Answers: I Am Pregnant With Twins. One Is Alive, One Is Not!

Home Prenatal Education Postnatal Education Bereavement Support Photogalleries For your information About Lynda

I Am Pregnant With Twins. One Is Alive, One Is Not!
Reader's Questions and Answers:

NOTE: Answers provided are of a general nature only and in no way reflect a medical opinion or diagnosis. If you are in doubt about any aspect of your pregnancy, please consult your physician immediately.

Feedback: February, 2010
I am 18 weeks pregnant, I just found out last week via ultrasound after an abnormal AFP test that one of our babies had died. They said for some time but he was fine at 14 weeks when I had my CVS. Thinking back at that ultrasound, one twin was moving and the other only moved his hand to scratch his little nose no matter how much the US tech was probing him to move. I wish I knew when and why. It's so unbelievably sad to have seen your child moving his little arm and then see him lying lifeless weeks later. You feel so helpless and no one seems to want to address it. All I hear is that the fluid will be absorbed and a skeleton will be delivered when I deliver my other child. This has to be one of the most horrible things for a pregnant woman to go through. Your's is the only site that shares stories and fears.

From Lynda: Hello, I am so sorry to hear of the loss of your wee baby. Having seen him move and wiggle must make it feel worse that he could no longer stay with you. It is no wonder you feel sad and helpless. You are one of the only ones whom is his hero and will remember him. There is another article on my Site which may help you understand a little more and it is called Vanishing Twin. From the dates you are mentioning, I would think that your experience may fall here. What occurs is that the baby was unable to properly attach itself to the uterine wall to get the nutrition it needed to grow and develop as your other twin was able. Depending upon when you give birth, there may or may not be something remaining. If you were to give birth at say 32 weeks, there will be more than if you were to give birth at 40 weeks as reabsorption does occur. That is nature's way of handling things. Hospital staff can help/adviseyou at the time of birth should you wish to see or not see. The choice is yours and your partner's. It may be that you each have different feelings. For some it is closure, for some it is too painful. There is no right or wrong way to handle it. It may be that there can be someone to take hand or foot print casts for you, or perhaps hand or foot photos. It may not be possible to do either. You can ask if it is possible should this be something you wish. Feel free to name your child, to honour him and to cherish his short time with you. You are entitled to do that. I am truly sorry for your loss.

Hugs, Lynda

Feedback: February, 2010
Hi Lynda, In the beginning of my pregnancy I have had 3 sacs with embryo. One of them had no heartbeat at 7 weeks. We had pain over loosing one of them, but doctors said, now the remaining two have better chances to being healthy, and carry them full term. We were also relieved the other two had strong hearbeats, similar sizes, doing well. Had 12 weeks scan, both with perferct results, then had the next scan at week 18, both were healthy from head to toe, they have separate sacs. We were very happy, and from that on, I eased my mind, and let myself to enjoy (until that point I was a little skeptical and worried to loose them, so I did not let the feeling to get close to me). I couldn't imagine not to have two babies, also we found out they were both girls, we were very, very happy. I started to feel them moving at 17 weeks, which was a great feedback of their existance, usually I felt the kicks more on the left side. At 20 weeks, I started to feel no movement on the left side, and thought 'just in case' and ease my worry I would go for another U/S, even though two weeks before at week 18 everything was great.... Well, the doctor who did the U/S said: - Yes, I understand why you did not feel the movements, very sorry, but Baby A is not alive. The other one is doing all right, growing well to the gestational age. He said we have lost the Baby A 1-2 weeks previously. I was in complete shock, I did not expect this. We were heartbroken for the one we lost, and also very worried for the alive Baby B. I still don't understand how can this happen with perfect results. I started to find faults in myself, if I had done something wrong, but still don't know what have happened. I had/have to be strong for the living one, she is my little hope. I'm 27 week along now, but still have big worry, if it could happen again? Is there an effect on the alive one? Can it cause infection or any other damage to Baby B? I have to give myself Fraxiparine shots every day, avoiding bloodclotting. Is that enough, no antibiotics needed? To be honest the doctors didn't give me much hope, they did not want to scare me so they rather did not say much...all I knew they did not have much or no experience with a case like this. As weeks passing by, I start to belive everything can be ok, and we can have a perfectly healthy little girl after all. Have you heard about somebody loosing a twin around 20 weeks, if so, is there any other treatment I can do to avoid any infection? Do you think I can do vaginal birth in this case (my doctor start to tell me I can), or there would be any chance of the healthy one to get infected during birth from the other one? Thank you in advance. Niki

From Lynda: Hello Niki,

I am so sorry to hear all that you have been through. Kinda like being pulled through a knothole backwards. There is nothing about losing a child at any stage that makes it easy to handle. Plus in our minds, we have walked, bathed, fed, these babies as well as showing them off to family and friends. It is so hard to lose that special fantasy.

