
Being told that you
are going to be parents of multiples (twins, triplets and beyond)
is truly a blessed event. You feel chosen and special. You may
have struggled with infertility, and so appreciated a pregnancy
with an instant family. You instantly became parents when you
became pregnant. It is not something that happens magically at
the birth of your babies. The emotional realization of this is
very important, especially when one or more of the babies pass
away. You will always be parents of multiples. Instilling this
message to yourselves, your family, friends and to the medical
professionals that take care of you, is connected to the sense
of Peace that you will feel in the months, years, and lifetimes
ahead after the delivery. What takes place during the delivery
is very much the key to this sense of Peace. The delivery must
be compassionate. It is a time to lovingly collect the keepsakes
that you will carry with you as if they were your children themselves.
The gift of time, memories, and keepsakes for all the babies is
on the main educational messages which encouraged the establishment
of The Twin to Twin Transfusion Syndrome Foundation.
When One Of
The Babies Pass Away
Deliveries including
both life and loss are unique. It is important to make a ‘birth
plan’ and communicate it to your doctors and nurses before
the delivery including when and how you will see all of your babies.
It is OK to make changes when the time comes, it is OK to be flexible.
After the birth, you may only feel relief when the surviving baby
or babies actually “make it”. It is very common for
the devastation and grief to overtake joy. This is especially
true for women who had to continue the pregnancy with a loss.
Their grief is so devastating, but the depth of their grief is
pushed into their subconcience in order to emotionally survive
each day of the remaining pregnancy. This occurs naturally. When
the moment comes that the babies are delivered, it is actually
the “true” beginning of their immense devastation.
It is almost like the loss occurred just then. Most likely when
there are surviving babies in a multiple pregnancy, they will
be delivered by c-section and will be delivered first. This means
when they are delivered it will be to a room filled with joy and
clapping. Then, everyone knows that the delivery is not over.
Suddenly, the room becomes a room filled with a piercing silence.
It is Ok to feel your emotions and ask questions about the babies
being born. It is OK to cry. Ask to see each baby after it is
delivered so you can have a memory of each baby being born. This
can take place even if the baby or babies that have passed away
are wrapped in a blanket and laid down next to each other for
the remainder of the surgery. Often, if the babies are born early,
parents only have a quick moment to see them before they are quickly
taken to the NICU (Neo-natal Intensive Care Unit). Pictures can
still be taken quickly of each baby, and you can quickly see him
or her, or them before they go. You need to understand that you
have rights as parents. It is OK to ask to see. Parents who experience
the loss of one or more babies and have a baby or babies that
survive are experiencing a great contradiction. They may have
a baby, but have lost a baby that looks just the same. It is very
important when in your private room, not to have a “one
baby in…one baby out” situation. This can be very
confusing because you know you gave birth to multiples. Medical
professionals often think that it is not right for parents to
see both babies at the same time..to see life and loss. But, this
is the reality. This is what you have to leave the hospital with
and go home with. This is what you will live with for the rest
of your lives…life and loss. You were never meant to experience
these two things at the same time. You need to see the reality,
so you know that it wasn’t a dream. It really did happen
to you. The reality is a nightmare come true, but it is the reality.
It is healthier for you to see your babies together because you
have to go home and live with it. We greatly emphasize the importance
of seeing all of the babies for these reasons, but even more importantly,
for the simple reason that you spend time with your family the
way you dreamed of for months, and for many…the way you
dreamed for years. It will not be the way it was meant to be or
a long enough amount of time, but it will be the time with your
family of making precious memories. You deserve at least that.
When The Pregnancy
Continues
With A Baby Who Has Passed Away
Often in a multiple
pregnancy with a monochorionic placenta, one or more of the babies
may pass away. The pregnancy continues because the babies share
a single placenta. This is a very uniquely challenging time for
the parents, especially the mother. It is very important for you
to talk about what you are feeling. You may be still feeling the
baby move when you know it is not alive anymore. This happens
when the baby or babies who have survived are moving your baby
when they move. It is the kind of experience that you can’t
really put into words, but you can cry. You need to be given the
permission to cry, and I am giving it to you right now. Of course
you need to continue with the pregnancy and have hope for the
other baby or babies, but it is OK to grieve. It will not hurt
the other baby or babies. The hope and strength is there naturally.
