimester” (Twin Research and Human Genetics, June 2005): some statistics and information on the loss of a twin in the first trimester, with babies who share a placenta at higher risk

Newman, Roger, MD and Barbara Luke, “Multifetal Pregnancy Reduction and Spontaneous Fetal Death” and “Obstetrical Complications Unique to Multiple Gestations” ( Multifetal Pregnancy, Chapters 4 and 8, see Books section): some aspects of in-utero death in multiples

Pauli, Richard MD, “Causes of stillbirth in twins” (WiSSPERS newsletter, Vol. 1 No. 3, Spring 1994)⁄wissp⁄wisspers⁄: about monozygotic (“identical”) twins

Schulz, Lynne, The Diary (Clever-clogs Independent Publishers, Murray Bridge, South Australia, contact the story (from a Christian worldview) of a mother in Australia whose twins were born in 1990 at 39 weeks, seven weeks after her daughter died in -utero

Woo, HHN, et al., “Single foetal death in twin pregnancies: review of the maternal and neonatal outcomes and management” ( Hong Kong Medical Journal, September 2000): a comprehensive review of available information

Yoshida, K., “Documenting the vanishing twin” (in Multiple pregnancy– Epidemiology, Gestation and Perinatal outcome, see Books section)

Knowing Ahead

Grisaru, D. and S. Lipitz, “Selective termination of the malformed fetus” (in Iatrogenic Multiple Pregnancy, see Books section): some information on congenital anomalies being more frequent in twins and higher multiples

Meyers, C., S. Elias and P. Arrabal, “Congenital anomalies and pregnancy loss” (in Multiple pregnancy–Epidemiology, Gestation and Perinatal outcome, see Books section): a review of the nature and incidence of congenital anomalies in multiples

Newman, Roger, MD and Barbara Luke, “Genetic Diagnosis in Multiple Gestations” (Multifetal Pregnancy, chapter 3, see Books section)

Delayed Interval Birth

Newman, Roger, MD and Barbara Luke, “Delayed Interval Delivery” (pages 201 and 237-38 in Chapters 10 and 11 of Multifetal Pregnancy, see Books section)

Van Eyck, Jim and Birgit Arabin, “Delayed-interval delivery in multiple pregnancy” (in Iatrogenic Multiple Pregnancy, pp. 280-81, see Books section)

Cacciopoli, Vera, “Buying Time: A look at delayed interval birth” (Twins Magazine, May⁄June 1997): includes a CLIMB family who lost one of their triplets

Loss of a Multiple to SIDS

Check, Alice, “SIDS in Twins“: summarizes the information available on the incidence of SIDS in multiples, with attention to the relative risk for survivors; bibliography of key studies

Check, Alice, “SIDS in Twins”, Twins Magazine, April 2005

CLIMB, Inc., “SIDS & Multiples” ⁄ SMSL y Nacimientos MúltiplesLe syndrome de la mort subite du nourrissonet les grossesses multiples (1995, 2004, 2004)

CLIMB, Inc., “The Loss of a Multiple to SIDS” (collections of stories in Our Newsletter through 1997)

Getahun, Darios, MD,, “Sudden Infant Death Syndrome among Twin Births: United States, 1995-1998” (Journal of Perinatology, 2004, 24)

Malloy, Michael H., MD, Daniel H. Freeman, PhD, “Sudden Infant Death Syndrome Among Twins” (Arch Pediatr Adolesc Med, July 1999): a comprehensive study

Koehler, Steven A., PhD, et al., “Simultaneous Sudden Infant Death Syndrome,” Am. Journal of Forensic Medicine and Pathology, 2001: an analysis of the available data that concludes that SSIDS is extremely rare

Perez, Christine RN, “Twins and SIDS”, New Mommy Media, 2014: an extensive interview with a mother who lost one of her identical twin daughters to SIDS, and commentary at⁄twins-sids-sudden-infant-death-syndrome⁄

“When Crib Death Happens to a Twin”, a booklet of poems and quotes by parents and other relatives (SIDS Resources Inc., not dated but we think late 1980s)

