Earlier this year, a mother wrote about her decision to abort one of her twin baby boys. She said the abortion would end the life of one to save the life of the other. But the truth is that both of those babies deserved a chance at life, and that chance was missed.
“On a Friday in May, I walked into the doctor’s office almost 20 weeks pregnant with identical twins,” wrote Shiri B. Sandler for Elle. “I came home that night pregnant with just one baby.”
At some point during the pregnancy, her boys were diagnosed with twin-to-twin transfusion syndrome, a rare condition that can occur in identical twins who share a placenta and blood vessels. One baby gets too much blood, and the other not enough. Both babies are at risk of dying, but in 1992 a new procedure was pioneered in the UK. Without this minimally invasive endoscopic laser ablation (laser surgery), there is a 70-80% chance both twins will die. But that procedure, which involves the use of a laser to disconnect the shared blood vessels, increases the odds of one twin surviving to 80-90% and increases the odds of both surviving to 60%.
Yet, according to Karin Sundberg, an OB/GYN specialist in Denmark, 50% of parents still choose to abort. “About half of our patients get laser surgery and half choose selective termination of one baby,” she said. “This is often the case if we can determine that one of the children is brain damaged, has a neural tube defect, other malformations or a large size discrepancy.”
However, the Twin to Twin Transfusion Syndrome Foundation has said abortion should never be used in TTTS cases. “When pregnancy termination (induced abortion) is recommended by doctors and counselors, it is done so not as a treatment, per se, but as a reflection of their lack of faith in the available therapies for TTTS,” said the foundation. “The Twin to Twin Transfusion Syndrome Foundation is a pro-twin and, therefore, a pro-life organization.”
There are five stages to TTTS, with stage five being fetal death. Mothers whose babies share a placenta are monitored by ultrasound every two weeks to search for signs. However, Sandler said that her boys’ health had taken a sudden and drastic turn at 20 weeks. Twin B, the small twin who wasn’t receiving enough blood, “had lost more than half of his minimal amniotic fluid in the hours since our last scan.” They were now at stage 3 of TTTS, she said, though the progression can sometimes be unpredictable. Laser surgery for TTTS can be performed as early as 15 weeks during stage two or stage three. Sandler was 20 weeks, knew about the TTTS, and there had been time to undergo the surgery prior to this devastating decline in Twin B’s health.
READ: Prenatal surgery for twin-to-twin transfusion syndrome is saving lives
In her essay, however, Sandler does not mention the life-saving laser surgery at all. She states only that she “needed medical care that can only be found in a handful of hospitals in this country.” She could be speaking of laser surgery to try to save both babies or she could be speaking of an abortion. But the fact that she doesn’t specifically mention the surgery brings to mind a question: Did the doctors even mention it, or did the parents refuse it?
However, the Twin to Twin Transfusion Syndrome Foundation is adamant that abortion is never necessary and that doctors who believe the babies should be aborted will neglect the mothers. On the website the foundation states:
We are in the business of hope, and there is always hope. Certain doctors refuse to believe that parents would risk any health problems in their surviving TTTS babies, and would terminate all TTTS cases despite the fact that the majority of twins survive and are normal regardless of treatment used.
Some physicians accomplish this end by ‘passive neglect.’ This is where there are signs of significant TTTS on ultrasound, and the doctor asks the patient to return weeks later instead of one week hoping the pregnancy ends in the meantime.
The babies can live, please give the parents the opportunity to save their babies. They all deserve the ‘right to try.’
Sandler said that Twin B had bleeding in his brain and the images of his brain told her “something was wrong.” She immediately thought of termination. If one twin dies, the other one is at serious risk and must be separated from the deceased twin. Doctors told Sandler and her husband that Twin B was going to die and that they needed to kill him before he died in order to save Twin A.
“We had an hour to decide,” wrote Sandler. “There was no choice. I’m their mother; I wanted Twin A to have a chance to live.” Any mother would feel the same way, which begs the question: Why did the doctors not give her the chance to save both babies?
Twins Keeley and Kambry were diagnosed with TTTS and underwent laser surgery. Via TwentyTwoMatters, Facebook
Sandler views her abortion as a life-saving medical procedure and wants the world to see it in the same way. However, in the weeks leading up to the abortion, Sandler could have been and should have been offered the surgery. The fact that she doesn’t mention this surgery gives the false impression that there were no other choices. If doctors failed to mention the surgery or pushed it off as something to be done in the future, they did a huge disservice to this family. But if Sandler and her husband knew about the surgery and refused it, they are misleading everyone who reads her essay into believing that nothing could have been done to save Twin B.
“We have seen babies in heart failure with hydrops, a chosen baby for cord ligation [to abort one baby], have laser surgery and live and be completely healthy,” said the Twin to Twin Transfusion Syndrome Foundation.
Sandler’s story is heartbreaking no matter how you look at it. Doctors gave her one hour to decide on an abortion. They backed her into a corner when they should have been opening doors for her that could have increased the odds of both babies surviving. Even if Twin B had died after laser surgery, it wouldn’t have left the death of her son resting on Sandler’s own shoulders.
The Twin to Twin Transfusion Syndrome Foundation is available to help parents facing a diagnosis of TTTS, including steps mothers can take with diet and exercise to help their babies. Abortion should not be recommended as an “option” for TTTS and is certainly not medical care.
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