Early ultrasounds often detect the presence of two babies, yet as the pregnancy proceeds, one of the embryos dies and slowly disappears, his body absorbed by the placenta, the mother, or his twin.  Though more probable as the title of a Nancy Drew mystery, this unnerving process has been named the Vanishing Twin syndrome.  The reabsorption process may be accompanied by bleeding or cramping, or it may be completely unnoticeable.  A silent death.  A quiet loss.  The only witness is the other twin.

I did not have any early ultrasounds; a seemingly uneventful first trimester made scans unnecessary.  I distinctly recall noticing a teeny spot of blood sometime near the end of the first trimester, but that was all, and certainly within the norm.  I didn't bleed at all for the rest of the pregnancy.

About twenty weeks on, I thought I was miscarrying.  Lower back pain...cramping...but no bleeding.  A quick scan revealed just one baby, our son lying healthy in my womb, his little heart pumping.  It even looked like he waved at us.  That scan failed to detect the second placental lobe, so despite a 'feeling' early on that perhaps there were twins, these miscarriage symptoms, and some dreams of multiples, there was nothing that occurred during the pregnancy that should have led us to explore the possibility of the existence of a twin.

Wondering if you had another child, but not knowing for certain, is bewildering.

We tend to think that 'bewilderment' is synonymous with 'perplexing', but its etymology means 'to be thoroughly lead into the wilderness'.  The wilderness of the human heart.  I am lost in the deafening silence of the forest, uncertain whether to fully enter into the valley of the shadow of death, or retreat to the safety of my happy home life.  Like the mother of a missing child, I am stuck.  There is a time to mourn, says Ecclesiastes, but is it that time?  Am I deceiving myself--am I a fool, if I embrace the pain of loss--am I mourning a shadow, an imaginary child?  Or do I dishonor a very real baby who is gone by failing to believe, by needing proof before careening heart-first through the remaining trees into the ravine of grief?  

An uncertain grief, a tentative grief, feels like I am playing make-believe with my heart, and it will have none of it.  Yet with no chance in this world to ever know for certain, it remains a quiet, unresolving pain.

Despite scouring the internet for information on vanishing twins, for information on the grieving process complicated by this syndrome, I have been sorely disappointed. This is a relatively common situation, yet sadly, it appears that very little practical help is available.  The few articles I could find concerning grief and vanishing twins seem geared to the loss of a multiple later on in the pregnancy, as if grief is only appropriate when the child you lost is a fetus.  Yet despite that, I am grieving my little lost embryo.  I am grieving the experience of a twin pregnancy, since I didn't even know there were twins until it was already over.  I am grieving the experience of birthing twins.  I am grieving the experience of nursing twins.  I am grieving the experience of raising twins.  My heart has fallen off a wall and shattered and 'all the king's horses and all the king's men' couldn't put it back together again.

I have hesitated to share this part of my story.  I have hidden it away.  The dramatic circumstances surrounding my surviving son's birth seemed so fantastical that I thought that telling this part of my suffering would be 'too much' for others.  But it is hurting so much to keep it in.  I believe that I have hidden it away because I just couldn't bear to hear the stupid things people say to grieving parents--especially if there is a survivor.  Let me make this clear--the existence of another child cannot replace the one who isn't with you.  The love for one child is a unique irreplaceable love.  You would never tell someone whose mother died that they should be oh so grateful that their father was still alive, would you??  So please let's retire the ridiculous notion that if a parent has at least one living child, that they should not grieve the death of another.

I have had the strange honor of welcoming five babies in my womb who died in a way that would make each of them especially easy to discount.  My first two babies were each a "blighted ovum"--a bizarre name for an equally bizarre condition in which the fertilized ovum implants but the part that is supposed to form into the embryo never develops.  Only the placenta grows for a time until the woman's body realizes that something has gone wrong, and begins the process of emptying the womb.  My next two losses were "chemical pregnancies"--another odd name--a situation in which an egg is fertilized (...tiny human person created...), begins to produce the hormone hCG (...positive pregnancy test...) but something goes wrong very early in development and the woman has her period (...actually an early miscarriage).  And with this recent loss, it isn't clear what happened, but it appears that, assuming that the second lobe and possible remnants of the cord were from my son's twin, there was a little human person who died fairly early on after implantation.  And then his / her little body was completely absorbed.

I grieved my first two babies with a pain so intense it was debilitating.  My next two losses were much less painful for me.  But this one is so very different from the other four.  I look at my beautiful son and I see his beauty and his intoxicating little person who draws me into love for him.  But I also see a shadow.  I see someone who should have been there, with him, but isn't.  I look at twins and I wonder what his twin would have been like.  Was his twin a boy or a girl?  Would they have both had the same color of hair?  What color would this baby's eyes have been?  Would he or she have snored and snuffled at night, like our son does?  How could I possibly have nursed them both?  How could I have not?   All I know are questions.  All I feel is an empty cavern, with the pieces of my heart, my broken heart, cascading ever down.

Yet God touches me with moments of hope.  "Lift up your heart," He said to me, through the person of the priest, at Mass.  I see myself lifting up my heart, all the shattered pieces, knowing He can melt them back together with His tears.  Because He does grieve with me--He authored the words: "Mourn with those who mourn."  He was a man 'well acquainted with sorrow'.  Jesus wept.  He healed with a touch...a word from afar...even with the hem of his garment.  And I know His tears can heal.

Health Foundations Birth Center (St. Paul, MN) recently published a great list of local, regional, and national organizations ready to help families facing loss.

