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Vanishing Twin Phenomenon

                                                                              

Dedicated to Mandi

In an email she wrote:

Hi

My name is Mandi... I am 11. A few years ago I told my mom that I had a twin, and I wanted to know where she was NOW I was kind of kidding but kind of serious. My mom looked at me and said "Um, yes, you had a twin...in my stomach. But she died." I was shocked because she had never told me... Apparently when I was born there was two placentas, but just me. 

I haven't told many people about my twin (Lexie, is what I call her because that's what my mom was going to name my brother if he was a girl, and she wanted to name me that, too) Because I told my step brother once (who is a twin, too) and he called me "Baby-eater" and said I ate her...that's why I wanted to find out about Lexie.

About the voices in the head... I do talk to myself sometimes, but I never thought of it much until I read your web page.

About the genius thing...I took an online IQ test and I am 178... I am pretty sure that is genius...
I am lonely a lot even with friends.

That's all I have to say.

Mandi

 The Vanishing Twin Phenomenon

An Overview by Caryl Dennis

        The Vanishing Twin Phenomenon or Syndrome (VTP), as it is known in the medical literature, is explored extensively in the 1995 text Multiple Pregnancy: Epidemiology, Gestation & Perinatal Outcome.  With contributions from over 80 experts from around the world, this book offers a definitive and comprehensive examination of the subject of twins.  In it, Dr. Charles Boklage states: "In reality…losing one or both offspring from a twin pregnancy is too common to be called phenomenal, and occurs for too many different reasons to qualify as a syndrome.  There is little room to doubt that the question of vanishing twins and sole survivors of twin gestation represent issues of broad and fundamental importance."   With the growing use of fertility drugs and in vitro fertilization, and as more women choose to begin their families later in life -- thereby increasing their chances of multiple ovulation -- the number of multiple pregnancies is soaring. 

Twin Statistics

        From the work of Dr. Thomas Verny, Dr. David Chamberlain and others, we now know that the fetus has consciousness and memory.  Dr. Verny declares in The Secret Life of the Unborn Child, "Birth and prenatal experiences form the foundations of human personality.  Everything we become or hope to become, our relationships with ourselves, our parents, our friends, all are influenced by what happens to us in these two critical periods." 

        My preliminary interviews with over 200 "twinless twins" indicates that the loss of a twin in utero can have profound physical, mental and emotional effects, both on the surviving child and its parents -- especially if it is unacknowledged.  Unfortunately, I have found very few instances in which healthcare providers discuss these potential problems with the parents. The surviving twin may never learn of the loss of its companion; myriad psychological problems can result, with no context in which to process them.  Parents are often left with unacknowledged feelings of confusion, loss and/or grief.  

History

        As early as 1945, the Text of Obstetrics mentioned the possibility of many more twins being conceived than born, but the VTP received its current name in 1980 at the Third International Congress on Twin Studies held in Jerusalem.  When the subject was raised, one of the congress participants cried out, "Vanishing twins!"  In 1995, Lawrence Wright published an extensive article, "Double Mystery", in the New Yorker magazine which gave the VTP some public exposure. 

        Multiple Pregnancy: Epidemiology, Gestation & Perinatal Outcome (cited above) is the first medical text I found that addresses the VTP in great depth. 

Statistics 

        Dr. Charles Boklage studied reports of 325 twin pregnancies and found that 61 ended as twins, 125 as singletons and the remaining 186 as a complete loss -- a measure of how risky twin pregnancies are.  "Somewhere in the vicinity of 10 to 15 per cent of us -- that's a minimum estimate --  are walking around thinking we're singletons when in fact we're only the big half", according to Boklage.  He estimates that for every set of twins born alive, there are at least six singletons who are survivors of twin conceptions.  Due to improved ultrasound technology and earlier detection of pregnancy, we are now able to see and document a phenomenon that has been occurring all along.

 Suffering Twins

        It is clear to me from my research that many surviving twins are suffering greatly from their in utero loss.  It is now known that multiples interact with one another physically in the womb as early as 8 weeks into gestation.  Apparently, relationships can be established very early on, the termination of which may be quite traumatic to the survivors.  Due to a deep longing for some undefined, missing part of themselves that, it seems, no mate can quite fulfill, single twins may experience problems with relationships, and/or with their sexual identity.  They often suffer from feelings of guilt.  They may be haunted by feelings that they’re “parasites”.  I’ve heard from more than a few single twins who for one reason or another felt they’d “eaten” or “killed” their twin. Troubling, recurring dreams of their twin, fear of sleeping alone, fear of sudden loss or abandonment, profound loneliness, eating disorders, “hearing voices”, extreme emotional sensitivity and even schizophrenia or multiple personality disorder can afflict survivors of the VTP.  If they are not aware that they are twinless twins, they have no context in which to place these disturbing and very confusing emotions.  The good news is that, if the survivor is aware of what happened, the trauma can be processed and overcome, sometimes quite rapidly. 