You don’t have to ‘try’ and be strong. It is
healthier for the pregnancy to be open with your feelings. Not
being encouraged to cry is the beginning of the “you should
be grateful for the one you have” and other hurtful comments
after the birth. We as women were brought up in this society not
to “put up a fuss” and to be “good little girls”.
It is OK to demand rights as patients. When you have to continue
with a loss, if you are given support about your loss, you can
be better prepared for your delivery. The delivery and recovery
should never feel to you like the loss “just happened”.
You have been given time to plan for their delivery. This time
is a gift in disguise, unfortunately, brought on by a deeply sad
tragedy and we are so deeply sorry.
When the loss
happens during or just before delivery
When multiple birth
loss happens during or just before delivery, the trauma is immense.
You feel that you have gotten to the “light at the end of
the tunnel”. You may have known that the pregnancy was experiencing
complications, but you had made it to your goal of delivery after
many weeks or months of struggling. Or, the pregnancy may have
been complication free. Then, all of the sudden, crisis enters
your life. You need to be aware that the shock is intense. You
have not had any time to take in the reality of the pregnancy.
You need time to ask questions. It is OK to ask questions repetitively.
You may not get answers immediately, but you will in the weeks
to come. You may just need to ask over and over because you are
in shock. If you are asked a question about your babies from the
doctor or nurses, don’t feel that you have to give answers
that are final. You can change your mind at any time. Your shock
levels will change every hour. It is OK to cry, you have permission.
The Compassionate Delivery-Loss of One Baby
You need to plan for
your delivery by talking with your doctor about your loss so you
understand each part of the delivery. Talk about it before you
get to the delivery table. The “unknown” is ten times
bigger then the truth. Having to ‘go longer’ after
the loss of a twin or triplet is more difficult and filled with
sorrow than words could ever describe. But that time can be a
time that you can think about their birth and in doing so, make
plans for the delivery that will help you for a lifetime. Your
fears are not real. Being with your babies will be a time you
will cherish, even though it will be so very sad. It is crucial
for you, your life and your marriages.
You need to ask yourselves if you want the doctors to listen to
a radio during the delivery. Believe it or not, often music is
played. It is such a personal and intense situation. It is OK
to request that this not be done. We suggest that you think about
this and give your doctors your answer before the delivery. You
can always tell the nurses too.
You may watch the delivery
with the use of a mirror. This is very important to be able to
witness the birth of your babies. Even if your loss occurred early
and the baby or babies may be in the placenta, watching the placenta
be delivered is still watching your baby or babies be born. Care
must be taken, in pathology, to detach the baby from or within
the placenta so you can hold your baby. We know this is overwhelming
for you. If the doctors have told you that your baby is attached
to the placenta or absorbed into the placenta, a pathologist can
compassionately work on the placenta and your baby can be brought
to you. We strongly recommend that you do this so you can have
a compassionate time with your baby and not regret not seeing
or holding him or her. We know that the baby maybe very small,
but it does not matter. These are still your children and it will
be very meaningful for you and bring you peace.
Get a private room for after the delivery
You need privacy. You
can spend your whole hospital stay with your baby or babies. You
can also see them more than one time. You are in control of this
and don’t ever listen to a nurse or medical staff that tell
you otherwise. This time is crucial for you to spend with your
children. This is a time to wash your baby or babies and have
them baptized. Dress them in special outfits picked out by you
(from home or from the hospital) and/or wrap them in matching
blankets. Take individual and group pictures. Place the babies
in your arms, and take pictures. Put your twins or triplets in
your arms, all of them, despite how early the loss, how small
the baby. These are your children. You need to see your surviving
children along with your baby that has passed away. This is your
only opportunity for a very long time to put a lifetime of love,
advice, hopes, dreams, and affection into a moment. Shock changes
instantaneously and frequently during and after the delivery.
If you have given an answer to a question about your babies during
prepping, your answer will be different in the recovery room,
and then in your private room hours later. Always ask to see your
babies more then once. Some parents feel there must be a reason
not to see their babies once they are asked if they want to. There
is never a reason not to see your babies. Your baby or babies
are beautiful. They love you with all their heart. Not seeing
them only sets the stage for later regrets.
