Towards a psychological profile for womb twin survivors

Towards a psychological profile of womb twin

survivorsAlthea Hayton

This presentation

• Literature search• Twins and twinning• Questionnaire • Analysis & results

Literature research

• When one twin dies before birth

• The development of a research questionnaire

• The results of the first analysis

The literature search

• Books• Articles• Web sites ?

A little-known area of study?

Dr Louis G. KeithEncouraging writing about twins

The Keith TwinsDonald (left) and

Louis

The Center for the Study of Multiple

Birth, ChicagoFounded 1977

Published articles

1982: The Vanishing Twin

Acta Geneticae Medicae et Gemellologiae (Roma)

Landy HJ, Keith L, Keith D.

Helain J. Landy, MD

Books

1995: Multiple pregnancy: epidemiology, gestation & perinatal outcome By Isaac Blickstein, Louis G. Keith (2nd edition 2005)

How many twins are lost before birth?

Charles E. Boklage, PhD

“For every live-born twin pair, 10 - 12 pregnancies result in single births.”

1990: “Survival probability of human conceptions from fertilization to term.” International Journal of Fertility

Conclusions

• On average 1% of live births are twins.

• For every live-born pair of twins there are 10 womb twin survivors

• Womb twin survivors make up 10% of the world’s population

How one twin may die before birth

No evidence

Evidence cannot be available if:

The baby was adoptedMother will not talk about itMother has diedNo other family members knewNo one suspected twins ?

Death in the womb

One foetal heart stops beating

The “vanishing” twin on the ultrasound scan

The “vanishing” twin

Bleeding in the first trimester

More than one embryo implanted after IVF

Miscarriage, but pregnancy continues

Abortion, but pregnancy continues

Multi-fetal pregnancy reduction

Signs of a lost twin at birth

One twin stillborn

An acardiac twin

Fetus papyraceous

In the body of the survivor

Parasitic twin

Illustration of an adult man with a parasitic twin from “Monstrorum Historia Memorabilis” by Johann Schenk, 1609

The fetus in fetu

Teratoma

Dermoid cyst

.

Characteristics of the opposite sex

Auto-immune disease

Lupus “butterfly” rash

Vitiligo

Irregular patches of dark skin

Other indications of twinning

?

Uterus extra large in first trimester

Mother took ovulation-stimulating drugs

Clomid Serophene

Cerebral palsy

Sole surviving twins are at increased risk of cerebral palsy.

1996 Pharoah POD, Cooke T. “Cerebral palsy and multiple births.” Archives of Diseases in Childhood.

Left- or mixed-handedness

Twins in the family

The psychological impression on the survivor

• No sense of time

• No sense of place

• No sense of process or logic• Confused senses

• Vagueness of impressions

• Chaotic perception ?

Creating the research questionnaire

• Details of mother’s pregnancy • Signs of a lost twin• Indications of a lost twin• Feelings, beliefs and attitudes

?

Details of pregnancy“Yes”, “no” or “don’t know”

Signs of a lost twin“Yes”, “no” or “don’t know”

Bodily indications of a lost twin“Yes”, “no” or “don’t know”

Feelings, beliefs and attitudes

A,B,C,D,E % No longer

The results

• 500 questionnaires were completed

• 266 respondents were able to provide evidence of their twin

• A preliminary analysis carried out by the Statistics Department of the University of Hertfordshire, Hatfield, UK in 2009

The selected respondents

• Only those able to provide evidence that their twin once existed

• Only those who showed the strongest agreement with the statement concerned

266 in all

A sense of self

• Not realising my full potential

• Feel different

• Two sides

• Torn in two

• Low self-esteem

Feelings

• Something missing

• Alone, even among friends

• Unsatisfied

• Deep pain that will not heal

Difficulty with relationships

• Fear of rejection• Fear of

abandonment• Searching• Strong inner life• Sabotage

Problem behaviours

• A problem with anger

• Restlessness

• I get bored easily

• Clutter/hoarding

A psychological profile of womb twin survivors

• An unusual person • Signs of psychological distress • Negative moods and feelings• Difficulties in relationships• Self-sabotage• Self-defeating behaviour• A fragile sense of self

The research continues

www.WombTwinSurvivors.com

The research continues

“Does zygosity matter?”

Identical (monozygotic) twins formed from one zygote

Monozygotic twinsZygote divided at 1-4 days after conception

Monozygotic twins

Zygote divided 3-8 days after conception

Zygote divided 8-12 days after conception

The responses of monozygotic womb twin survivors

ANGER VULNERABLE PERFECTIONIST

The psychological characteristcs of monozygotic womb twin survivors

ANGER: I have a problem with anger - either there is too much or too little

VULNERABLE: Deep down I feel very vulnerable, as if it would not take much to totally annihilate me as an individual

PERFECTIONIST: I am a perfectionist

Fraternal (dizygotic) twins formed from two separate zygotes

Dizygotic twins

Separate placentas Fused placentas

The responses of dizygotic womb twin survivors

DARK RESTLESS DEEP PAIN

The psychological characteristics of dizygotic womb twin survivors

DARK: I am afraid of being alone in the dark

RESTLESS : All my life I have felt restless and unsettled

DEEP PAIN : all my life I have carried deeply felt emotional pain that persists, despite all my efforts to heal myself

A multiple pregnancy formed from three or more zygotes

Triplets

The responses of multiple womb twin survivors

REST GUILTY DEATH

The psychological characteristics of multiple womb twin survivors

REST: I know I do not rest enough

GUILTY: I feel guilty about everything

DEATH : deep down I somehow know I experienced death before I was born

A complex of vague impressions dating back to pre-birth, which for womb twin survivors includes a vague imprint of the presence

of Another.

The Dream of the Womb

www.wombtwinsurvivors.com

All you ever needed to know about womb twin survivors