        Elizabeth Noble says, "...unlike cases of survivor guilt from accidents, the experience of twin loss (in utero) is not part of the conscious mind and therefore is unavailable for discussion, rationalization, and integration without assistance...Twins from whom information about a twin's death is hidden or who are not allowed to express their feelings about the loss suffer most."  

Twinless Twins Support Group

Parents

        The parents of VTP survivors may suffer confusion and unresolved feelings of great loss if the VTP is not carefully explained to them and allowances made for the grief a parent feels upon losing an offspring, whatever the circumstances.  Unfortunately, busy doctors and our society’s general attitude toward death (ignore it as much as possible on the personal level, while often obsessing about it on a cultural level) more frequently than not result in both parents and child being left in the dark. 

        What are the physical signs for the mother of a possible "vanishing twin?" Cramps, bleeding, and/or decreased hormone levels during the first trimester, say the doctors.   Often there are no physical symptoms at all.  Also, if there is a history of twins in the family and/or if a woman has already borne twins, the chances increase for VTP incidence.  

Parents of Multiples Forever
Twin Loss Support Group

Medical Opinion 

        Mainstream medical opinion is that these fetuses are “resorbed” by the surviving twin or the mother.  Occasionally the remnants of a twin are found in the placenta or, more rarely, in a teratoma or dermoid tumor, which may contain hair, bone, teeth or other fetal tissue, and which may occur inside or outside the surviving twin or in the mother. According to a leading obstetrician I interviewed, the "resorption" explanation is only viable before the second trimester, and does not explain the cases I have  encountered in which the fetus disappeared as late as seven months into gestation.   

A Medical Perspective

Reasons for bleeding during pregnancy (other than the VTP):

Miscarriage: Bleeding while pregnant doesn't mean that miscarriage is certain, but it can occur. About half of the women who bleed do not have miscarriages. Miscarriage can occur at any time during the first half of pregnancy. Most occur during the first 12 weeks. Miscarriage occurs in about 15 to 20 percent of pregnancies. If you think you have passed fetal tissue, take it to the doctor's office so it can be examined.

Threatened miscarriage: You may be told you are in danger of miscarrying if you experience some bleeding or cramping. The fetus is definitely still inside the uterus (based usually on an exam using ultrasound), but the outcome of your pregnancy is still in question. This may occur if the developing fetus is abnormal in some way, if you have an infection (of the urinary tract, for example), get dehydrated, use certain drugs or medications, suffer physical trauma... or for no apparent reason at all.  Miscarriages are generally not potentiated by things you do, such as heavy lifting or having sex, or by emotional stress

Incomplete miscarriage:  You may have an incomplete miscarriage (or a miscarriage in progress) if the pelvic exam shows your cervix is open and you are still passing blood, clots, or tissue.  The cervix should not remain open for very long.  If it does, it indicates the miscarriage is not completed.  This may occur if the uterus begins to clamp down before all the tissue has passed, or if there is infection. 

First trimester bleeding is, obviously enough, any vaginal bleeding during the first 3 months of pregnancy.  It can vary from light spotting to severe bleeding with clots.  Vaginal bleeding is a common problem in early pregnancy, complicating 20-30% of all pregnancies.

Completed miscarriage:  The most common cause of first trimester bleeding is the completed miscarriage (also called spontaneous abortion).  If bleeding and cramping have slowed down and the uterus appears to be empty based on ultrasound evaluation, the pregnancy can be considered terminated, the fetus lost.  The causes are the same as those listed for a threatened miscarriage. 

Ectopic pregnancy:  Ectopic or tubal pregnancy is the most dangerous cause of first trimester bleeding.  Diagnosis is based on your medical history, ultrasound, and in some cases laboratory results.  An ectopic pregnancy occurs when the fertilized egg implants outside of the uterus, most often in the fallopian tube. As the fertilized egg grows, it can rupture the fallopian tube and cause life-threatening bleeding.  Symptoms vary and may include pain, bleeding, or lightheadedness.  Most ectopic pregnancies will cause pain before the tenth week of pregnancy.  The fetus is not going to develop and will die because of lack of supply of nutrients.  This condition occurs in about 3% of all pregnancies.  Risk factors for ectopic pregnancy include a history of prior ectopic pregnancy, history of pelvic inflammatory disease, history of fallopian tube surgery or ligation, history of infertility for more than two years, having an IUD (birth control device placed in the uterus) in place, smoking, or frequent (daily) douching.  Only about 50% of women who experience an ectopic pregnancy have any risk factors, however. 

