IVF and multiples: the lifetime effects of "vanishing twins"

An Australian radio programme, broadcast in August but which I found today, includes a study of hundreds of thousands of pregnant women, tracing the events in pregnancy as related to health risks later.
The issues covered in this programme include obesity and how that is related to your mother's pregnancy, particularly in the early months.

Most importantly, the risk of birth defects in a single baby from an IVF cycle was found to be higher.  Womb twin survivors are three times more likely to have birth defects than babies who never had a twin. It is interesting that this is the last thing that advocates of multi-fetal pregnancy will mention, of course, let alone the psychological effects on the sole survivor, which we know so well......

Listen now

DZ womb twin survivors - preoccupation with pregnancy and birth

DZ womb twin survivors of both sexes seem to be preoccupied with pregnancy and birth and also have strong feelings about it.  This includes pregnancy and birth issues, miscarriage, abortion, stillbirth, neonatal death, infant death and the death of a child of any age.  If a DZ womb  twin survivor finds out that he or she will never have a child, this becomes a particular focus for grief and loss. This appears to be a simple transference of the feelings of loss of the womb twin onto another baby.

The current president of the Association of Pre and Perinatal Psychology and health is a womb twin survivor, and many of the pregnancy and birth experts who I have had contact with during the last eight years of this project have also been womb twin survivors. I would go so far as to say that, if someone is very interested in life before birth, there is something going on in their minds about their own pre-birth experience.

My own preoccupation with the unborn, which started in 1977 and still continues, may be a good example of this (I am a DZ womb twin survivor.)

Risk for the survivors of "vanising twin" phenomenon

There are many risks for the survivors of a "vanishing twin" pregnancy, see here..

Research from the 2010 Annual European Society of Human Reproduction and Embryology (ESHRE).

For instance, vaginal bleeding in the first trimester  ( sign of a lost twin) increased the risk of

• preeclampsia,
• premature or very premature delivery and
• more than doubled the risk of low birth weight and very low birth weight.
• These risks were further increased after detection of an intrauterine haematoma.

The survivor in a vanishing twin pregnancy (a twin pregnancy in which one twin miscarries very early in the pregnancy) was at increased risk of

• premature or very premature delivery,
• had double the risk of low birth weight,
• three times the risk of very low birth weight, and
• more than three times the risk of perinatal death.

 The researchers reviewed previously published studies and determined that early pregnancy complications increase the risk that the pregnancy will have complications and future pregnancies are at higher risk also.

And that is not to mention the psychological difficulties.......

A "Vanishing twin" pregnancy: should I tell my child?

Lucy and Jack, after several years of IVF treatment, were delighted to find they were expecting twins. A scan at eight weeks showed two sacs, each with a tiny fetus, but a few weeks later there was only one baby left alive: the other sac was empty. Lucy went onto the Internet to find out more about vanishing twins and found my site at wombtwin.com. She emailed me the next day,  “It seems that the remaining twin may have some psychological problems: what do I tell my child?”

Then I heard from Margaret. Like Jane she had noticed a little spotting in the early weeks of her first pregnancy - which is a sign of a vanished twin. Her daughter Elinor, now aged six, was born at thirty-six weeks. She was small but very strong. She is left-handed.

“She has always been very mature for her age,” Margaret told me. “She has always been very nurturing with her two younger sisters. She gets very frightened when she hears loud noises. She tends to be reserved and somewhat clingy. Sometimes when she cries, she says that no one loves her and no one understands her.  Since she started school I have noticed that she often talks to herself, as if she is in her own little world.  Then today she asked me where her sister was!  I was speechless. I didn’t know what to say.”

My research with hundreds of womb twin survivors from all around the world is beginning to show us that womb twin survivors are often sensitive, caring people. They are so sensitive to others that they feel as others do. This means they make wonderful therapists and nurses. 