Guidelines For Collecting Keepsakes
The Twin to Twin Transfusion
Syndrome Foundation is available to help parents think about the
idea of spending time with their children, the gifts they would
give to them, and the keepsakes they will make to cherish forever.
The following guidelines are given to help parents begin to do
this, and to help medical professionals and caregivers to be sensitive
to their needs and wishes. Unless you have experienced a multiple
birth loss, you cannot truly understand the uniqueness of the
experience. We are here to help you because we have experienced
this ourselves. The following guidelines come from the pain, healing,
and hearts of those who have truly “been there”.
1. Take Photographs
with a 35mm camera of all the babies
Often, professionals
involved in a multiple pregnancy with loss are educated on taking
pictures of the baby that has passed away. They do not, however,
often understand the importance for there to be pictures taken
of all of the babies and not to do so with a Polaroid camera,
but a 35mm for negatives and clarity. This is important for you
to understand. You have to be your own advocate. Taking pictures
is proof that you did give birth to twins or triplets. Something
tangible for you to look at later of your beautiful children.
They are very important for you to have for many reasons.
It is such a state of
confusion for families. Pictures reaffirm what you know deep inside
your hearts. But, often parents doubt their status as parents
of twins or parents of triplets since they had a loss. Am I still
the mother of twins or triplets? Of course you are. But, when
numerous comments are made about your “baby” or the
“twins” when it is really the “twin” baby
or the “triplet” babies, it is difficult for parents
to have the confidence to explain the reality of their birth.
It can be difficult to voice out loud and to others that your
parental status has not changed because of the loss. It should
not have to be our job to explain ourselves, but unfortunately
it becomes necessary. It is very emotionally draining for parents
to explain our unique birth and loss of our babies, because it
may bring on more unsupportive comments from others. It is important
to start right at the delivery in letting it be clear that you
are still the parents of multiples and that your delivery will
represent that. You will be gathering keepsakes for all of your
babies and taking pictures. Tell your nurses and doctors you want
to see all of your babies together. You have every right to do
so.
The more parents talk
about their baby or babies that have passed away, the stronger
they will become in their self-esteem and in their confidence
to continue their lives with Peace. Taking pictures will provide
you with the reality that you are the parents of multiples, and
you will not have to question if you still are or if you ever
were. It helps tremendously.
You have waited months
to see and hold your babies. By not treating the delivery and
recovery respecting this fact, a stage is being set for you to
believe your status has been taken away from you. Being parents
of multiples will never change…it is a bond with your babies
that can never be broken. The nicest thing said to one mother
whose donor twin passed away, “There is nothing that did,
can or ever will change the bond between a mommy and her babies.
You will always be as one.” Getting keepsakes for all of
your babies confirms that yes, you are the parents of twins, or
yes, you are the parents of triplets…and your babies love
you and are truly precious.
(Special Note) Pictures
Will Benefit The Surviving Children
Taking pictures of all of the babies also benefits the surviving
babies. Survivors of multiple pregnancies always know that they
are a twin or a triplet. If they were never told that they are,
they would still know. Studies have shown that in pre-school when
survivors were asked to draw a picture of themselves they drew
a picture of two people or a pictures of one with parts of them
missing. This happens even if they were never told that they are
a twin. They feel a sense of loss. By telling them, what they
already know, parents set forth an environment of pride in their
child in the special bond with their twin and in the status of
being a multiple. Not telling them makes the truth build up to
something so big that it takes on the form of a secret. When the
child learns of the truth, they will probably blame themselves.
They must have done something wrong or otherwise they would have
been told. Being a twin or triplet is very special. The surviving
children will help the parents so much once they have been told.
You will all grow together from keeping the truth an open subject
and a sense of pride. One mother told her surviving twin, “we
miss your brother so very much and we are so happy that you are
here, here with us. One day, after we have lived a long, long,
long life and have done so many fun and important things in our
lives, we too will go to Heaven. It is important to live long
and be happy so when we do go to Heaven, we will tell your brother
all of our stories. And, do you know what he will say? He will
say, I know…I remember…I was right there with you.”
The following are guidelines we suggest in the photography of
your babies.
Photographs
to Take:
Take
pictures of all the babies individually.
Take pictures
of all of the babies together.
Take pictures
of them touching each other (skin to skin contact).