Implantation bleeding:  There can be a small amount of spotting associated with the normal implantation of the embryo into the uterine wall, called implantation bleeding.  This is usually very minimal, but frequently occurs on or about the same day as the menstrual period is due, which can result in its being mistaken for a mild menstrual discharge and the belief that one is not in fact pregnant.  Implantation bleeding is a normal part of pregnancy and no cause for concern.

Blighted ovum (embryonic failure) Although an ultrasound shows evidence of an intrauterine pregnancy, the embryo fails to develop as it should, most likely due to abnormalities in the fetus itself, as opposed to something the mother did or did not do.  

Intrauterine fetal demise (IUFD -- also called missed abortion, or embryonic demise):  The developing baby dies inside the uterus, for any of the same reasons a threatened miscarriage occurs during the early stages of pregnancy.  This diagnosis would be based on ultrasound results and can occur at any time during pregnancy, although it is rare in the second and third trimesters.  Causes also include separation of the placenta from the uterine wall (called placental abruption) and insufficient blood flow into the placenta.

Molar pregnancy (technically known as gestational trophoblastic disease):  Ultrasound may reveal that the developing fetus is not actually a baby but is abnormal tissue.  This is actually a type of cancer that occurs as a result of the hormones of pregnancy.  While usually not life-threatening to the mother, in rare cases the abnormal tissue invades the uterine wall and metastasizes.  

Postcoital bleeding is vaginal bleeding after sexual intercourse while pregnant.  It is not abnormal.  

Another perspective

Another perspective

Another perspective

Higher Risk

        Twins and higher-order multiples appear to be at greater risk of neurological and cognitive problems than singletons, as well as a vast array of physical problems.  To name but a few:  malformations of the cardiovascular, gastrointestinal and central nervous systems, kidney and organ misplacement, auto-immune disorders, clubfoot, extra fingers or toes.  Also, current studies are confirming a previously suspected link between cerebral palsy and the twinning process. 

Chimera 

        A curious phenomenon of the twinning process is the chimera, an individual with different cell populations derived from more than one fertilized egg.  According to Lawrence Wright's "Double Mystery" article,  "Charles Boklage cites (speaking of the chimera)…though it has rarely been detected, it may not be at all uncommon.  'Possibly some of us are twins who are walking around in a single body,' Boklage says...Occasionally, blood donors are found to be carrying two different blood types:  it could mean that fraternal twins merged in the womb.  Of course, there is no way to determine whether identical twins have merged, since their genes and blood types are the same.  In those cases, the twins don't vanish; they amalgamate." 

       After I gave a talk on the VTP, a woman came up to me and said, "Now I know what's happening to my husband. This explains it!"  She told me that her husband was occasionally "different, somehow" -- he looked the same, but there was something wrong.  It was most apparent to her when they made love.  One day she asked him if he really was her husband, and he replied imperiously, in a loud, flat voice:  "We will not speak of that again!"  It frightened her the woman to the extent that she never did.  She told me, "They're switching him.  Now I know for sure."  According to his mother, this fellow was a VTP survivor. 

Very interesting article

Ethical Issues 

        The increased use of fertility procedures is presenting doctors and potential parents with new moral and ethical problems.  Because an infertile couple spends between $1,500 and $6,000 per attempt, there is a tendency for doctors to place multiple fertilized eggs, often resulting in multiple viable fetuses.  Because of the greater odds against bringing  multiples successfully to term, doctors may resort to a procedure known as multifetal pregnancy reduction (MFPR) in order to increase the probability of producing at least one healthy child.  This of course places parents in the difficult position of deciding whether to abort one or more of the new lives they have struggled (and paid dearly!) to start.  MFPR may also place the entire pregnancy in danger (although risks are being reduced with practice).  The  trauma of the procedure may itself create devastating psychological problems, just as an attempted abortion that unknowingly takes only one of a set of twins can mentally and emotionally scar the survivor, leaving him or her with the same psychological issues as a twinless twin.

DES

        Between the early 1940's and 1971, a drug called Diethylstilbestrol (DES) was given as a miscarriage prevention measure to between 5 and 10 million pregnant women who were, usually, bleeding vaginally.  Bleeding during pregnancy is known to be a sign of the VTP, when there are any signs at all.  It is also known that twinning rates increase after a period of sexual abstinence.