Please know I am not medically trained, nor do I have personal knowledge of your medical situation. I have been working with multiple-birth parents for over 27 years and have learned a few things over the years. You state you are 27 weeks, which is really good. Your baby is now viable and if born now, has a very good chance at being healthy. In truth still more time in utero would be ideal though to allow the lungs to properly develop and for her to put on more weight. Because you have lost two out of three, you should be considered high risk and carefully monitored until birth. You could expect to deliver early, i.e. before 38 weeks. That would be normal for someone in your situation. There should absolutely be no infection and your doctor will be monitoring you carefully to make sure all is well.

You did nothing wrong. It is not your fault, nor the fault of either of the other babies. Loss like this is Mother Nature's way of handling the situation when something is physically wrong with that particular fetus. It is completely outside of our control and is not your fault at all! Please be gentle with yourself.

Yes, I have heard of someone losing a twin in a late term pregnancy and I have an article on my Site, One is Alive, One is Not, which addresses some of the issues which can be faced in that situation. Check it out and see if it makes anything clearer for you and your husband. www.multiplebirthsfamilies.com If after reading it you have any further questions, please contact me again.

The big thing is that you will no doubt need a death plan as well as birth plan for your delivery. Ask yourselves some questions: do you want to see the baby? should you see the baby? - the choice is yours and your husband's. Be prepared that you may have different answers. There is no right or wrong way to handle this. It just has to work for each of you. Discussion with hospital staff at the time of birth can help you with the decision. Further the nurses can wrap the baby's remains so you can see only her face, hands, feet, should you wish. You can also take photos, or ask the hospital to take them for you. You may wish to photograph the girls together as this is the only time they will be together. The choice is yours and don't let anyone push you into anything you would rather not do or even to give up your daughter too soon. There is no unreasonable time limit that you can keep her with you.

As I noted, if you have more questions, please don't hesitate to contact me again.

I am so sorry for your losses
Hugs, Lynda

Feedback: January, 2010
hi I was pregnant with identical twins and it was discovered at 20 weeks they had TTTS. I had the laser surgery and unfortunalty the larger twin passed an hour after operation due to heart failure. I am now 22 weeks 3 days and terrified. I had no counselling or after care and I feel empty. I have been told I am more likely to go into labour due to operation, is it true that I am technically safe after 24 weeks to go into labour everyone is telling me different things ? thank you jo

From Lynda: Hello, I am so sorry to hear of the loss of your precious baby. I wish I could tell you definitively what to expect. I am not medically trained, nor do I have knowledge of your personal medical situation. I can, however, let you know what I have learned from over 25 years of supporting families with multiples.

When families find themselves in the position you are currently in, it is true that you can expect to deliver early, i.e. before 38 weeks. How early depends on your personal medical situation. In my opinion and experience, 24 weeks is still too early. Even so, we cannot say when we will deliver and the decision is completely up to Mother Nature. We can stack the cards in our favour as best we can. You should now be considered High Risk with your doctor and both you and your baby need to be monitored regularly, i.e. at least once a week, earlier if there are any issues for any one of you. Do you know why you were told you are likely to go into preterm labour? I would like to know why it is felt that I would go into labour? Is there something with the survivor, yourself or the deceased wee babe? If yes, what is the issue(s)?

I have worked with several parents whom have had a baby pass away in utero and as long as the survivor is healthy, things have progressed through to a healthy birth at various gestational ages. In many cases, parents need a death plan as well as a birth plan, so that there is something in place for the deceased baby. You can let the hospital take care of the remains, or you can arrange your own funeral. In my area, funerals for infants under two years old are free from many of our funeral homes.

From this point forward, be aware of what is going on with your body and if you feel there are any issues, e.g. bleeding, excessive lower back pain, even a general feeling that things "aren't right," then go to the emergency and have yourself and baby checked out. It is better to make sure all is well than be too late for the doctors to try and stop labour or give you steroids to help the baby's lungs to develop.