“When a Twin Dies of SIDS”, a handout on the emotional and social impacts (Maryland SIDS Information and Counseling Program, 1994, prepared by C. Hosford, LCSW-C), a major source of information on SIDS in general; a Google search for “SIDS” will also show a number of other sources, such as the SIDS Alliance⁄First Candle., a website on Sudden Unexplained Death of a Child; see also

Loss of an Older Multiple

CLIMB, Inc., “The Loss of an Older Multiple” (collections of stories in Our Newsletter through 1998)

Kollantai, Jean, “The Loss of a Twin or Multiple in Childhood” (CLIMB, 2007)

Kollantai, Jean, “El fallecimiento de un niño mellizo o fruto de embarazo múltiple durante la infancia” (CLIMB, 2007)

McInnes, Sheryl, “Death of a Twin”, TWINS Magazine, March⁄April 1985: on the loss of a twin generally, and includes the articles “A Special Relationship” by Gus Boyle and “My Son Charles” by Grace Dibble Boyle, parents of identical twin sons one of whom drowned when they were 3

Multiple Births Canada⁄NmC, “The Loss of a Multiple: Childhood, Teens”: (from Multiple Births Canada⁄NmC, formerly POMBA, also written by the late Sheryl McInnes, who was the bereavement coordinator for some years)

Pearlman, Eileen, PhD and Jill Alison Ganon, Raising Twins (HarperResource, 2000): Chapter 12, “When A Twin Dies”: some basic points, by a psychologist who has been active in the area of twin loss

Redfern, Suzanne and Susan K. Gilbert, The Grieving Garden, Living with the Death of a Child (Hampton Roads, 2008) : stories and comments of parents who have experienced the death of a child in childhood or young adulthood, including those of a family who lost one of their identical twins to SUDC, Sudden Unexplained Death in Childhood, when they were 2-1⁄2


Barron, D.S. “Once There Were Two…Stories from the Lone Twin Network” (Health, September 1996): a surviving twin whose brother died when they were 12 describes a trip to England to meet Joan Woodward and members of the network she founded.

Bennett-Santoro, Michael and Pamela, “Talking to Teachers About Grief” (We Need Not Walk Alone, the magazine of the National Compassionate Friends, Spring 2004): a thirteen-year-old boy deals with the third anniversary of his twin sister’s death.

Davis, Deborah, PhD, “Multiple Birth Survivors” (in Empty Cradle, Broken Heart, Fulcrum, rev. 1995): a psychologist’s comments and suggestions on relating to young survivors

Hanrahan (Medler), Junelle, “Breastfeeding after the Loss of a Multiple” (Leaven, October-November 2000), and “Grieving While Lactating” (Clinical Issues in Lactation, November 1999) LVOctoNov00p102.html: for professionals but also helpful for parents.

Medler (Hanrahan), Junelle, “Breastfeeding and Multiple Birth Loss“: based on her own experience.

Pector, Elizabeth, MD, “Thoughts on Parenting a Twinless Child” (Twinsworld, Winter 1998) articles.html

Pector, Elizabeth, MD, “Raising survivors of multiple birth loss: What can parents expect?“: a summary of available information

Piontelli, Alessandra MD, Twins From Fetus to Child (Routledge, 2002): from her many years of experience, information on twinning, maternal-fetal complications, and intrauterine behavior and development of twins

Polley, Kate, “Sam and Finn”, 2014: a storybook for a young surviving twin, based on the author’s experience.

Samuels, Valerie, Always My Twin: a last, a storybook for young surviving multiples and their parents! ISBN 1-4120-6036-2⁄05-0937. (The author may be contacted through CLIMB for larger orders or questions.)

Withrow, Rebecca and Valerie L. Schwiebert. “Twin Loss: Implications for Counselors Working With Surviving Twins” (Journal of Counseling & Development, Winter 2005): a comprehensive article. A statement in it (about substance abuse in bereaved parents of a young twin) that was not cited this was later formally corrected by the journal. (So delete that sentence in the second-to-last paragraph!)