        The post-World War II "baby boom" came after just such a period.  I suspect that many of the women given DES at that time were experiencing the VTP -- hence the bleeding. 

Sonographers 

        A number of sonographers at a convention I attended in 1996 expressed frustration about a situation that apparently occurs too often:  early in her pregnancy, a mother receives a sonogram.  The sonographer and/or the doctor spot two fetuses. Subsequently, however, one “vanishes”.  By way of explanation, the busy doctor may tell the mother that the  sonographer made a mistake -- hence the sonographers' frustration -- or merely dismiss the whole thing with a remark like, “It happens all the time.  Be glad you’re only having one!”  Potential psychological issues are not addressed. 

NET

        Scott Walker, D.C., (a twinless twin) has developed a process of psychological kinesiology and spinal adjustments known as Neuro-Emotional Technique (NET), which he has taught to thousands of chiropractors.  Dr. Walker incorporates information on the VTP into his training;  many people are discovering their twinship through the NET process.   I have communicated with many of these people, as well as some of the chiropractors, and found that a desire for more clear, accessible information about the VTP is widespread.  

Dr. Brent Babocks' NET/Vanishing Twin web site

Other Methods
Psych-K

Psychic Bond 

        According to Dr. Segal in Entwined Lives, "There is no evidence that twins' similarities are caused by mental communication between them".  Perhaps this is because it is difficult to obtain grant funds to thoroughly research such things, or perhaps it is because the clinical research setting disturbs the psychic process in some way.  Whatever the reason, there is certainly no shortage of anecdotal evidence of the existence of such psychic bonds. The "Jim twins", identicals who where separated at birth and raised apart, made sensational headlines when they eventually found each other.  Both had been named Jim, both had married a woman named Linda and subsequently divorced her.  Both remarried, this time to women  named Betty.  One twin named his first son James Alan, the other James Allan; both had owned a dog named Toy; both worked part-time as deputy sheriffs; both had been employed by McDonald's and both had been attendants in filling  stations.  Both spent their holidays at St. Petersburg Beach, FL, and both drove Chevrolets to get there.  Both bite their fingernails and drink Miller Lite Beer.  Both built a white bench around the trunk of a tree in their respective gardens.  These are but some of the astonishing parallels in their separate lives.  One has only to attend a "Twinless Twin" conference and hear the attendees tell of knowing when their twin died, of feeling their pain and of communicating with them after death to see that there is something unique -- beyond coincidence -- about the bonds between twins, and that it may not end with the death of one of them.

Personal Experience

        I began researching the VTP in 1993 after finding out not only that I am a surviving twin, but also that my fraternal twin siblings probably began as triplets, and that my youngest brother was a surviving "mirror" identical twin.  I also have a cousin who is a "mirror" identical twin (her twin vanished), whose organs are on the opposite side of her body. I have traveled extensively since 1993, researching and lecturing to hundreds of people on the VTP.  I’ve heard many fascinating and often heart-breaking stories.  My web site, which generates emails from surviving twins from around the world, has been up since 1997.  Numerous guest appearances on national radio and TV programs have also generated a good deal of correspondence from “twinless twins” and their caregivers, as well as health and educational professionals. 

         In 1997 I published, with my partner Parker Whitman, The Millennium Children:  Tales of the Shift.  This book contains a large section on the VTP, along with my life story (I share much of my personal story of the discovery of my twin, who I named "Karyl") and a great deal of material concerning the increasing number of children being born today with exceptional intuitive, intellectual and physical abilities -- children who speak of past lives, of  “being in spirit”, of “imaginary friends”, and of extraterrestrial contact.   Much of the information on the Millennium Children was gathered in the course of my research into the VTP.  The Millennium Children has generated additional correspondence from twinless twins.

Summary

        While medical information about the VTP is now available, information concerning its psychological impact is only available in bits and pieces in various publications.  Dr. Nancy L. Segal, one of the nation's premiere twin researchers, states in her book Entwined Lives: Twins and What they Tell Us about Human Behavior (1999), "No one has systematically studied the psychological effects on children of losing a twin before birth or in infancy."  VTP survivors and their parents need such information; healthcare practitioners need the knowledge and the resources to provide it.  I hope that my efforts will help to address these needs.  

Join our Vanishing Twin Phenomenon 

Discussion Group    http://groups.yahoo.com/group/vanishingtwins

 

LINKS

Vanishing Twin E-Group

Vanishing Twin Phenomenon -  Dr. Brent Babcock's site

Twinless Twins Association - Annual Conference & info

Pravda - Russian article about VTP

Wombtwin.com -Another perspective

 

More information on Vanishing Twins available in

The Millennium Children: 
Tales of the Shift

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