Take pictures
of them holding hands.
Take pictures
of you holding all of the babies in your arms.
Take pictures
of you kissing your babies.
Take pictures
of you holding your babies’ hands
Take pictures
of the entire family including other children. If your children
are not present, which we strongly encourage that they be, use
a photograph of your children to lay on the blanket and be part
of the picture. You deserve a “family portrait”. This
is also true for babies that survive and have to go to the NICU.
You can be together with all of your babies in the NICU or take
pictures of your survivors to place in their portrait with their
twin or triplet that have passed away.
Take pictures
of your babies wearing identical baby hats
Identify inside
the hats which hat belongs to which baby.
Wrap your babies
in their own baby blanket for pictures.
Mark which
baby blanket belongs to which baby
Take pictures
of all your babies wrapped in a single blanket. Mark this as the
family blanket.
Have private
family time alone without the caring individual helping to take
the pictures for you.
2. Film The
Time With The Babies With A Video Camera
What is most painful
for parents after the loss in a multiple pregnancy, in time, becomes
what they treasure and cherish most. Many would not think to video
this time with their babies, that this is behavior meant for a
happier occasion. But, this is a very private time for parents.
What others think, is irrelevant. Your time with your babies is
precious and you will always remember it even without video. But,
with video you will have one more keepsake. Keepsakes will help
you get through very difficult days. You will hug them on rainy
days, birthdays, Easter, and Christmas morning. The more keepsakes
you give yourself, the more you will have to help yourself feel
a sense of Peace later. So many of us have only Polaroid’s
to hold dear to our heart, and we have to worry about them fading.
To prevent that, we somehow have to take them to a photo lab and
have them made into negatives. It is a very painful and scary
process for fear that the pictures might be lost or damaged and
that is “all that we have”. Having video takes you
right back to the intense emotions and love. Those emotions will
be there without a video, but having it is a very precious gift.
It is also very helpful and important to show the survivors when
they get older. The Twin to Twin Transfusion Syndrome Foundation
will help any families who would like to have video taping done
for them in a quiet, loving manner with experienced members of
our organization who have also lost children in a multiple pregnancy.
The following are guidelines we suggest in the video taping of
your babies. Suggestions are for all of the babies despite the
outcomes or how early the losses…how small the babies.
Videotaping Your Babies
Have the video
placed on a tripod so time together with the babies can take place,
then take it off of the tripod to film the babies and yourselves
up close.
Make sure that
there is plenty of light in the room so the pictures will be clear.
Use the video
camera to film close ups of the babies features, such as their
hands, feet, fingers, toes, face, nose and so forth.
Talk to your
children of your hopes and dreams for them.
Kiss your babies
and tell them how much you love them and always will.
Tell your babies
that you did everything you could for them.
Let them know
that it isn’t good-bye, only I love you…
Take this time
to baptize the babies and announce their names.
Have the babies
touching you and each other so you can film it up close.
Sing to the
babies.
Tell them a
story.
Read to them
from a special childhood book.
Give them a
bath.
· Brush
their hair, cut off a piece of their hair to treasure.
Dress them
in baby clothes you had purchased or have at home that are special
to you and that you had planned to use.
Rock them,
sway them, tell them it’s gonna be OK.
3. Take Footprints Of All Of The Babies On The Same Card
Make sure to put the personal names of each baby under the footprint.
4. Take Handprints Of All Of The Babies On The Same Card
Make sure to put the personal names of each baby under the handprint.
5. Take Lockets Of All Of The Babies’ Hair And Mark
Each One With Their Names
You may also want to cut your babies fingernails as a keepsake
for each of your babies.
6. Give The Babies Baby Bracelets To Wear With Their Name
On It And That They Are A Twin, Triplet Or Beyond
7. Give The
Mother A Baby Bracelet To Wear For Each Of Your Babies With Its’
Personal Name On It And Multiple Status (twin, triplet, quadruplet)
You don’t want bracelets only for the survivors, but for
all of your babies by name. If you were pregnant with triplets,
and two babies survived, don’t put twins. They are triplets.
Don’t take this status away from yourself or the babies.
It is reality, and it is a sense of uniqueness, specialness, and
pride. Don’t let a nurse do it either. Make sure that you
go home with all of your baby bracelets with your babies’
names on them.
