HOW EXTENDED FAMILY OR ACQUAINTANCES CAN RESPOND TO MULTIPLE BIRTH LOSS, compiled by Elizabeth A. Pector, M.D.:

1. Some parents may appreciate a card saying "Congratulations on the birth of your twins/triplets" with a notation of condolence inside. If there are survivors, consider sending two separate cards (one for congratulations, one for sympathy) or a handwritten note mentioning both events. Ignoring the loss, or avoiding acknowledgement of the event altogether due to feeling awkward, can worsen the bereaved parents’ burden.

2. Consider, instead of sending flowers, donating to a charity in the name of the lost baby. Some parents are overwhelmed by flowers, which are something else to take care of that dies too soon.

3. Know that any surviving children are still twins, triplets etc.

Parents usually call them survivors of the original number.

4. Parents should be asked what they want done with duplicate

clothing, double strollers, extra cribs, gifts for the deceased child, etc. Many parents want to keep such items in memory of their lost child(ren). Others would rather put away or give away these items. It’s thoughtful to donate unwanted gifts in the deceased child’s name to a charitable organization, or arrange for sale through a Mothers of Twins/Multiples Club so the parents don’t need to make that contact. Don’t try to guess the parents’ desires in these matters, because a mistaken but well-intended action might be seen as uncaring or insensitive.

5. Any personalized or handmade items (blankets, crocheted or knitted clothing, posters, artwork or cross-stitch work), especially those which include a deceased baby’s name, may become a treasured keepsake for the bereaved family. Present it to the family in memory of the lost child, and if it is refused, save it for a future occasion when the family might want it (e.g. first birthday or death anniversary). Such items shouldn’t be later given to another child in the extended family. The bereaved parents will think their lost baby is being forgotten and its gifts callously recycled.

6. The deceased child(ren)’s name(s) should be respected as a permanent part of the bereaved family, especially if there are

survivors. The name(s) will be used often within that family. Children of extended family members, friends or neighbors born later who are given the same name(s) will constantly remind bereaved parents of their loss. People considering using the name of a parent’s deceased multiple should discuss it with the grieving parents first, asking their feelings and permission rather than announcing it as a final decision. Naming a child in honor of a deceased multiple is a sweet idea, but make sure the bereaved parents are fully accepting, aware that it will be a lifelong reminder of their lost child.

7. Be aware that encountering intact sets of multiples is painful to bereaved multiple birth parents. They don’t want to hear other multiple-birth stories just because they’ve experienced multiple pregnancy. It merely reminds them of their failure to bring all of their own babies home. Don't pressure parents into attending social situations with twin encounters that they will find difficult, or tell them to suppress their feelings out of consideration for others. Parents need time and patience to learn to deal with “Close Encounters of the Twin Kind.” Try to forgive apparent rudeness, envy, avoidance & tears if you’re a parent of multiples, or a multiple, yourself. With time, grieving parents will handle reminders better.

8. Avoid platitudes. One mother newly diagnosed with a twin pregnancy told her friend who'd lost a twin, "God gave me twins to help you through your loss." This was not helpful.

9. Carefully review the comments following in IX. Immediately after their child's death, most parents want loved ones to admit their child's death is tragic, listen to their mixed-up feelings when they need to talk, and help them get practical things done that they cannot manage themselves for physical or emotional reasons. Parents' self-esteem has often been shattered by what for many is the most devastating event in their lives. They may need advocates to help them get what they need from hospitals, funeral homes, insurance companies or other bureaucracies, since they may be too distraught to fight for themselves. Support them through the ups & downs of their grief process. Realize it will probably take a few years for them to work through this major trauma; for some it may be even longer. With help from family, friends, peers and sometimes professionals, they can heal, but will heal with a scar. They will never be the same as they used to be. Expect them to include the children who died as part of their family history in some way. In one mother's words, "I'm moving on, but I'm taking my baby with me."

Distressing comments try to minimize or shorten grief; explain the death in spiritual terms; or encourage parents to look on the bright side because things could have been worse. Understanding this, try your best to avoid the "Don’t Say" comments listed in IX, or if you do slip, apologize to the parents, since they probably heard you anyway. Realize actions will speak louder than words in the long run.

IX.

DO SAY:

I’m so sorry to learn of your child's death.

I'm happy you have your survivor, but also very sad one baby died.

I don’t know what to say.

I’m here to listen whenever you need to talk.

Is there anything I can do for you? Anyone I can call?

I can’t imagine how you must feel. Please tell me.

This must be hard for you.

DON’T SAY:

At least you still have one (two, or however many) left.

At least you won’t go home empty-handed.

At least the baby was a twin, otherwise your grief would be so much worse.

At least you will always have a reminder in his/her twin.

Since one of your twins died early in utero, it’s really just a single pregnancy now.

Aren’t you over it yet? After all, you do have an(other) one(s).

Don’t be selfish. Be thankful you still have one, and get over it.

See the glass as half full, not half empty.

Focus on the living, your survivor’s still critical and needs you.

Get over your grief, your survivor(s) will sense something wrong.

Don’t project your grief on the survivor(s), they’re fine & happy.

At least you have other children at home.

It was only a baby.

You can always have another baby (or try again).

Things happen for a reason.

It was for the best.

You would really have your hands full if all the babies survived.

Humans weren't meant to have litters.

God must have known you’d only be able to handle one baby.

God never gives you something you can’t handle.

God meant for this to happen (or It was God’s will.)

Count your blessings.

You had your priorities out of line and wanted your babies more than

you wanted God, and that’s why he took them.

You must have known this could happen, they were so premature.

You knew he was going to die.

The baby would have been handicapped/had major problems

if she survived, so you’re lucky this happened now.

I'll bet you're glad you don't have to bother with the other one now.

It’s better it happened now and not months or years from now when you really would have been attached.

You never know what would have happened if they lived; they might have gotten cancer, a serious illness, or died in an accident.

You don’t need to nurse your survivor so much. It’s not like

you still need enough milk for twins. (said by nurse)

All the other triplets delivered here survived!

Think of the money you'll save!