To add to their list, please keep in mind St. Croix Birth & Parenting.  The Tiny Treasures Love Cupboard is now open!  A Love Cupboard is a clothing donation program for families experiencing loss, run by volunteer coordinators, and sponsored by Stillbirthday.  What will families find in the Tiny Treasures Love Cupboard?  Families facing and experiencing loss will find a variety of hand-made tiny/micro-preemie, preemie, newborn and small infant clothes and baby blankets in both gender-neutral, boy, and girl styles, made by Team Tiny Treasures, a group of talented volunteers who knit, crochet, and sew.  The clothes can be used in the interim, if the length of the baby's life is uncertain; or to dress the baby after he or she has passed away.  We also provide maternity clothes for families facing financial difficulties--common when your pregnancy is high-risk.  Here are some examples of lovely donations available now to receiving families, and made by members of Team Tiny Treasures:

Team Tiny Treasures would love to expand!  We are especially looking for additional seamstresses who can make bereavement diapers and tiny shrouds/wraps for miscarried babies.  We are also in need of additional crocheted burial cocoons.  Patterns are available from St. Croix Birth & Parenting.  We would especially love to welcome jewelry makers who would be willing to make matching mom/baby bracelets.  If you aren't the crafty type, financial gifts are always welcome which we will use to purchase items for memory baskets or to ship items to families who are located out of the area, or families who cannot visit the Tiny Treasures room.  Gifts of new or like-new baby clothes up to size 0-3 months and gently used maternity clothes are also welcome!  Contact us for more information, to volunteer, or to donate items.

Whether your baby dies soon after your positive pregnancy test, in the middle of your pregnancy, at or around your baby's due date, or early in your baby's life--all these different types of loss mean saying good-bye to your child.  Perinatal loss (loss of your child or children surrounding the time of birth) can cause a range of emotions: numbness, disappointment, anger, isolation, depression, anxiety, bargaining, hyper-vigilance, loneliness, and profound grief, among many other feelings.  It is common to experience physical signs of grief and re-adjustment to life without baby, including uncontrollable tears or sobs, arms that truly ache with emptiness, the need to hold a doll or stuffed animal, breasts that fill with milk or become engorged, increased or decreased appetite, and insomnia.  You may hear what sounds like a baby crying.  You may have vivid dreams of your baby or of being pregnant again.  Depending on the age and condition of your baby, you may have to make decisions about things with which you may have no experience, such as organ donation or funeral plans.  It is common to feel overwhelmed and in such a state of shock that details simply pass through you.

A Perinatal Loss Doula is (typically) a woman who has received professional training in normal pregnancy and birth, and specialized training in a variety of types of perinatal loss (usually including ectopic pregnancies, molar pregnancies, and other miscarriages; stillbirths; and neonatal loss) so that she can help you understand, if possible, what has happened to you and your baby, as well as inform you of options you have for creating memories of your baby--something that likely will be very important and healing for you.  Many Perinatal Loss Doulas are 'loss moms' themselves--or have close friends or family members who are--so they well understand the pain and grief of the loss of a child.  Many will perform their services voluntarily as a service to you from the heart of one who has experienced healing to the heart of one who is still hurting.  A good Perinatal Loss Doula will walk by your side for as long as it takes until you feel ready to go on without her; listening to you; explaining what you are likely to experience, physically and emotionally; and helping with practical needs like meals or child care.  A perinatal loss doula is also a welcome person on your birthing team should you become pregnant again, since she understands how different the experience of a pregnancy and birth after loss can be.


Like other doulas, a Perinatal Loss Doula is typically not a health care provider, but if you are pregnant and have recently received the horrible news that your baby has died, but have not yet experienced the loss/birth of your baby, a Perinatal Loss Doula can accompany you through the miscarriage or during the birthing process, as long as you are under the care of a midwife or doctor.  The further along you are in the pregnancy, the more the process of birthing your baby will resemble the experience of the birth of a live baby, so having a doula present to help you give birth makes sense, especially when you consider the additional emotional difficulty involved with birthing a baby who has already died.  A well-trained Perinatal Loss Doula will not only support the birthing mother, but the baby's father and other family members as well, who will undoubtedly feel their own crush of grief, as well as concern for your health and well-being.  Your doula can suggest ways that you can bond with and create memories of your baby, such as naming your baby, washing and clothing the baby, taking photos and footprints, and holding your baby skin-to-skin.  She is also trained in different types of farewell ceremonies you may choose and has the contact information for local resources which can assist you so that you do not have to make those phone calls or searches yourself.

I recently was granted a partial scholarship to become a perinatal loss doula from a perinatal loss doula training organization called Stillbirthday (because even though your baby has died, the day you hold your baby is still his Birth Day).  I hope to complete the training early this fall and believe that I will be the first Stillbirthday-trained Perinatal Loss Doula in the states of Minnesota and Wisconsin.  This is a deeply personal journey for me, as I am myself a loss mom.  My first two pregnancies ended in loss, one at eight weeks and one at eleven weeks.  These two miscarriages were both devastating to me, and so I write about the feelings and experiences of loss from personal experience.  I later experienced two very early miscarriages, just days after two faint positive pregnancy tests.  Those losses were, for me, less painful at the time, though I miss those two babies just as much as the first two.  The decision to become a Stillbirthday perinatal loss doula, however, is to honor a dear friend of mine, whose baby died just after their due date.  I would like to honor their baby, as well as my friend and her family, by helping other families in our area who are saying good-bye to their precious children, at a time that seems all too soon.

If you are in immediate need of a doula to help you cope with the loss of your baby, please contact me or visit the Stillbirthday website.  There are several experienced doulas listed on the site who are available to help you today.