One sick twin one healthy twin. Selective termination

[Chattycat78]

Hi guys, complacated problem undoetunately. Am 13 weeks with non identical twins. The 12 week scan on Wednesday showed severe issues with twin 2. The lower body has not developed properly. It is missing limbs, as well as probably bladder, kidneys etc. If it were to survive it would be severely disabled with limited wuslity if life. The consultant thinks it has issues which are likely not survivable, but we would not know this for sure until later on. Twin 1 is healthy. The hospital have offered selective termination of the sick twin. Sadly there is a 5 percent rusk of losing the healthy twin.

However, if we do not act now, sick twin could die, taking healthy twin with it, or it could survive longer, maybe even be born, but possibly die very quickly after birth, or if not, survive for a time, but gave a very u pleasant short life. This would also mean compromising the quality of life of our cureent small child (who is 1) as well as the healthy twin, as the sick one would need so much care.

I feel like I'm damned whatever I do. I ve also nrver agreed with abortion (personal choice- not judging anyone else) and I'm mortified to be in this position.

I should also say that pregnancy has never come easy to me- so there are no guarantees that this would not be my last prwgnancy if we lost both Babies.

Any words of wisdom?

[Chattycat78]

Sorry about all the typos! Hopefully it's easy to get the gist...
One further important point- if we leave it for a while to see whT happens- the longer we leave it to do a termination, the higher the risk to the healthy twin.

[BoboChic]

It's a horrible problem to have but the way you describe it suggests that you have understood that the risks of terminating are smaller than the risks of not terminating.

[PennyHasNoSurname]

Personally I would sacrifice the poor unhealthy twin to increase the viability of the healthy twin.

Should the UT make it to birth, their life sounds as if it would be brief, possibly traumatic for them, and result in a no doubt traumatic death.

Personally (and all I can tell you is how I would handle it), I would want to give HT the best chance overall, knowing that there is no chance UT would be born even remotely healthy.

[UninventiveUsername]

That is awful, I'm so sorry. Do you have a gut instinct on what you want to do? It sounds like the selective termination offered by the hospital is what they'd recommend and I think that is what I would do. I appreciate it might feel totally different to you, actually being in this situation.

[Chattycat78]

Thanks. Yes I think we re going to do it early next week, but I have to justify it to myself as I feel like I'm killing my own child (which I am I suppose).

[Eminado]

Gosh this is a very hard decision and I am so sorry you are facing this.

I just wanted to say that, I genuinely dont know what to advise but personally I would struggle with making the decision to terminate.

Most unhelpful post ever, I am sorry, I wish you all the best and in fact hope for a miracle for you.

[Chattycat78]

Thanks. And just to be clear- I am struggling. This is now a case of choosing the least worst option.

[DramaQueenofHighCs]

No advice but just to say am thinking of you. It must be the most awful decision to make.

[Eminado]

Did the doctors give you any indication as to what they think is best?

"...as I feel like i am killing my own child"

I didnt want to write that but I think that is exactly how I would feel

It's not your fault though OP, you didnt choose this.

I think the best thing you can do is follow the medical guidance you have been given.

[BessieBlount]

Please don't look at it as killing your child. Look at it as saving your other child. The poorly twin is unlikely to survive and if they pass away during the pg that risks the life of the other twin. I used to work with a lady who sadly lost both babies at 23wks due to a similar but not identical situation. She didn't discover the issue until her scan at 21wks though and was just in the process of working out what to do. She miscarried one which sadly caused the second miscarriage.
Only you and your partner can make the final decision but opting for the medical termination may give your healthy twin the chance to thrive. But you must also allow yourself time and space to grieve for the lost twin if you go ahead with the selective.
Selective us a horrid word anyway as it suggests you are selecting one over the other when instead you are saving your poorly twin from further pain and distress whilst saving the life of your healthy twin.
Thoughts are with you

[Chattycat78]

No- they would not say/decide. They have said that we must make the decision. therefore we have not been given a clear direction medically speaking. That's why its so hard.

[Womaloosh]

I know it's very hard, but keep telling yourselves that you are making the right decision. This has been forced upon you by forces outside your control and you're not a bad person for terminating.