They can become distressed at some point about the loss of their twin but not all of them do.  If they know for sure that they once had a twin, it simply becomes part of who they are.  If they know they were once a twin then, when they feel sad or lonely they can know they are are responding perfectly normally. After all, they did lose their "other half."   For this reason, if your child is a womb twin survivor, it is best to make this clear as soon as you can.  Research has shown that it is helpful to tell your child, as soon as possible and in the calmest and most natural way, the truth of what happened to their twin.

It is important for both parents to be in agreement on this. Sadly, Alice, who is now 35 years old was pregnant with her son Jason when doctors detected two sacs in the eighth week and later on there was only one. “Jason has always been complaining about not being meant to live and missing his brother,” says Alice, “ but my husband thinks this can't be a suitable explanation. I feel there is no way I can talk about those things without being labelled crazy myself or hurting my child.” As a result, Jason, now aged ten, has not yet been told about his twin.

It is normal for a lone twin to have feelings of loneliness, emptiness and sorrow and that goes for womb twin survivors too. If you have had a twin pregnancy that ended up with one baby then you have a womb twin survivor in the family. Rather than leave your child with unexplained feelings, tell him or her about the lost twin - make it real.

Tell them early in life, and make sure you are well informed about the details of  your pregnancy, because you may find that as they grow up they will want to know more and more about what happened.      

It can help everyone if you find other parents of womb twin survivors and team up for mutual support. Not everyone will believe that the loss of a co-twin so early in life can leave an impression. Validate your own child's feelings in the face of public scepticism, and they will never complain that "no one understands how they feel."

Prebirth experiences and mental illness

Stress in early pregnancy linked to schizophrenia.

Yes here we go again; I missed this one, as it was in February and I was busy collecting stories, but today a quick browse found this link to some research connecting difficult intrauterine experiences for a foetus and the eventual psychology of the born child.

Of course these scientists missed an important element: one in 8 pregnancies are multiple at first.

Stress in pregnancy compromises the pregnancy and can cause the loss of the entire pregnancy. How obvious that stress in early pregnancy would have an effect on the born child! The survivor of such an experience (stress hormones from Mum passing via the placenta through the blood supply of the foetus,) would most probably be a wombtwin survivor. Hence etc....

What a different result we would see if such research factored in the vanished twin! Then we would see that the symptoms we call " schizophrenia" are a completely normal reaction to an intense and very difficult prebirth experience.

There are a couple of stories in A Silent Cry of the mis-diagnosis of schizophrenia, and I have spoken of this before on this blog, in connection with the eight years that Janet Frame spent in mental hospital hell. Maybe things will change when these stories are made available. I do hope so!

Platitudes for the depressed

So Pamela Stevenson (now Connolly) has written some books about psychology.

The one about depression seems to be full of platitudes that get nowhere near the problem.
Here is a a short list of what you can do about depression while you wait for that appointment with a psychiatrist for some antidepressants which will slow you down and nicely blurr the issues and make life liveable again.

• Educate yourself and others round you about depression.
• Make a list of any specific concerns that may be contributing to your depression.
• Try to take care of those things as best you can.
• Make a list of positive things in your life about which you feel hopeful, focus on these things.
• Try to exercise. Try to eat a nutritious healthy diet. Pay a little more attention to your physical appearance.
• Gather support from friends and family. Garner human touch. Don't isolate yourself.
• Create a daily schedule of activities for yourself.

If the individual concerned is capable of any of this then they are no longer depressed. If I knew all about depression and exactly why I was depressed and I was able to do something about it, I would have no problem.
If I was bothered about myself enough to exercise and eat healthily and have friends who hugged me and had a structured meaningful existence I would not be depressed at all.

We dont know about depression. Depression is a mystery. People don't suddenly get depressed, they have a lifelong tendency towards depression. What if depression is grief and loss and terrible sadness and utter helplessness and isolation? What if people with a tendency to depression get platitudes thrown at them and no empathy whatever for how they truly feel?

No one is listening to the wombtwin survivors who feel grief and loss and terrible sadness and utter helplessness and isolation. Call it depression, a personality disorder or what you will, but there is a rational intelligent and loving reason why some people feel this way.

We need to ask those vital questions about the mothers pregnancy!