Termination of a twin at 32 weeks

[NannyAli]

I'm not really sure what responses I'm looking for tbh. My daughter is pregnant with twins. She has been told one baby is so very poorly that if he even survives until birth that he would have no quality of life whatsoever. I'm absolutely heartbroken as I know she's looking to me for an answer and I can't give her one. She already has two children 4 and 2 and I know this is going to affect them all. I think she has made the decision to terminate him at 32 weeks but I have no idea how to help her through it! She has also said she doesn't want a funeral for him or to hold him or even see him. I'm not sure that's the right decision, although I haven't told her that. I'm worried she would regret it. Anyone have any advice or anything as to how I help her? Thankyou for reading this it's very much appreciated xx

I am very sorry that you are facing the loss of a grand son.

there will be a bereavement specialist midwife who can be accessed through your daughter’s own midwife and possibly her GP. If I was in your postion I’d find out about the local services and SANDS.

There are often volunteer photographers who will come and take really beautiful photographs of the infant. Obviously, we all grieve in different ways, but it strikes me that there is now an appreciation that we have a very small window to make important and loving memories and it might be wise to have that opportunity organised and refused rather than not and regretted.

I hope the other twin is well and that your family is well cared for as you get through this.

FWIW, you sound like a really lovely mum.

Sorry your dd is going through this, but would she actually be able to terminate at 32 weeks or even advised to given she’s having twins.

As I recall termination of one baby carries a significant risk of losing the other one, what have her medical team said?

I’ve seen cases like this where the mother is induce early, although not quite that early, in order to save the other baby.

But a 32 week termination involves induction and labour which is very dangerous for the remaining twin.

She really needs medical advice here. All you can do is be there for her.

We chose to TFMR a single pregnancy so my experience is different.

Throughout the induction process we had some absolutely amazing midwives. We knew we wanted to hold our daughter when she was born but at every step of the way they asked us what we wanted to do regardless of what we previously said we wanted to do. When she was born they asked if we wanted to see her right away or if we wanted her wrapped up first. What your daughter says she wants to do now may change when the baby is born. I appreciate you saying she may regret not seeing her baby boy but let her just go with it - she may change her mind. Our midwives took photos and hand/foot prints. Your daughter can ask for these to be done and given to her if/when she is ready. If she decides not to see him, she may regret it in the future but all you can do is support her day by day.

With regards to the funeral, we were adamant we didn't want one. But once we realised our daughter would be cremated along with other babies we decided to hold a private funeral so we can have her ashes back. This sounds recent so perhaps once your daughter has wrapped her head around it as much as she can, she may change her mind. Or she might not. Whatever she decides is OK.

Before we decided to TFMR we looked to friends and family for guidance. No one could tell us what to do because ultimately we would be the ones dealing with our daughter and the issues she faced. Granted we would have lots of support but it's not the same as dealing with it 24/7. And actually no one wanted to tell us what to do. It was only after that we got lots of comments like "yeah I would have done the same thing".

The bottom line is just support her. Her needs will change day by day. I found a lot of people said "let me know if you need anything" which means when I was in the deep grieving process I was also expected to reach out for help when all I wanted to do was cry. The best ones were when they told me "right, today get dressed and we are going for coffee/wine/dinner/lunch". You know your daughter best, if she's one to reach out for help then follow her lead, if she needs a bit more encouragement then be proactive and tell her you are popping round to have a coffee/clean the kitchen/do the laundry.

I've read various peoples experiences with regards to TFMR, and I believe with twins the lost baby will be born alongside the living baby. That will be hard for your daughter as she will be celebrating the living twin and grieving the lost twin.

It's going to be a tough road for her but it sounds like she has some good support from you. Just take it a day at a time. One day she might need you to hold the fort with her older children, other days she may just want some space with her husband/partner and the children.

The hospital should have some specialist midwives to talk about the lost baby and holding him and funerals etc. We didn't really speak to them prior the birth but as I was in labour for 24+ hours we got talking about if we wanted to hold her and the funeral etc.

You may want to think about some keep sakes. We bought 2 lots of teddies etc one for us to keep and one for our daughter to take on her onward journey. There are a few charities which donate boxes, we got ours from the hospital. There was so much inside and everything was double so we could keep one and our daughter keeps one. We got one from SIMba www.simbacharity.org.uk/what-we-do/memory-boxes/large-memory-box/

ARC is a good resource for your daughter as well as well as SANDS.

I'm so sorry for your loss

I lost a baby earlier than your daughter and it wasn't TFMR so I can't relate to that, it must be incredibly hard. I echo PP advice about seeking bereavement midwife support, mine was incredibly helpful.

What I can say is I didn't meet my little boy, we only had 48 hours to make all the decisions and I wasn't in a fit state to do that (I don't imagine anyone is) but in those 48 hours I was constantly having flashbacks to the scan where we found out he had passed away. I was terrified if I saw him I'd never get that image out of my head. It was very hard not meeting him and now we have our rainbow I feel awful, I feel like I abandoned him and I could never do that to our rainbow so how could I do it to him. I have also never been able to remove the image of the scan or the feeling of delivering him so it probably wouldn't have made a difference seeing him as nothing makes you forget, it was just how I was thinking at the time. I regret it every day and regret not naming him, but have named him now, it's not the same but it feels better to have a name when speaking about him. Having said all of that though, I know that it was the right decision at the time, I wasn't strong enough for anything else.

You sound like a lovely mum and all you can do is support her, which you are doing wonderfully, and encourage her to speak to the bereavement midwife, like others I found SANDS helpful.

Also, my parents are lovely but whenever I now try and talk about our little boy they say 'its hard but at least you have your rainbow so focus on him'. I find that frustrating and dismissive even though it is said with such good intentions. I think part of it is because we didn't name him or have a private funeral (we did hospital funeral) so it gives people the view that we just want to forget - I say this just to keep in mind, whatever decision your daughter makes.

I'm sorry you are all going through this x

Hello. I am so sorry to hear this. I too would be surprised about termination at this stage ( I had twins at 29 weeks and my eldest daughter died just after birth as background). I would make contact with the Bereavement Support Service from the Twins Trust and SANDS too as others have said. SANDS have a helpline you can call.

So utterly sorry.

A long time has passed since this post but I felt compelled to offer my brief comment to correct some errors in the replies above.

You can indeed terminate a twin at 32 weeks and in the case of one poorly baby, that is what is usually recommended as it poses the least risk to the other baby. I went though a termination at 32 weeks back in May 2022 as one of my twins had spina bifida and extensive hydrocephalus. My survivor is here now, very well and very loved.

I delivered both my live baby and my lost little girl by c section at 37 weeks.

I am so sorry that the OP daughter is going through this. Please reach out to me if you like.