Ideally, babies are in utero for about 40 weeks. 24 weeks is still too early and even though I am aware of births at 25 weeks with no issues, there are just no guarantees. Every day still in utero helps in the count up.

Other things you can do, is eat nutritiously, no smoking or around secondhand smoke, no alcohol, rest as often as possible with your feet up but not higher than your toosh, so you look like an 'L' and of course keep all your regular doctor appointments.

I do hope these few ideas help you keep your little one in utero as long as possible. Please write again if you wish.
Please accept my sincere condolences on your loss.
Enclosing best wishes. Lynda

Feedback: January, 2008
One of my friends is four months pregnant with twins. She recently lost one of them. How rare is it to be this far along and have a miscarriage? Does it affect the health of the other?

From Lynda: While not common, it is also not uncommon and I receive several inquiries a year. While I do not know in your friend's case, it usually means one of the babes had anomalies and would have been unable to survive after birth, should s/he have gone to term. While very anxiety provoking for the parents, this situation does not usually affect the other baby, and once again, I do not know the medical situation of your friend, and the pregnancy is carried to a healthy birth. She will no doubt to considered high risk until birth, can be expected to deliver earlier than her due date and may need a death plan in place at the birth as well as a birth plan. The hospital staff can advise the parents in this regard.

I am very sorry for your friend's loss. She will need a lot of support in the days and weeks to come, especially as she will have a constant reminder in front of her of what should have been. Remember that children are not interchangeable and they will need support and understanding as they come to gripes with losing a much-wanted child. You are a good friend to reach out on behalf of your friend.

Feedback: December, 2007
I have experienced the worst pregnancy. I lost a twin in my 38th week. I am going thru emotional problems. I keep thinking the doctors killed my baby boy. I am still carrying my daughter. What do I do?

From Lynda: It isn't unusual for you to feel shocked, robbed, or to look for someone or something to blame. You have lost a child and nothing can prepare us for such a devastating scenario. Please rest assured that the doctors would never knowingly do anything to harm you or your babies. Their first rule is "First do no harm." I know that they would have done their very best to ensure your safety and that of your children. They couldn't keep their licenses otherwise. You can still look for answers, schedule an autopsy (which still may not provide answers or reasons for your son's death but it is a good start) if you need to know. You need to be aware that at birth, you will also need a funeral plan. Also, when the babies arrive, you need to know you can take pictures, you can hold both babies, you can bath and dress him/them if you wish. If you cannot take photos have a friend, relative, or nurse take them. You may not wish to view them initially but you may some months or years down the road. Be gentle with yourself. Let yourself cry if you need to, keep the lines of communication open with your husband, surround yourself with positive people and do remember that you are still a mother with a daughter on earth who needs you and a son whom is An Angel. You have a different parenting situation, but you are still a parent. If you need connection with another bereaved parent, let me know and I am sure I can arrange it.

I am so sorry for your loss. Go slowly, take a deep breath. Enclosing peace, comfort and a big Hug.
Lynda

Feedback: November, 2007
hi I am 10 weeks pregnant and been sent for a scan becauseI've had some admominal pain but no bleeding. The scan showed that I was carrying triplets and two are dead but the third one might still be alive. I've got to go for another scan to see if it has a heart beat because this is smaller than than the others. What do you thing the chances are at surviving this as it has really turned my world upside down because I really wanted this baby.

From Lynda: Hello, I am so sorry to hear your news. I am sorry I cannot guess at the prognosis for your third baby. I know it is difficult to wait, but a detailed ultrasound and the doctor's review is your best place to get an accurate status. You might let them know that you need to know the viability of your third baby after the ultrasound as you just can't bear waiting any longer. I am sure they will be compassionate and try to relieve your anxieties. I am very sorry to hear of your losses.

Feedback: October, 2007
I WAS PREGNANT WITH TRIPLETS AND LOST THE TWO IDENTICAL TWINS AT 20 WEEKS DUE TO TWIN TO TWIN TRANSFUSION. I AM NOW 26 WEEKS. THE TWINS SACK BROKE AT 24 WEEKS. WHAT SHOULD I EXPECT FROM HERE ON OUT?

