» Loss of a Supertwin(s)

If you are visiting this section because you have experienced the death of one or more of your supertwins – triplets, quads or more, also called higher order multiples, or HOMs – with one or more survivors, we are very sorry. You are not alone. As we’ve mentioned, the time that CLIMB began in response to twin loss was the time that fertility technology dramatically increased not just the number of twins but the number of triplets and other higher order multiple conceptions and births. So over the years we have known and been in contact with an uncountable number of parents who have conceived “a whole family, at last” and then experienced tragedy in their pregnancy or at or after birth, or in infancy or beyond. Triplet pregnancies, which had been estimated at 1 in 6,400 to 7,910 pregnancies without fertility technology, already by 1990 had become 1 in every 1,341 pregnancies in the U.S., and in 1998, 1 in 570 pregnancies (Luke and Newman, Multifetal Pregnancy, see Bibliography) – so while the number of twins did double, triplets went from being something quite rare to something that occurred much more often, with not much known yet about the pregnancies, birth and parenting. Similar things were true of quads, quints and more, which were an extreme rarity before (as noted on our home page, these numbers have declined since 1998 but are still much higher than before widespread use of fertility technology). Though the media and others tend to focus on the “miracles” and the very rare mega-“successes” of 6 or 7, or even 8 (which make it look like triplets or quads are supposed to be easy) and the idea that somehow every mother can do it if she wants to enough, the sad truth is that in having three, four or five (or more) babies at the same time, there are very high risks that can become reality for parents no matter how much they love and want their children and try to do (and do) everything right.

Whether or not it is after years of trying and fertility technology, it is incredibly difficult to have such a special “gift”, then have to experience everything about the death of a baby or babies while also becoming the parent of and caring for a baby or babies who is part of the same set and often has special care needs and issues because of being very premature. This kind of loss situation been mostly unrecognized and unsupported and we hope that this section will develop over time into something that is truly helpful to parents who are having to travel this road and also to those who are involved in these pregnancies and losses in any way. The article below describes more of what we have seen over the years, and some of the various loss situations that parents have experienced.

No matter how many babies have lived and how many have not, loss in supertwins is an incredibly difficult journey into some pretty uncharted territory, and one that parents could never have imagined as being what it would be like to be a parent, or a parent again, and the more so after the kind of bonding that takes place through ultrasounds. All the things that can be said about the emotional aspects of the loss of one twin, and what parents need to know after they have lost one of their twins, are relevant here – but we’ve noticed that there are some things that are especially important for supertwin families:

· With so many babies and so much potentially going on with them at the time of the birth(s) and after, parents are even more likely not to have enough opportunity to see and hold their babies or babies who died. Mothers are even more likely to have had a traumatic birth medically, and fathers are even more likely to be separated from the mother and some of the babies because of going with one of the babies to another hospital or some other special care. Staff may be even less likely to realize how important it is for parents to see and hold their baby or babies who has died, spend time, and have good photographs and other mementos, or to plan and participate in the arrangements for their baby and for a memorial service. Parents, relatives and caregivers all need to know how important these things are and get or arrange support in any way possible. One hospital made arrangements to transport two triplets who were doing well over to the hospital where it was known that their co-triplet was not going to be able to live much longer – the parents were able to experience having all of their babies together during the time that it was possible, and to have good photographs and mementos of that time, along with their survivors knowing later that they did get to meet and say goodbye to their brother. Also, mothers who experience the death of more than one baby at separate times need extra support when they have already used many of their coping resources.

· Delayed grief and delayed onset of the active grieving process is really likely, it’s probably the rule more than the exception, since there is some much involved in not only the birth and loss, and everything about having a tiny survivor or survivors. Homecoming is often the beginning of it – being out of the world of the hospital and into what is “new normal” at home, with a little more time to even begin to truly experience and process it all while being forced to recognize the reality that that baby or babies didn’t come home, or didn’t stay. Often, it’s later, because of the intense care of tiny babies or a very tiny sole survivor and the expectations of others that mom be grateful and never take any time to grieve. Sometimes dads are afraid of what would happen if mom would openly grieve. One mother called because – with two surviving triplets now doing well, another child before and another baby after the triplets, all under the age of 4 –her husband was concerned that if she took time to grieve for her triplet son she would become “obsessed” and unable to function. She herself felt that if she did NOT grieve and do what she needed to for him, that’s exactly how she would become “obsessed” and less able to care for and enjoy her living children as well as feel more peace herself. When parents – and this does include many fathers too – do begin the more open grieving process, it can be especially difficult because of the lack of opportunities and mementos at the time of the birth and loss that many have experienced. We hope that the article below by a CLIMB member, Brenda Noble, who lost one of her quadruplet sons when he was born at 18 weeks along, will be helpful, and we really welcome the development of more features that address these issues and share the experiences of many different people and what was helpful.

· Parents are especially likely to have a survivor or survivors who are medically fragile, have special needs, have longterm disabilities or issues about whether there will be longterm health or other impacts, and in any or all of these ways and more require a great deal of special care and concern for many months and years. Relating to all of that also involves constant reminders, and having to tell others what happened. This also may create some special aspects of issues about trying again – some parents would like to also have another pregnancy, with hopefully a nice, normal experience and outcome, some feel that that is not possible because of the needs of their survivor(s) or other factors (and then this becomes also their entire experience of parenting).

As mentioned earlier, this is just the beginning, an overview so that something can at last be “out there” on this kind of loss. We will be involved in and really welcome help in developing more features for this section, and also developing a more interactive portion of the site for members of CLIMB. We also very much hope that an e-mail network, or more than one, will develop that will help to connect parents and generate further ideas and resources. If needed, please be sure to see our site sections on Selective Reduction (MFPR and selective termination), If You’re Pregnant Now (“going longer” after loss in-utero – “knowing ahead” that one or more babies will not survive – “delayed interval” early delivery of one baby). (The stories of supertwins in that section are included in this section also.) Sadly, with more supertwins there has also been a steady rate of the loss of a triplet to SIDS; and an increase in the number of losses of a young triplet or higher to illness or accident. Please see our site sections SIDS in Multiples and Loss of an “Older” Multiple if needed. CLIMB has an active parent contact list for supertwin loss which members are welcome to join.

Supertwin loss: what we have seen, what parents face

The Death of Your Higher Multiple Baby

La muerte de un niño trillizo, cuatrillizo, etc…

Dealing with delayed grief and remembering our babies

How We Deal with Labeling Our Surviving Children

Examples of birth announcements