[BoboChic]

I think that you are quite right. You have the choice between two horrible decisions. You need to be clear in your own mind which of the two is the least worst.

[Chattycat78]

Bessie- Thank you. I needed to hear that.

[Keeptrudging]

I think in your situation, heartbreaking as it would be, I would have to go with medical advice and give the healthy twin the chance to survive and thrive. The risk sounds higher to both if you continue. You would be saving the life of the healthy twin when it sounds like the other twin won't survive anyway. I am so sad for you having to face this, I would also struggle with this. I think if you were just carrying one it would be 'easier' to choose to continue and let nature take its course, but in your case the risk to the healthy twin is too high. Wishing you strength whatever you decide .

[IrritableBitchSyndrome]

I think you are just being an extremely loving and responsible parent, caring for all three of your children in the best way possible, minimizing unneccessary suffering for all of them. The only one suffering here is you, in this terrible situation. Very best wishes, at this sad and difficult time.

[UninventiveUsername]

I agree Bessie, op you would be saving the life of the healthy twin and you would also be saving the sick twin from having to suffer. It isn't an easy decision at all but I think the termination is definitely the least worst option.

[Needtoprotect16]

My heart goes out to you. As someone who also experienced fertility issues, I know that this adds another layer of emotional complexity to your decision.

However, I think the healthy twin takes priority here. What I would say is that it might help you to talk to a genetic counsellor. Can you access this through your hospital or clinic?

[Pipistrella]

This is a very hard call and I am so sorry.

I have never been in your situation and I imagine it would be more helpful to hear from those who have.

However my own default position with babies is that I don't take matters into my own hands, precisely because I'd feel like I was 'playing God' I suppose, and a decision like that would be beyond my capabilities.

I think I would be hoping for nature to take its course and to decide for me - while being minded to do the very best I could to keep them safe for as long as possible, ie, if bed rest might help (I don't know if it would) then staying put for a few weeks until there was a greater chance of the healthy twin surviving if I did miscarry both.

I might be talking bollocks. It might not make any difference whatever you do.

But I think that might be the line I would take; especially if there is a small chance of losing both with a termination.

I wonder if it is more likely you would lose both through a natural miscarriage than through the selective termination?

I think that would be my question....I mean, if you decided to keep both and wait and see, then miscarried - would that have meant that terminating one of the pregnancies would probably have had a similar outcome?

Or is one chance far greater than the other?

Perhaps you could ask them that and it might help to weigh it up.

[Pipistrella]

By the way my instinct given the information you have shared with us is that the termination would probably be most pragmatic.

It's sad that it comes down to pragmatism. You would not be in this position if you had had any choice in the matter - we all know this.

Collect as many questions together as you can and then ask for some answers, maybe there will be something that swings it for you, or at least clarifies the options as they stand.

[Chattycat78]

Pipistrella- I see what you are saying. But the point is, terminating now means that the baby is smaller and therefore less risk to the other. If we wait and see if miscarriage happens, for each passing week, there is increased risk to the healthy twin if the sick baby does die. In other words, it is a risk- it may survive until 24 weeks at which point miscarry- causing far more risk to the other than at 13 weeks when it is tiny.

As far as I lnow, bed rest is neither here nor there and would achieve nothing.

[Pipistrella]

Oh Ok. No it sounds like you have a better grasp of the comparative risks than I had understood.

(I am sorry, my post is really unhelpful and I can get it withdrawn if you like? I honestly don't mind.)

In that case I think you kind of have a clear 'better' option. You have my utmost sympathy. I hope that it goes as well as it possibly can and that you are able to have a safe pregnancy with your healthy little one after the procedure.

[Chattycat78]

I should perhaps also mention that the consultant suspects that kidneys etc will not develop because they could not be seen (and they were seen on the healthy twin), this means that survival would not be possible and may mean miscarriage is inevitable anyway. bUT waiting to miscarry is risky to the healthy twin. If this was the only baby I could see this approach / you could see if nature took its course. But there is another baby to consider.

[Chattycat78]

No need to withdraw. It's a complicated problem.