8. Use Measuring Tape To Measure Your Babies, And The
Paper Or Blankets They Actually Laid On.
Identify which baby each blanket or paper was for. Put weights
and measurements on the same card and separately name the baby
or babies.
9. Get The Hats And Blankets Of Each Of Your Babies In A Separate
Zip-Locked Bag
Identify the
inside of each hat and blanket with your baby’s name so
these items can never get mixed up.
Identify the
outside of each zip-locked bag.
The zip-locked
bag will keep the smell of your baby. Do this for each baby whether
it has lived or been born silently. Do this regardless of how
young the baby was when it passed away or how small it is.
10. All Of The Keepsakes Need To Be Placed In A Very Special
Box To Be Taken Home And Marked PRIVATE
“Private”
should be marked on the box so others know that they are not to
enter the box and disturb the keepsakes.
11. PLEASE DO
NOT THROW ANYTHING AWAY.
You may have prepared
your nursery for two or three babies and have everything in place.
Husbands or other family often feel an urgency to give everything
away or take it back to the stores. You need to leave everything
there and let the mother put things away at her own time. Again,
put things away, but do not throw them away or take them back
to the stores. Even with things such sympathy cards, baby clothes
or other items….do not throw them away, but simply put them
away. It is much healthier for the mother to come home to her
house the way she left it before the delivery. In time, she will
put things away or return them to stores. What is very important
is that she do these things herself.
Other family members
must have trust in you. Tell them, “If you love me, then
trust me that this is what I need from you.” You need them
to let you deal with the nursery on your own. You need them to
let you send out a birth announcement representing all your babies.
You need to do, what you need to do to keep your status of mother
and father of twins or triplets and don’t let anyone, including
family, make you feel it is wrong. It is the truth and the key
to your Peace and health.
12. You Cannot
Be Rushed.
Grief overtakes joy
when life and loss occur at the same time. For moms, it is possible
to take care of your baby during such deep sadness, but you
need to be a mother and learn how to take care of your baby on
your own. It is a time of great self-doubt. The more you can do
on your own with encouragement, the stronger and more self-confident
you will become. All mothers who have experienced loss in a multiple
pregnancy need to give themselves permission to let out that painful,
longing cry for their babies. It is there.
Moms, take one minute
at a time. In many ways, you have to learn how to live your life
over again. But, as you do, you will be bringing all of your babies
with you. Learning how to do that takes a lot of time and soul
searching. Remember, it is never goodbye, only I love you. Find
your own way to bring all of your babies with you. I believe in
you and know you can do this.
From the Foundation
We have found from speaking with many of the mothers and families
that the way your delivery is handled plays a very crucial role
in the sense of Peace that you will feel in years ahead. Keepsakes
are more than reminders of our babies…they are tangible
gifts from them to us. Too many insane statements are heard on
how better off we are in some way or another for having lost our
children. We know these statements are not true. As our self-confidence
becomes stronger, we will verbalize it. You just have to take
a deep breath and start. Having the keepsakes gives us a place
to go when we know these statements are not true, and we need
to tell our babies so. On Christmas morning, we can hold their
baby blankets up to our cheek and hold onto them in our arms.
We can hang their footprints in a beautiful frame on the wall
for all to see. We can wear their lockets of hair in a locket
around our neck. We can see their faces from their photographs
and watch them on video. We can be with them whenever we want.
This can be done regardless of any keepsakes, but they help tremendously.
If we can’t have the lifetime of memories, we certainly
deserve this much. We deserve them truly being here more. Remember,
one day, we will truly be together again. After we have lived
a very long, long life we will go to them and tell them all of
our stories. Do you know what they will say? “I know mommy…I
remember, I was there.”
We hope that this booklet
will be a source of comfort to families experiencing the loss
of one or more of their multiple babies, and to the medical professionals
to guide them in collecting keepsakes.
The Twin to
Twin Transfusion Syndrome Foundation
International Office
Compassionate Deliveries©
411 Longbeach Parkway
Bay Village, Ohio 44140
Phone: 800-815-9211 and 440-899-8887
Fax: 440-899-1184
Web: tttsfoundation.org
©The Twin to
Twin Transfusion Syndrome Foundation
Copyright December 1994-2004
All Rights Reserved