Loss of a twin: If your loss is now

If you have experienced the death of one of your twins through stillbirth, or at or after birth, these are some things that you have the need and right to do, based on the experiences of those of us who have “been there”. It is such a difficult time, and you have a tiny survivor who may be in the NICU; your caregivers and others may not be aware of what is important to parents who lose a twin – yet these things are really important for later on being able to cope and heal while raising your surviving child. And they’re all the more important (not less important) because there were two…

· Hold the baby for as long as you can, and more than once, including later at the funeral home. Babies don’t have to look completely “normal” for their parents to need and want to see them, and parents tend to see the beauty of their child (instead of imagining the worst if they don’t see him or her). (And babies who were stillborn or have congenital or other abnormalities can be wrapped or draped sensitively by staff if that makes it better for you and others to view him or her.) Some people didn’t think they had the emotional stamina or composure to hold their dying or dead baby (and weren’t encouraged by their doctor or staff) and have had to struggle with their regrets at not having this opportunity while it was possible. Their advice to you would be, “You CAN do it. Yes, you might feel as though you would fall apart but you will be okay.” Also, you can ask to see and hold the baby the next day (if not possible after birth, or if you want to see him or her again) – the baby is yours, not the hospital’s, and you have the need and right to see him as often as you want during the days that you are in the hospital. It is not necessary to settle for a few foggy minutes after the birth when these days are the time you will have here on earth with this baby. You should also be able to see and spend time with your baby at the funeral home right up until the time of cremation or burial, and many (especially those moms who were ill themselves at the time of the birth) have truly appreciated doing that, along with bathing and dressing their baby at the hospital or funeral home

Hold both babies together if at all possible, and ask for special arrangements to do so if necessary. After conceiving and carrying twins, we all deserve our chance to hold them together while it is possible – and it’s hard to say goodbye to “my twins” without first saying “hello”. Also it really helps later with not feeling as confused as to how many babies we had, or feeling like we had two completely separate babies and experiences, so it helps promote healing. It also helps the surviving child later to know that he met his twin and got to say hello and goodbye. Some caregivers may be nervous about this, but you should insist on your need and right to experience your babies together.

Invite your other children (if any) and any relatives you wish to see the baby (and both the babies if possible)…then he or she will be real to them, too, and they will have a chance to show their love and sorrow. Even young children usually handle this well when given the chance.

· Get many photos (NO polaroids, use a “real” camera with 35 mm film or digital and if desired also a video camera). Photos are one of the most cherished mementos of your baby. Take as many pictures as you can. If at all possible, hold and photograph the babies together, and request special arrangements to do so if necessary. One picture will truly be worth a thousand words later, including for the surviving child. For parents, it makes the experience of having had twins concrete in a way that promotes healing later, and helps create special memories that are cherished later when the loss is not so painful. Also they can be used to create a portrait by an artist later, as many have done. Suggested photos are:
– both⁄all babies together
– Mom holding baby (even if baby has already died), Mom holding both⁄all babies
– and the same for Dad, if he wishes.
– a photo of the whole family including the baby who died
– siblings (if any) holding baby

· Make sure you get all the mementos you want – locks of hair, hand- and footprints of both babies (taken at the same time if possible), the blanket your baby was wrapped in, the crib card if there was one, and anything else that came in contact with your baby which would be meaningful to have later…nothing is too unimportant to ask for! It is also important to receive the baby’s birth certificate and death certificate – or if stillborn, the certificate of fetal death, which serves as both – properly completed. Some hospitals offer an attractive “birth record” certificate for all babies, including those who are stillborn, and some offer special mementos for all babies who have died…don’t be afraid to ask.

· Speak up quickly to ask your physician about any testing that is recommended or is possible to determine the cause of death if it is not clearly known – this may be very important to you later for emotional and practical reasons. With stillbirth, it is not always possible to determine the cause, but it can be helpful later to know that you did everything you could to know. Also, if your babies are of the same gender, ask about zygosity testing to determine whether or not they are monozygotic (“identical”) or fraternal – babies who don’t seem to look alike may actually be identical, and babies born after fertility technology may be identical. If they were identical, knowing that fact is a major clue to the cause, because of the special complications of sharing a placenta if they did (2⁄3 of monozygotics do); and either way it will be important in knowing how to mentally picture your baby who died in relation to your survivor in the future. A careful examination of the placenta(s) and cords by an experienced pathologist can be helpful in determining the cause, and in determining zygosity (and there are other ways as well).

· Don’t go to the maternity floor if you prefer not to – get a private room away from the moms who are “only” happy. If it’s a larger hospital, be aware that seeing or hearing of healthy twins will be painful. Arrange for your husband⁄partner⁄relative to stay with you. Ask your caregivers to let staff know of your situation so you are not always having to answer questions or put up with things that are painful. Put up a “No Visitors” sign if you want, you have the right to mourn in this bittersweet time, and having some time to do so before having full-time care of a newborn when you go home can be very helpful.

· If your baby was 20 or more weeks along and weighed more than 500 grams, in most U.S. states you will be responsible for arrangements. There should be no rush to have to decide everything immediately. The hospital social worker should be able to give you referrals to funeral homes that are sensitive to the needs of bereaved parents of a baby…then you can work with the one you choose to plan what you truly feel is the best choice for you, possibly with the help of trusted relatives or friends. Don’t let anyone rush or pressure you into anything. Burying your child is the most difficult thing a parent can do, and you need the chance to gather a little strength and then later be able to look back and know you did everything the way you would have wanted to.

· Plan a funeral or memorial service for your baby – everyone who has done it has truly appreciated later having taken the time to honor that child while it was possible. Send a birth announcement – it’s a way to honor your baby and “your twins” and let others know how you feel. This section includes a number of examples of what parents have created for announcements of both babies. This can be done weeks or months later.

· Realize that there will always be people who “forget” your baby who died…and don’t be afraid to speak up even though it’s difficult.

· Never be afraid to cry.