From Lynda: I am so sorry to hear of your losses. I am sure that you are feeling very scared and anxious. If so, that would be very normal. I can't tell you what could happen for the remainder of your pregnancy, but I could speculate. No doubt you will be followed very closely until birth of your remaining triplet. You could probably expect to deliver early, i.e. before 35 weeks. Your remaining baby will not yet be viable but would certainly be so by about week 27. Of course, every week after that will benefit the baby and provide the best chance. Your doctor will no doubt advise you on how to provide the best care to help the baby stay in utero, e.g. no smoking or around secondhand smoke, no alcohol, eat nutritiously, keep all doctor's appointments and so on. Learn the signs of premature labour and if you think you are in labour, go directly to the hospital, preferably where you will give birth as they will have all of your records handy. Another difficult issue for you and your husband will be that you will no know need a death plan for your two identical babies as well as having one for your surviving triplet. The hospital staff should be able to direct you in this regard and you have a choice whether or not to see the babies. You could ask that they take photos which you could see directly or later when you feel able. Or you an see them after birth and take hand/foot prints and photos of the babies feet, hands perhaps faces, as you feel you might like. You may also wish to take the babies' photos together. These are your choices and discussing them with your husband and your doctor will help you decide what works for you. You can change your mind right up to the last moment about whether to see them or not. It needs to work for you. I wish you well and enclose comfort and peace. Please feel free to write again, if you need to.

Feedback: October, 2007
I have a friend who delivered a twin, 1 dead and 1 alive. Its a mixed feelings and senstive. It is ok to send condolence flowers or wait to send congratulation note. We do not want them to concentrate on the loss. When and how should we send our gift and what kind of message should we send?

From Lynda: Hi, I am so sorry to hear of your friend's loss and what a good friend you are to recognize the challenges of this situation: the joy of birth and despair of loosing a precious baby. When there is a survivor(s), there is a constant reminder in front of you of what should have been. Nothing about this is easy. Please know that anything you do will not "make" them concentrate on their loss. That happens automatically because of losing a baby. Your mentioning this baby, and do use his/her name if you know it, will make it easier for the parents. Begin by saying how sorry you are for the loss and they will take it from there. Listening, holding them, perhaps sharing tears will probably follow. I think initially mentioning a loss is a good way to begin because that baby needs acknowledgment as he/she will not be going home from the hospital and a funeral will no doubt be needed. It will be overwhelming for the parents, especially in the early days. Sending flowers and/or a card or making a donation to the hospital where the babies were born, any of these is a good idea. So many people make the mistake of not mentioning a deceased baby in the hopes of making things easier for the parents, but the opposite is true. When we mention the deceased baby, we acknowledge the parents' grief journey and let them know they are not alone, plus we honour their deceased baby and recognize the baby's brief life even if it was only in utero. I would also suggest you do something for their live baby, a card, baby gift, perhaps two donations, one for each child. You can expect your friend to have a difficult time for a long time to come and need times when she or they will need to talk about their loss or just be quiet. It is a difficult road, but taking your cue from your friends will help you know how to help them and listening, without judgment, is always a good idea. Best wishes in a difficult situation.

Feedback: August, 2007
HI, I'm Tammy, I've read most of the articles. This is my first time talking about my pregnancy with twins. I was five monthis when I found out that one of my twin boys had passed away within a month's time of going back to get my six months' checkup and ultrasound. I was never told why this happens but I would like to know someday.

From Lynda: You didn't leave an address for an answer, so I do hope this reaches you. VT occurs by about week 12, you are way past that. Have a look at the article One is Alive and One is not on my Site and it may have more pertinent information for you. You are allowed to request copies of your medical records and they help you understand one of your boys passed away. Please note that there is not always an answer, especially how long there is between the death and your delivery of your second baby. There can be such deterioration that an answer for death cannot be found. Please also know that it is not your fault and you didn't do anything wrong. Sometimes unfair things happen and this is one of those times. I am so sorry for your loss and hope that your surviving little boy helps to fill some of the void left by the loss of his brother. Big hug!

Feedback: January, 2007
Hi I'm Karen, 23yrs old and 20 weeks preggy with twins (2boys). My twin boys were sharing one placenta but had a wall between them. One died, no heartbeat anymore. Will it affect my other baby? What should I do?