Woodward, Joan, PhD, The Lone Twin: Understanding Twin Bereavement and Loss (Free Association Books, 1998): by a psychotherapist who lost her own twin sister at age 3, and has worked professionally with surviving twins as well as founding the first “lone twin” group, in England. She believes that the lack of support for the parents of the surviving twins of birth loss (Chapter 2, and very evident in most of the accounts) is a major factor in the survivors’ reactions.

Elizabeth Bryan – Bereavement Articles and Book Chapters

Death of a twin. E M Bryan. Maternal and Child Health. 1983, 8: 201-6.

The death of a newborn twin: how can support for the parents be improved? E M Bryan. Acta Genetica Medica Gemellologicae (Roma) 1986, 35: 115 8

The intrauterine hazards of twins. E M Bryan. Archives of Disease in Childhood. 1986, 61: 1044-5

Management of perinatal loss of a twin. E Lewis & E M Bryan. British Medical Journal 1988, 297: 1321 3

No longer a twin. E M Bryan. Journal of Obstetrics & Gynaecology, 1987, 8: 70-86.

The response of mothers to selective fetocide. EM Bryan Ethical Problems in Reproductive Medicine 1989;1: 28 30

The death of a twin. E M Bryan. World Pediatrics & Child Care 1991, 5: pp. 1-3

Some Ethical Dilemmas. E M Bryan, R Higgins, D Harvey In: Stress of Multiple Births. eds D Harvey & E M Bryan. London. Multiple Births Foundation. 1991

But there should have been Two. E M Bryan In: Stress of Multiple Births. eds D Harvey & E M Bryan. London. Multiple Births Foundation. 1991

The Death of a Twin. E M Bryan. In: Caring for Dying Children and their Families. ed L Hill. London. Chapman and Hall. 1994

Problems Surrounding Selective Fetocide. E.M Bryan In: The Human Side of Prenatal Diagnosis. eds L Abramsky, J Chappel. Blackwells. 1994

Perinatal Bereavement after the loss of a twin. E M Bryan. In Multiple Pregnancy. eds R H Ward, M Whittle. RCOG Press 1995

The death of a twin. E M Bryan. Palliative Medicine 1995; 9: pp. 187-92

Ethical Dilemmas. R Rowson & E M Bryan. In: Infertility: Nursing and Caring. eds L Meerabeau, J Denton. Scutari Press 1995

The Death of a Twin. In: The Psychology of Twinship. ed A Sandbank. Routledge 1999

Loss in Higher Multiple Pregnancy. E Bryan, J Denton Triplets and Higher Order Pregnancies. Eds I Blickstein, L Keith Parthenon Press 2001

Yoruba customs and beliefs pertaining to twins. F Leroy, Taiwo Olaleye-Oruene, G Koeppen-Schomerus, E Bryan. Twin Research 2002

Loss in higher multiple pregnancy and multifetal pregnancy reduction. E Bryan. Twin Research 2002, 5: pp. 169-174

Also chapters in the following books:
The Nature and Nurture of Twins. Eastbourne. Bailliere Tindall 1983

Twins in the Family. London. Constable 1984

Twins, Triplets and More. London. Penguin 1992 (updated edition 1995) and New York St Martin’s Press 1992. (also translated into Japanese, Danish, German, Dutch and Portuguese)

Twins & Higher Multiple Births: A guide to their Nature & Nurture. Sevenoaks. Edward Arnold 1992

Infertility: New Choices New Dilemmas. E M Bryan, R T Higgins. London. Penguin 1995 (also translated into Portuguese and Japanese)

Multiple Births and their Impact on Families. Guidelines for Professionals. E Bryan, J Denton, F Hallett. MBF.

1. Facts 1997
2. Multiple Pregnancy 1997
3. Bereavement 1997
4. Special Needs 1999
5. The First Five Years and Beyond 2001

Loss of a Twin, Triplet or Higher Multiple. Special Issue of Twin Research 2002;5(3)Eds E Bryan and R Higgins

[ back to “Loss of a Twin” Bibliography section ]