The Bewildering Case of the Vanishing Twin

When our son was born lifeless and revived two months ago, our concerns and energies were necessarily focused on saving him.  After the ambulance roared away, after my husband raced off to be with him, a mother was left behind.

"Any chance you had twins?" asked our second midwife as she examined our placenta.

A second, much smaller lobe of placenta was present in the same amniotic sac, separated from the larger lobe that had sustained our son.  When viewed from the top, adding this smaller lobe to the large one made them look a little like a broken heart.  In the center of the small lobe, there was a white circle, the remnants perhaps of a second umbilical cord.  A vanished twin?

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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.

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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.