From Lynda: Hi Karen, I am so sorry for your loss. I am sure you are so nervous and anxious. It is good that the babies have a wall between them and I have no doubt that your doctor will now be following you very closely due to your situation. What makes things difficult is that it is still very early for your second baby to be born. He still needs some time in utero to grow and develop, at least 10-12 more weeks would be great. What I suggest is that you do the best you can to help him along and here are some suggestions:

-Keep regular doctor's appointments
-If you have questions, write them down and ask them until you get answers you can understand (sometimes doctors can use big words)
-Take someone with you to each appointment so that both of you are receiving the messages.
-No smoking, exposure to second hand smoke, alcohol, drugs
-Eat nutritiously
-Be proactive and do your own research regarding this type of situation. Doing so will make you knowledgeable and able to make decisions based on knowledge. -Knowledge is power.
-Connect with others whom have been in the same situation. I might be able to help you in this regard if my contact addresses are still good. Connection will help relieve your mind.
-Keep positive

If all things are equal, your other baby should be fine. One can't say definitively but things mostly work out really well for the other baby but you also need to be on board to help things along.

If you would like to contact me again, please feel free to do so. I am so sorry for what you are going through.

Feedback: June, 2006
My cousin just found out that one of her 3 babies has died. She is due to deliver in late October..they were going to deliver her sometime in Sept....does the baby that has died have to stay in her belly until she is ready to deliver and will it put the other two in any jeopardy?...thanks

From Lynda: I am sorry to hear of your cousin's loss. I am not a doctor and don't know anything about her personal medical situation so my comments are general. Usually the deceased baby will stay in utero until birth and depending how long that time would be, it may "break down" as the body tries to reabsorb the fetus. The hospital delivery staff can help with the decision whether or not the baby would be viewed. It has been known for some women to deliver the deceased fetus and remain pregnant with the other(s).
Usually when there is a loss, there is no problem for the other baby(ies), assuming they themselves are healthy.

Feedback: February, 2006
I was so happy to read the article. I was carrying twin girls in 2002. A 26 wks twin 1's heart stopped, she was the larger one. The smaller twin was born at 33wks when I was induced. It was a miracle she survived especially as they were identical and shared the same placenta. No one should have to go through the heartache of losing a child, but I stayed positive throughout [the rest of my pregnancy] and planned the birth beforehand. If I hadn't, I don't think my surviving daughter would have lived. She's nearly 4 and knows she had a sister, but I wont tell her they were twins until she is old enough to understand. We still have her sister's ashes, which some people think is strange but I would like my daughter to decide what she wants to do with them when she's older. Everytime I see my mother in law she gets on to me about it, but it is my choice. What do u think? Claire, Scotland

From Lynda: Hello Claire, I am so sorry to hear of your experience. It is a unique situation to carry one live baby and one deceased. Bittersweet. I am very impressed with your thoughts on how you got/get through it. When we ignore such difficult feelings and try to sweep them under the rug, all we get is a lumpy rug and eventually we trip over the lump. It sounds as if you did what was right for you and I commend you for that. Grief is individual and each person copes in their own way. There is no right or wrong way to do it. It will probably be very positive to involve your daughter in her sister's burial and have her help with the memorial plans. You will need to keep the lines of communication open and use age-appropriate words when you decide to tell her. She may ask the same question over and over as that is how kids process death. I have an article on my Site with hints on speaking to children about death, if you think it might be of value. Their views, and death's permanency, are different from adults' of course.

Regarding your mother-in-law. I have a few suggestions for you:

-she comes from an old school and may have difficulty understanding that today's view are different;
-can you and your husband sit down and talk with her, explaining your feelings, the current views and perceptions of death, and letting her know that her persistency is very difficult and emotional for you? It doesn't have to be a negative conversation, but is an opportunity to express your views and hopefully she will learn to respect your differences in viewing this situation;
-if things don't change, you might explain that you cannot have this conversation any longer with her because it is very emotionally costly for all of you. Your husband should be present for that as well because she is his mother;
-your husband could handle the whole thing on his own because she is his mother;
-there is also an article on my Site about Grieving Grandparents. You/she might benefit from some of the hints within.

If you wish, I would love to hear about your decisions on your Memorial Service and involving your surviving daughter. I would be pleased to post it on my Site to support and help other families, if you agree.

I wish you well, also peace, comfort and happiness.
Lynda

Feedback: August, 2005
My cousin just gave birth to twins but tragically one of the boys died 2-3 days before delivery due. He ingested his own feces. He was 6lbs 13ozs and the larger of the 2 boys. How may the family (the mom has 3 older siblings, all have older children) help her thru this most difficult time. Also do you know how common the above is? thank you for sharing the above article.

