If your loss has just occurred…

These are some of the things that parents who have lost their twins, triplets or higher have done. Though it was difficult, they believe that it helped their peace of mind and healing later. Some of them may be more complicated to do than others, especially if one or more of the babies has died earlier…and every family and every person is different – but as much as possible they are all valuable to do, while you have the opportunity.

It is also very important to know that all these things, and more, are your need and your right to do as the parents of your babies, and no one should in any way rush you or try to discourage you, no matter how well-meaning they’re trying to be. Ask for and expect as much help as you need in order to do what you as the parents of your babies need to – and for as much time as you need, especially if you are having to recover from anesthesia, blood loss, or other physical traumas that so often are part of the loss of multiples.

· · Seeing and holding the babies…It’s hard to say goodbye without first saying hello. It is very important not to settle for a few groggy moments after the delivery, or a few minutes after they have died and you are in shock. Both mother and father need to spend as much time as desired seeing and holding each and all of the babies, over a period of hours, and days, while you are in the hospital, and after the babies are at a funeral home up until the time of burial or cremation. Many parents have appreciated unwrapping the babies and seeing their whole bodies, and bathing them. Babies do not have to look totally “normal” for their parents to need and appreciate seeing them, and to see their beauty (and people’s imagination of what they haven’t seen, is usually worse than whatever the reality is). One mother said that she spent hours “soaking in the precious reality of their being” even though the circumstances were so sad. You will be grieving for each of the babies as well as for “my twins” or “my triplets” and it is important to spend time getting to experience each baby individually, too, in addition to the pair or group. One mother, who like many was very ill after the birth, said that the most meaningful thing she did was to spend time with her triplet babies at the funeral home, counting the fingers and toes of each, seeing which parent each of them looked like, and dressing them each for their burial – getting to feel like their mother while it was possible. The photos taken by her funeral director of her holding each of her babies, even though they had died several days before, are her most precious possessions.

· It’s also very important for other family members – grandparents, siblings, aunts and uncles and others, as well as close friends – to see the babies, and hold them if they wish. This chance to meet them while it’s possible and see their reality is very helpful to them, and to you. Even very young siblings appreciate when they are older knowing that they, too, got to see the babies and say hello and goodbye. Many families have photographed the babies being held by their older sibling(s), and their grandparents.

· · Getting photos…good quality photos (35 mm or digital, and if desired, videos) of mother holding both or all babies, dad holding the babies, and both parents holding them – and photos of the individual babies themselves and being held. They should not look like clinical photos, or only a few polaroids taken by staff – the babies should be washed and dressed in clothing and other special items that you have chosen, and placed in a loving setting. Many have appreciated having their babies’ hands touching, and placing favorite items with them. One family photographed their triplets together in a beautiful bowl of water, surrounded by their favorite flowers.

· If the babies look a lot alike, it is helpful to give each of them a certain color of cap, a name tag, or some other thing that enables you to know later for sure which baby was who.

· There are artists who specialize in drawings and portraits of babies who have died, as well as many possibilities nowadays with photo-enhancing…so any photos you are able to obtain can also be very helpful in later creating something that may be shown with pride in your home.

· If it does happen that the hospital takes the only photos and tells you that you may claim them later when you’re ready, don’t wait too long as they are sometimes lost. You may also want to pick them up rather than have them mailed.

· If you have photos developed, have a trusted friend or relative go to a place that processes on-site while you wait, and explain to them the nature of the photos, to make sure they will not be lost.

Almost everyone who has shared their story in our newsletter over the years, has commented that their photos of their babies are their most precious possessions, along with their mementos from them.

· · Obtaining mementos…handprints, footprints, locks of hair, fingernail clippings, crib cards, name tags – anything associated with the babies is a precious concrete remembrance of their existence. Some parents have had to insist on having these. In most places in the United States, most babies who die before birth will not have a birth certificate but do get a fetal death certificate. Some hospitals make “birth record” certificates or “certificates of life” that include a baby’s name and footprints which can be given to stillborn babies as well. Many hospitals now keep the blankets of all babies but other things may be offered. Later on, learn about the correct storage of locks of hair and photos so that nothing will be damaged over time. Many parents have later put together beautiful shadow boxes with their mementos framed within, or specially made memory boxes.

