Losing a Twin During Pregnancy
For some women, finding out that they are pregnant with twins may be an extremely exciting (if overwhelming) time in their lives. While the idea of two babies can seem like a great way to build your family, the pregnancy itself comes with a higher risk than a singleton pregnancy. When the announcement that there are two (or more) heartbeats is quickly followed by a label of “high risk” and talk about additional appointments and concerns it can feel like so much can go wrong.
While it's true that you are facing an increased risk it is important to keep your concerns in check. You should speak directly with your care provider if you are experiencing any symptoms that have you concerned. If what you're seeking is information, here's what you need to know about your risk of losing a twin during pregnancy, and resources to help you along the way.
How common is losing a twin during pregnancy?
It's actually suspected that losing a twin during pregnancy is more common than doctors and even women ever realized, primarily since more information is available with the advancement of IVF and other fertility treatments that lets doctors control the conception process and monitor it more carefully. Additionally, with many doctors performing ultrasounds that can detect twins or multiples even earlier, they are better able to diagnose twins very early on in a woman's pregnancy.
A 2014 study review estimated that if doctors are able to identify two embryonic sacs in the first trimester of pregnancy, 27.1% of pregnancies that used reproductive assistance would have a twin loss, while 40.5% of pregnancies that did not would suffer a loss. Once the sacs have developed into actual embryos that were identified via ultrasound, the numbers actually reversed, with a twin loss occurring in 38% of pregnancies achieved by artificial reproductive technology and only 7.3% of spontaneous pregnancies. However, exact numbers are still hard to estimate for how common it is to lose a twin during pregnancy because there are many factors involved, such as when a woman finds out she is pregnant, when she receives her first ultrasound, and her own medical history.
How does losing a twin during pregnancy happen?
Losing a twin during pregnancy can occur in a few different ways. A woman may start out her pregnancy carrying twins, and then have one of the fetuses pass away early on in the pregnancy, usually in the first trimester, often called vanishing twin syndrome. Vanishing twin syndrome seems to occur more in twins or multiples that were conceived through intercourse than in twins who were conceived with IVF, suggesting that there may be a genetic component. In vanishing twin syndrome, the twin that is deceased is reabsorbed into the uterus, so there is typically no physical sign of the twin left by the time birth occurs.
There is also the possibility that one twin may die later on in the pregnancy, especially if there is a complication such as twin-to-twin transfusion syndrome, which can be dangerous for the twin who doesn't get as much nutrition. And lastly, a twin may suffer a complication at birth, resulting in the birth of one live baby and one stillborn baby.
How to care for yourself if you lose a twin during pregnancy
As a mother, if you lose a twin during your pregnancy, there are resources that can help. Talk with your OB/GYN or pregnancy care provider about connecting you with resources such as support groups for women who have lost a twin or a pregnancy in a multiples pregnancy, search online, and if it helps, share your story. The process of grieving a lost twin while celebrating the arrival of the surviving twin can be very difficult and come with a lot of mixed emotions, so give yourself permission to acknowledge all of the different feelings you are having without judgement. It is possible to grieve a loss and be grateful for the life with you–the two are not mutually exclusive.
You should also realize that studies have suggested that the grieving process can be highly delayed in parents who have lost one twin and have a twin who survives, because they are so focused on caring for the surviving infant that they never get the chance to properly process their feelings and emotions about the loss. Especially if the surviving twin is born with any medical needs, spends time in the NICU, or needs any special care, it could be months and even years before your grief process truly begins, so you shouldn't be ashamed at seeking help whenever you need to.
How to talk about a lost twin to your children
As a family, you can make a decision about how to talk to your children about the loss of a twin. Some studies have suggested that surviving twins can sometimes struggle with mental health challenges or feelings of “being left out,” even if they were never told about their lost twin. Deciding how to handle conversations about this loss is very personal and you may want to consult a counselor or experienced parents or even groups catering to twins who have lost their twin to consider your options.
Essentially, you need to know that there is no shame in talking about a lost twin in whatever way works for you and your family, and to know that feelings of grief and loss, even years down the road, are very valid. If you lose a twin during pregnancy, you are not alone and there are other mothers and families out there who can help you in your journey too.