From Lynda: It is hard enough to lose a child but particularly so when one gets to the end of the pregnancy and the loss occurs. His was definitely a healthy birth weight.

I have some suggestions for you. Let her talk, listen to her whenever she needs, say the baby's name, don't be afraid to do so. The problem is when the baby's name is NOT spoken, not when it is. Hold her - and her husband (it is his baby too), cry with them if you want. On the anniversary of the baby's death one year from now, please make sure to mark your calendars and mark the date: it could be a card, a single flower, a balloon, a donation in the baby's name. Do make sure that the date is marked. Some families have prepared a shadow box with the baby's name, foot and/or handprints, a photo if you have one, born still date, if he was dressed, maybe the sweater and/or hat could be included. It is a beautiful gift, momento, if that works for your family. The parents may wish to prepare it themselves.

Yes, unfortunately it does happen. A baby has a bowel movement (meconium) before birth, for some reason, and then it is inhaled or swallowed. This can cause infection and is of great worry to delivering doctors.

I hope some of the ideas are helpful. I am so sorry for your loss.

Feedback: June, 2005
I just found out today that my brother and his wife lost one of his yet to be born twins. They were I think only one or two weeks away from birth. They are in Chicago and I am in central Missouri. I would like to do all I can and be helpful in some manner but I don't have a clue as to what I can do. I am especially bad when it comes to these things and the only thing I could muster to say was "We have to be happy for the boy". I know they are broken to pieces about this as they had all kinds of complications in trying to concieve. They went through all sorts of specialty pregnancy procedures for couples having problems getting pregnant. I am not sure what it is called but I think they implanted two fertilized eggs into my sister in law after weeks and weeks of shots. Not only that, they were so close to birth, its just horrible, I haven't cried like this in 10 years. Also, my mother who has always wanted a daughter/grandaughter is devastated. Between my older brother and myself she had a miscarriage and even I was named Rebecca until I popped out a boy. I've been reading twin loss websites all evening and it seems crazy to me that the joy of the first grandbaby/nephew is conflicted with the loss of the twin girl/niece. I am lost for action, any thoughts/suggestions would be greatly appreciated. Thank You Craig

From Lynda: Hello Craig,

I am so sorry to hear of the pain and grief your family is currently facing. Nothing can ever prepare anyone for the loss of a child. Everything about it is wrong. Babies need to be with their parents, safe in their loving arms.

I am so impressed with your capacity and initiative in trying to support your brother and sister-in-law. Your reaching out to them will be very helpful and comforting. And the fact that you are trying to over come your own feelings speaks volumes about the kind of man you have become - sensitive, caring, loving, concerned, involved. Keep going, you are doing just great! Here are some things that can you could say that may help all of you: I don't know what to say. My heart is broken. What can I do to help or support you? I wish this was not so. Any of these will start the conversation and your brother and sister-in-law will know they can talk to you about their pain, their devastation and loss. With grief it isn't always about talking so much as about listening. You will hear when to say something or when to hold them in your arms as you all grieve together.

What is important to grieving parents is that their loss not be denied or ignored by well-intentioned people. Avoiding the topic does not comfort the parents but does scream louder about the 'elephant in the room' that everyone is trying so hard to ignore. If you find that your niece's life and death is being 'ignored,' Perhaps you could take the initiative and let the well-intentioned people know it is OK to speak about her. The parents do want to. This could help your brother and his wife to do this for them.

Encourage them to name her, to honour her memory, to make a donation to a child's organization, hospital or library in her name. Celebrate her short time with you. You could have two types or a combination type of birth/death announcement: Our family is thrilled to announce the birth of Robert and devastated to let you know that his twin sister, Rachel died in utero. I may go for the former, i.e. two announcements, so that your nephew does not have to look at his birth announcement in the future and feel the pain. The two announcements could be tied together with pink and blue ribbons. Whatever the parents decide though is the right thing to do. There is no right or wrong way to grieve.

Just to point out: you are talking about two extremes of human emotion, joy at birth and devastation at death. None of this will be easy or clear cut.