· In most states in the U.S., there is a certain time in pregnancy that is considered the difference being miscarried and being stillborn or a perinatal death (usually, 20 weeks along). Miscarried babies are considered the responsibility of the hospital and you must speak up at the earliest possible opportunity if you wish to see the babies or make the arrangements yourself. Some parents have donated their babies’ bodies to medical research. If your babies were born after the number of weeks that the law specifies in your state or country, you are considered responsible for all the arrangements. Some hospitals have offered parents to “let us take care of it” but most parents have not been happy later with the results. Many parents have appreciated having a trusted friend or relative to help locate a funeral home and help plan everything they want to do.

· With multiples, sometimes there is confusion because one or more babies died before the 20-week (or other number) time, but both or all were born later. If this is your situation you may need to insist on your wishes in regard to the baby or babies who died earlier, including asking the doctors to ascertain whether there are any remains of a baby who died in the first or early second trimester.

· Even if you think you know, it may be very important to you later to know as much as you can about the specific cause(s) of your babies’ deaths. Many have appreciated having autopsies for this reason, though they are often not conclusive. It is helpful to make sure that the placenta or placentas and cords be carefully examined by a pathologist knowledgeable in twin/multiple matters, especially if there is any chance that they were “identical” (monozygotic). Even babies born with the help of fertility technology may be monozygotic, many are. It is helpful to request a determination of whether or not they were monozygotic (if they were the same sex) because of the additional, special risks for these babies – it may shed some light on what happened even if the other testing is not conclusive…and it’s helpful in how you picture the babies in your mind. It may also be helpful in considering another pregnancy, to know whether the loss was the result of certain risks that would not occur in a pregnancy with a singleton or fraternal (dizygotic) multiples.

· Birth announcements…Very many parents have created beautiful announcements for their babies. There is no time limit, this can also be done months later. CLIMB has examples to share of announcements that people have done; some of them are included in this section.

· · Making arrangements…Most parents find comfort in their twins or multiples being buried together, and some have been able to do this even though one had died earlier. Many have included special items and letters to the babies along with them at the time of burial or cremation. It’s important to chose the option that you prefer and not (for example) choose cremation because it may be less expensive even though you’d prefer burial. It’s important to find a funeral home that will work with you sensitively and not rush you. If you choose cremation, it’s not at all necessary to scatter the ashes – many parents have kept them for years, or permanently, in a special container at home. Many parents have created and held special services for their babies, at the funeral home, in their own home, at their church, or outdoors, either at the time of burial or cremation, or later as a memorial. Many have appreciated videotaping the service so that they can replay it whenever they wish later.

· · Dealing with the babies’ things…If you have things that you had bought or been given for the babies – clothing, baby things, possibly the stroller – it may be very painful to see them, but even more painful to have well-meaning others dispose of them. Some of them may become precious keepsakes later, and in any event, most parents say that it was best that they dealt with the things themselves when they could. Meantime it can be helpful if a friend or relative puts them wherever you would like to have them kept, if you wish, or helps you in doing so. If you had prepared a nursery or nursery area, dealing with it is something that you and your partner if any can do as you are able to. Sometimes the local twins club can be helpful in selling items for you that you decide not to keep.

· · Getting support…Coming home without the babies, and then for some, going back to work a few weeks later instead of being home with them, is something no one should have to experience – what one mother called “the deafening silence”. It helps if even before you leave the hospital, both mom and dad have someone whom you can really talk to at any time. It’s not uncommon to have many difficulties eating, sleeping, or leaving the house or your room. Dads often worry a lot about their wife and what she is going through, while grieving themselves and having to go back to work. (One dad has said that the most helpful thing to him was his 2-week leave from work to get through the initial phases, mandatory because he is a policeman.) It’s a good time to check out local infant loss support groups – and many now include parents of multiple birth loss. It’s a good idea to talk with the leader and see what their sensitivity is in that area and whether there have been other families. We have often called professional counseling an insurance policy on what’s left of our sanity, and it’s true – trust your sixth sense in finding a counselor who is attuned to infant loss and its impacts, and who won’t run away or just tell you time will help (although with support it will when you least expect it). There are more counselors now who specialize in reproductive issues and this has been especially helpful to those who have lost their multiples after infertility. Also, quite a few parents have been helped by medications, provided it is on a temporary basis and accompanied by “talk therapy”. Seek and ask for all support and help you can get, from those who are not afraid to give it. Nothing will make you feel good now but the difference the support makes will be really obvious in how you feel later, including when it comes time to try again if or when you do.

© 2002 Jean Kollantai, CLIMB, Inc.