Thesis advisor: June Horowitz / Parents who simultaneously grieve the loss of one twin and nurture the surviving twin experience a paradox of grief and joy. The acute grief of losing a twin coincides with a critical time in the development of the parental role and relationship with the surviving twin. Very few researchers have addressed the unique parenting situation in which one twin infant dies. The aim of this qualitative descriptive study was to describe the experience of parents who lose one twin in utero, at birth, or in the neonatal period. The study question was "What is the parenting experience of mothers and fathers who simultaneously face the grief of the loss of one twin while nurturing the surviving twin during infancy?" Nine parents, recruited via a support group, were interviewed. Systematic content analysis, emphasizing in-vivo coding (participant's own words), was conducted until data saturation was reached. A comprehensive description of the experience of raising a surviving twin was constructed. Four descriptive themes were identified: (1) Living with ambiguity: the irony of raising a lone twin, belonging and not belonging, and at least there is one; (2) Communicating the family journey: telling or not telling, deciding who needs to know, and how many children; (3) Parenting with wonder and worry: doubt and hyper-vigilance, unanswered questions, and the living twin as a unique person; and (4) Life is different now: loss of innocence, honoring both twins, making and keeping relationships, work-life challenges, and accepting that it doesn't go away. Issues raised by parents included the ambiguity and irony of losing one twin, no one understands, multiple losses, and living with this loss. The description of this experience gives insight to the dynamics and burden of this loss. Data from this study can inform pediatric nurses about the issues, concerns, and needs of parents who sustain this kind of loss. Therapeutic interventions based by the tenets of family-centered nursing care can be developed by understanding the long-term effects of grief on parenting. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.