On my Site is an article entitled Carrying One Alive and One Dead. Reading this through may be helpful because your sister-in-law has a time yet to carry them both and it is SO painful. As long as they are inside of her, they are 'safe.' The birth will be difficult and traumatic. Try to encourage them (or the hospital staff) to take pictures of the babies, together and separate. Try to get hand and foot plaster prints which can be put into a shadow box. Over time these will be invaluable and will be tangible evidence of your niece's life, albeit a short one.

Please encourage the family and friends to celebrate this little boy even though girls are hard to come by in your family. He will have a lot to bear at losing his twin sister. Be prepared to talk to him over the years and let him know, in age appropriate language, about his sister and the pride you all feel in both of them. He needs not to feel that he has to live up to a deceased sister's image but to live his own life fully and completely while cherishing the short life of his sister. No easy task.

If I can help you in any further way, don't hesitate to write me again. I am so sorry about this loss of your niece.

Feedback: Thank you. Your article answered many questions for me. Sadly, I just lost a fraternal twin at 18 weeks. How much energy will my body need to deal with the dead baby?
Kristin

From Lynda: I am truly sorry to hear of your loss. To make matters more difficult, you will now have a rough road until delivery. Psychologically things may be rough as well.

Depending upon when you give birth to the survivor, there may or may not be little left of the deceased twin due to reabsorption by your own body. If you were to give birth at 28 weeks, say, there would be more left than if you gave birth at 35 weeks. You can expect to be followed more closely by your doctor due to these extenuating circumstances. What I would suggest is that you work on a birth plan with your doctor. Some parents feel that they want to see their baby regardless. The hospital staff in the delivery room will be able to give you counsel on this when you deliver on making this decision.

As far as energy goes, you shouldn't feel any expenditures of energy that are not normal. Most women in your position report no differences in their bodies' behaviour, just that they feel very sad and experience peaks and valleys of emotions - which are very normal considering the circumstances.

Remember to grieve, remember to take time with your partner, name your baby if you wish and remember him/her as you need (at delivery, the staff may be able to let you know the sex of the fetus. If they can't, choose [or not] what you feel the fetus may have been or choose a name that is unisex - Jody, Cody, Taylor - for examples). Be gentle with yourselves and take what you need.

Please feel free to write to me again and let me know how you are doing. Enclosing very best wishes.

Feedback: My daughter has just been informed that one of her babies has died. She will remain on the hospital until she gives birth to the other twin. We are lost. Please send advice.

From Lynda: I am so sorry to hear of the loss of your grandchild. It is especially difficult for grandparents because not only do they lose a grandchild, they often feel that they have not properly protected their own child from this pain of loss. On my Site, I have a bereavement article for Grieving Grandparents. Please have a look at it and if you have any questions, don't hesitate to write me again.

It sounds as if your daughter is being very well looked after medically and there is no reason at all that she cannot carry the surviving child to a healthy birth. You didn't mention how far along she was, but she will probably deliver at least a little earlier than expected. In consultation with her doctor and hospital staff, a decision can be made whether or not to see the little one, take photos of the babies, together and separate and to hold him/her. If you wish, suggest naming the baby and having a memorial service. You could make a donation to a children's institution or of a book to a children's library in your grandchild's name. Your daughter will need your understanding, shoulder and comfort as both she and her partner struggle to come to terms with their loss and the happiness of also having a living, baby. It is very complicated with these two extreme human emotions.

Please feel free to write me again, if you need. I enclose comfort and very best wishes.

Feedback: How common is it to have a twin die at 20 weeks? I have just found out that one of my babies is dead. I had assumed that this would've happened earlier in the pregnancy rather than now. Also, do you know what I can expect for the rest of my pregnancy, assuming that the other baby continues to progress?

From Lynda: Hello, I am so sorry to hear of your news and the loss of your baby. At this late stage of your pregnancy, it is not likely that you have suffered Vanishing Twin as this type of loss occurs by the 12th week.

Depending upon when you give birth (i.e. say 30 weeks or 36 weeks), the pathologist may or may not be able to tell you why one of your babies died as the Mom's body begins to reabsorb the fetus once it dies. The longer you remain pregnant, the harder it is to tell what happened. You can ask to have the placenta looked at and assessed for a reason but you need to know that they may not be able to give you an answer. Sometimes Mother Nature steps in and makes a decision, the reason for which is not always identifiable.

Please look at my Site at the article One is Alive and One is Not. It has some information that may assist you and answer some questions for you. It will take some getting used that you are not now going to have two healthy babies and both you and your husband will need to try to get your mind around this news which has turned you upside down.

