Mental health implications for womb twin survivors

Currently, the term ‘womb twin survivor’ is not commonly known, so if you recognise this term, maybe you have been affected by it or know someone who has. Research has shown that losing a twin or multiple in the womb can have an impact on the mental health of the surviving twin. So, what exactly is a womb twin survivor and how can their mental health be affected? 


What is a womb twin survivor? 

A womb twin survivor is someone whose twin or multiples died during pregnancy or shortly after. The loss can occur from vanishing twin syndrome, miscarriage, stillbirth, abortion, or neonatal death. It is estimated that between 10-15% of all live births originated as a multiple pregnancy with survivors perhaps told as a child or found out much later in life.

Learn more about womb twin survivors and how counselling can help. 

Who can it affect?

With one in four pregnancies ending in loss during pregnancy or birth in the UK and a big proportion happening within the first trimester, many mothers are told to be grateful for the child that has survived. It is a complicated loss for parents, as on one hand, you can be so happy to have a new baby to cherish, but on the other, there is the missing twin/multiples who should be there and grieving for them. It comes with every milestone or family moment where there is the void of the twin who ‘should have been there too’, which then results in walking your happiness hand in hand with your grief.

This is not just affecting the mothers, but also the fathers who have the burden in our society of having to appear “strong” and not cry, to support the mum, and not allow themselves to feel what they are feeling. Then there are also the other siblings, grandparents, and other supporting loved ones who were expecting to share in their joy.

At times, they are deeply affected by a pain that can be invisible in our modern culture. Sometimes, those closest to us are the ones who don’t understand the pain that is endured and tell you the surviving baby is similar to a condolence prize with little compassion or empathy. This is why is it so important to educate and inform people of the impact of womb twin loss and the survivors. 

As we have emotionally developed as a society, there is now greater awareness of the mental and emotional implications for the mother after the loss of their child while still bringing new life into the world. Our language and procedures are being looked at. However, we still have a long way to go to understand and support the surviving twin of this loss as research is only now showing us that it can have a detrimental effect on their mental health. 

How you may be affected

There has been a lot of personal research and opinion on this subject with little peer-reviewed, academic research done to offer definitive answers. As a womb twin survivor and counsellor, I have researched this as my Master's dissertation and continued to research and raise awareness on this topic. 

Womb twin survivors can unconsciously try to re-enact the twin bond in their relationships by searching for the twin they lost in other people. The twin relationship is special and unique but, for survivors, it was severed as they were developing.

Research is showing us the concept of ourselves and our way of attaching in relationships is developing from conception into young adulthood and the twin bond starts within the womb before any other. Is it any wonder we want to reconnect to it?

Survivors can struggle with survivor guilt whereby a narrative was given to them as to why their twin died such as “you took all their sustenance for yourself” or “you took up too much room”. Or “just why did I get to live and they died?" which sometimes can result in trying to live your life for two and can feel that you are only half alive. Survivors can suppress their feelings due to the lack of awareness and understanding from others and fall into loneliness and isolation which further impacts their mental health and self-esteem.

Overall, as a survivor, it is about the story you keep telling yourself. Your worth, your value, your identity even. Can you call yourself a twin? Do you need or want to? Do you feel whole or is something missing? Is there grief or pain that wants to be heard?   

A little of my own story and my practice

I found out I am a womb twin survivor when I was 37. Hints and clues were there along the way but I never picked them up to explore. It wasn’t current and I was busy with life now. But at 37, I was given the gift of being allowed to acknowledge and grieve for the twin I should have had, by being told by twins that “once a twin, always a twin”. It blew open my heart to something I didn’t realise I had stored away for so long. The poems, stories about my twin brother, and my questions about 'where is my twin?' My belief is that half of me was missing and he is in the Otherworld. It all came crashing down on me and now I understood - or started to.

It became a painful and lonely road as I tried to understand what happened and why I felt so much grief for someone I hadn’t shared life with. He died through a miscarriage at 13 weeks gestation. In those days, like many survivors, it wasn’t acknowledged as a loss and therefore not something to discuss or mention. But now it consumed my every thought and my body ached with the grief of what could have been.

Over the years I have found peace for him and myself. I have found a way to incorporate him into my life (which isn’t for everyone) and a way to honour us both over all the anniversaries and milestones ahead. That is what I needed. For other womb twins, they need different things because we all have individual stories and I understand and respect that. 

How counselling can help you

Counselling can help you to make sense of all that you are thinking and feeling. To have someone truly listen and strive to understand you can be hugely validating. It is helpful to have a safe place to explore your relationship with yourself as well as the idea of your twin, to explore how this has been experienced with the rest of the family and loved ones - how it has been impacting your self-concept, relationships, and mental health, possibly unknowingly.

Through my work with womb twin survivors, I have found there is often more than one painful thread linked to them being a womb twin and, first and foremost, we need to create safety. There can be a lot of misunderstanding on this subject and it can feel vulnerable to talk about it. There can be a lot of conflicting feelings and beliefs and this needs to be gently grounded for you. I seek to understand your cultural, spiritual and personal beliefs, as well as the support and beliefs of the family and those supporting you as this all impacts how we internalise and make sense of being a twin and the grief.

If you have just discovered you are a womb twin survivor, then it will come as a shock. Even if, somehow, you have questioned it before. It can bring an intense feeling of grief and confusion, along with possible relief, understanding, and a love you didn’t expect. It is OK to feel all of it. I will support you in making sense of your experience.

We need to understand the story of what happened and how this experience has been showing up in your life. How has it impacted you, if at all? What feelings are sitting with you that are disruptive and need to be expressed or let go of? We would explore if you want to make room for your twin in your life and how you can do this that is personal to you. 

There is no one right way to find healing as a womb twin as we are all individuals with different experiences and needs. What I offer is to respect you and your experience, to hold a safe space in order for you to explore, and to offer you tools and strategies as well as to build upon the ones you already have. To use your whole sense of self in that process that honours you, by working with your body’s memory, your felt sense, your thoughts, feelings, and beliefs. We work collaboratively, at your pace to uncover your needs now.

If you'd like to find out more about how counselling can support you as a womb twin survivor, you can reach out to me via my Counselling Directory profile. For additional support, you can connect with the Womb Twin Survivor Reflections pages on Facebook and Instagram

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Airdrie, North Lanarkshire, ML6
Written by Donna McDonald, Msc (with Merit) PGDip MBACP - Peaceful Grove Counselling
Airdrie, North Lanarkshire, ML6

I am an experienced counsellor working in Airdrie from a beautiful, relaxing, tranquil space where I offer short and long term counselling. I know how it feels to be vulnerable and looking for some help and not knowing where to turn and who to trust. So I offer a warm safe environment for you to exp...

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