<snip>Jo-Anne Elder wrote: "I am beginning to believe that there are women who
are "meant" to carry and birth twins, and by this I mean their bodies
are capable of it, and these ones (who, moreover, are usually happy to
learn they are carrying them) have big, healthy, full-term babies."
I think that
it is wonderful that you had such successful twin pregnancy and
birth experiences, however, I feel it is extremely insensitive for a mother of twins to take a superior
attitude in regards to success of multiple gestations. I am mother of spontaneous, "naturally-occurring", twins. Although if you saw me or spoke
to me casually, you would never know. That is because of one my twins died
in-utero. The point I am trying to emphasize here is that while it is quite easy to "see" all the
thriving successful twin births, it is quite difficult for a mother who has
experienced the death of a twin to introduce her twin as a "twin". Or for that matter, present
for breastfeeding assistance as a mother of a surviving multiple. And let us not forget, how many "twins" have been seen that are not actually twins at all. They are triplets or higher and only two remain. While the JAMA article does not specifically address the differences in rates of fetal
demise or loss in multiple gestation, loss in a multiple birth situation
still unfortunately continue to occur.
I realize it may seem contradictory to hear "successful management" and
"preterm delivery" used in conjunction. I recognize that my experience,
exposure and parent contacts with other multiple birth loss parents has
influenced my opinion on this topic. What do we say to the mother who
viewed her babies alive and well on an US at 36 weeks, but her doctor
insisted she carry her twins "full term" only to have one of them die in
utero in the meantime? The result is a mother in pain always to wonder "what
if" and never know. I also recognize that society attributes a celebrity
status to mothers of twins or higher order multiples. It is painful to give
press to the scenario in which a baby(s) dies. This is especially true in a
multiple birth situation where one baby survives and it is presumed the
loss is less significant because the mother still has a baby left.
Unfortunately,there are many parents who had spontaneous multiple gestations
and none of the babies survive.
We can not as breastfeeding support providers in any way imply that these mothers bodies are not capable. On the contrary, we need to empower and support to build the confidence in the mother who might feel that her body has betrayed her and therefore lack confidence in her ability to adequately nourish her surviving infant(s) or subsequent babies at the breast.
Pre-term delivery is a well- known risk factor in lactation management. The death of a twin or higher multiple is also a risk factor for establishing and maintaining the breastfeeding relationship with the surviving multiple. If interested in lactation management suggestions
in multiple birth loss situation, read my article "Grieving While Lactating" in Clinical Issues in Lactation (BSC) Nov. 1999. In addition, I recently launched a questionnaire to explore this topic further.
Junelle Hanrahan
Vancouver, WA
Accredited volunteer breastfeeding counselor
Parent contact and member of CLIMB (Center for Loss in a Multiple Birth)
List administrator for CALM, Conceiving After the Loss of a Multiple http://www.egroups.com/group/CALM
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