There is no reason at all why your pregnancy can't continue to a healthy birth. You will be watched more closely now until birth and your unborn baby closely monitored in order to make sure that all is progressing well.

If you need to, name your baby - you can pick a generic name such as Taylor, Skye, River, for example should the pathologist not be able to let you know the sex of the baby. If you need to mourn, do so and don't let anyone talk you out of it, try to change the subject or make you feel guilty. You have lost a baby and babies aren't interchangeable, so if you need to take time for yourselves, be sure to do so.

I am truly sorry for your loss. Please feel free to write me again, if you feel the need.

Feedback: My daughter just found out she was pregnant with twins but one died at about 9 weeks. What is done now in reguards to the dead fetus and what are the chances that the remaining one will be normal? Are there any test[s] that can be done to find out if there will be any abnotmalities? My daughter is 22 and in the army and worries about the army doctors because they haven't told her anything that may happen with the other baby. Thank you, Carolyn

From Lynda: Hi Carolyn,
I am so sorry to hear of the loss of your grandchild. It is so unfair that things can happen this way and not always comprehensible.

What I think has happened to your daughter is Vanishing Twin [VT] (see the article on my Site). When a multiple (can also happen with triplets and higher) is lost before 12 weeks, it is commonly known as VT. What appears to happen is that the fetus does not properly imbed into the uterine wall to receive its fair share of maternal nutrition so that it can survive. The downside of early ultrasounds is that we know very early we are pregnant and with how many and then by about 12 weeks, our world is turned upside down!

Unfortunately VT is all too common and usually there is no danger or risk to the surviving fetus. The pregnancy continues to a healthy birth. The dead fetus is reabsorbed by the mother's body and at birth there may be nothing left other than a "thickening" in the placenta. There should be no anomalies to the surviving baby either. The article on my Site explains things in greater detail. There are also some memorial ideas, should you wish to remember the other fetus - some parents like to and some don't. There is no right or wrong way to handle this and don't be talked out of anything that you wish to do. Your daughter conceived twins and Mother Nature has stepped in to change the situation. She, her husband and yourself can grieve, if you need to.

I hope this is helpful. I am so sorry for your loss.

Feedback: My sister was expected to have triplets and unfortunately lost one of them this week - the only girl. She still has four months until she is full term but will probably not carry that long. She has been doing emotionally well for a few days but is now starting to feel the pain of losing the girl - especially after seeing pictures. I was wondering what to do for her and the girl fetus when the other two are born. Will there be enough recognizable tissue to have disposed of - a cremation or funeral? I want her to be able to recognize the little girl and be able to grieve appropriately. I would appreciate your help.

From Lynda: Hello, I am so sorry to hear of your sister's loss. There are a few painful factors at work here: 1) the loss of a baby; 2) the loss of the only girl; 3) worry over the health of the survivors for the duration of the pregnancy; 4) the loss of a special triplet relationship between the babies themselves.

While the situation cannot be changed, there are a couple of ways to honour her daughter and how important she is, and continues to be, within the family. How much tissue that is left will be affected by how long the pregnancy continues. 3 more weeks vs 6 more weeks vs 8 more weeks and so on. Some parents, regardless, want to see their baby and some do not. There is no right or wrong decision here. It has to be what works. Preparing a birth plan will help the parents in making the decision. At delivery and in consultation with the staff, it can be decided whether or not to view the baby, take photos (alone, just a hand, just a foot, with the others, as a family), hand and foot prints may be able to be taken. These can be framed in a shadow box with a plaque stating the name (and death or delivery date?) of the baby - this could be a wonderful keepsake gift that you could arrange for your sister and her husband. The hospital staff, and possibly funeral staff, will be able to help decide if there should be a funeral and in what form.

Encourage your sister to name her daughter, be a shoulder for her (and you) to cry on, listen, listen, listen. Know that at delivery, grief (and some time afterwards - grief is a journey and not a destination) will rise its head again as the family contemplates what should have been. Have no judgements, use the baby's name, listen. Ask Dad how he is too. Often the father is somewhat ignored in these situations.

You can make a donation either one time or annually, to a children's charity, or an age-appropriate book to a library or school library each year in your niece's name.

I hope this is helpful to you. Please write me again, if you need to. All the best.

DISCLAIMER