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Psychologic support is important for couples who have lost an offspring from any cause – a situation compounded by fetal or congenital abnormality.^{1024, 1025} The birth (or prenatal detection) of twins discordant for a chromosomal disorder is not rare, given the increased frequency of multiple pregnancy associated with advanced maternal age and the use of assisted reproductive techniques. Pregnancy reduction¹⁰²⁶ (see Chapter 32), or the death of one twin, or delivery of both, evokes severely conflicting emotions that may well affect the mother's care for the surviving child.¹⁰²⁷ Considerable psychologic skill must be marshaled by physicians if meaningful care and support are to be provided.¹⁰²⁸

Supporting telephone calls from doctor and staff, and encouragement to attend appointments every 6 weeks, or more frequently when appropriate, are often appreciated by patients. Review of the autopsy report and discussion with reiterative counseling should be expected of all physicians. Frequently, parents receive an autopsy report by mail without further opportunity for explanation and discussion. In one study, 27 percent failed to receive autopsy results.¹⁰²⁹ Providing contact with support groups whose focus is the disorder in question is also valuable. In the United States, the vast majority of these groups have combined to form the Alliance of Genetic Support Groups, which acts as a central clearinghouse and referral center.