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?

You sound very sensible and intelligent OP. I'm sorry you're having to go through this. It does sound like the early selective termination is the least risky option for your healthy baby. It sounds like, sadly, your other baby won't survive whatever you do. It must be awful for you

Please don't look at it as killing your child. Look at it as saving your other child.

I agree with this. Like you, my personal choice is generally against termination. However, it gives the healthy twin the best chance and also prevents the unhealthy twin undue suffering. It is a horrible choice to make and and I wish you well.

Yes from what you say it sounds as though the poorly one has very, very little chance of surviving anyway.

In which case you are not taking anything into your own hands, really. You are lessening the suffering, by acting now, and it would very likely happen anyway and could put the other baby at risk.

It's pretty clear cut isn't it.

Chatty Cat. Unless for extreme moral/religious reasons, I cannot see how you can make any decision other than to save your healthy child, by terminating the unhealthy one. You wouldn't apply the whole 'playing god' argument to any other form of modern medicine. The other twin will die, and it is better for this to happen before it is old/developed enough to suffer, whilst simultaniously giving the other twin the best chance of survival. I am so sorry you are in this situation. I wish you all the best. Xxx

I think you've been given a very difficult decision and that this is the way of modern medicine as we move away from the paternalistic approach. It can seem that you get very little in the way of guidance which is very frustrating.

What I've found useful in difficult situations is to ask the medical professionals what they would do in a similar situation. I've always had very frank and honest answers (including not to operate from a pioneering surgeon). Make it clear you aren't asking what to do but what they would want to do.

The choice is always yours but you can get a considered view from someone with a lot of experience that way. And I think that's very helpful.

Dana- we already asked the consultant what she would do if it were her. She would not answer.

What a terrible situation you are in - please be kind to yourself at this time.

I have sadly been in a position with a pregnancy where the baby would not survive once born. The one thing I was thankful for was that it was not a borderline "maybe the baby could survive" situation -it was definite it could live no longer than a few hours if the pregnancy proceeded.

It sounds like perhaps this is similar in your situation -waiting to see how things progress won't make it better for the ill baby sadly.

I would feel compelled to do all I could for the healthy twin.

Such a tough situation that no one chooses to be in. I really feel for you and hope things become clearer -whatever that may look like.

What an awful situation to be in. It's such a hard decision to make and you have to make the right choice for you and your family.

I had a tfmr at 22 weeks for a leathal diagnosis. The only thing I will say about feeling like you're killing your unborn baby; I felt a similar way until someone explained to me that the baby will die either way, the condition is unsurvivable. Opting for a termination means that you are saving your baby suffering were they to be born alive.

I am by no means saying those who choose to continue a pregnancy with a leathal dx are making the wrong choice, however, that explaination has helped me many times when I have felt guilt and grief.

From what you have said, the choice seems clear (though difficult of course) to me - I would prioritise both the healthy twin and your existing child.

Handbag- there is a chance it could survive BUT if it did (and its a big if) it would have severe complications, many major operations and a poor wuslity of life. The consultant pointed out to us that you don't see people with this level of illness in society today because I guess they don't survive long, or dont survive past birth. Hiwever, she said that she suspects that the baby has no kidneys etc which is not survivable anyway. We could wait until 16 weeks to have this confirmed, but if we decide to terminate then, the risks are higher than they are now to the healthy one.

I read something recently about other mammals being in a much better position to deal with this scenario themselves (eg. by the mother reabsorbing or expelling a non-viable foetus) whereas human placentas have evolved to be more "aggressive" and prevent the mother's body from prioritising herself/her other offspring so we sometimes need outside help. I have no doubt that in nature, without any of the moral/emotional concerns humans have, other animals would 100% prioritise a healthy foetus and any existing offspring.

That's disappointing Chatty I honestly have no other advice, but hope you manage to find some peace with whatever deco you make 💝 Xxx

Sorry to hear this. Must be really hard.

Personally I wouldn't hesitate to protect the health twin. Talk of playing god is unhelpful. No one says that if you prolong life through treatment for other diseases. We are lucky that modern medicine can help us have better outcomes. And it makes sense to use that ability to help your healthy twin.

Best wishes whatever you decide to do.

From your last post I would weigh up:
If you waited until 16wks to confirm the lack of kidneys but then the termination sadly caused the loss of the healthy twin. How would you feel? What can you live with more?

1. The tiny chance that they are wrong about the kidneys and that your severely disabled and extremely poorly baby could have survived for a short while, possibly in pain or distress Or
2. that you waited and allowed nature to take its course but sadly this resulted in you losing both babies.

In 5yrs time, which decision would cause you most regret and heartbreak? Because that's the crux and you, your partner and your other child need to be able to move on and enjoy family life afterwards.
Neither is an easy decision and the fact you are so torn shows you are taking your time to come to the correct decision.

Honestly OP? I don't think you have much choice, not if there's a healthy twin to consider.

I really really feel for you though. I don't agree with abortion either, but sometimes you just have to choose the lesser evil, so to speak.

I really feel for you here. I know what I would do, I would protect the healthy twin, but if you were my friend in real life, I would support you in whatever you chose.

Thanks every one. It helps just to talk about it. I'm pretty sure we are going to go ahead with the termination BUT I need to be absolutely sure that I can live with myself afterwards.

Oh Chatty, what a terrible situation.

I can see from what you've posted that you probably are going to take the pragmatic course of saving the healthy twin, and for what it's worth, it's what I would do. I know you are feeling terribly guilty about this choice, but again, for what it's worth, pretty much no one I know in RL would judge you for making this choice; on the contrary they would think you were very brave and clear thinking (and decisive, given that time matters here) in making the best choice in truly dreadful circumstances.

Do try to do as the poster up thread has suggested and think of it in terms of saving your healthy twin (and, I would suggest, saving your unhealthy twin from pain and suffering. )

I hope you can find peace at the end of this, and joy with your baby after the birth, and that you are able to lay your other child to rest and mourn. Try to be kind to yourself: you have nothing to feel guilty about (even though it's emotionally understandable that you do).

What would be worse?

Living with yourself if you did nothing, and the sick twin died later on, thus killing the healthy twin?

Or living with yourself after terminating the sick twin, knowing that you were giving the healthy one the best chance?

It must be so difficult and my heart goes out to you. I can imagine how hard it would be to do, but I would do this as quickly as you can to help your healthy baby survive.

Have you been in contact with arc? They are a wonderful charity for antenatal tests and choices. They may be able to help in a simple 'someone who knows' to talk to.

I know sands also support families who have lost one twin but have one surviving, they might be someone else to consider.

Tbh what pp have said is true, it's a Sophie's choice but I guess you have to choose the least worse option.

I would also suggest counselling, whatever decision you make.

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

Life has a way of teaching us the error of our ways, doesn't it?

In your place, I would bite the bullet and terminate the misformed unhealthy twin - for his own sake as well as that of the healthy twin.

Cote I'm not sure that's a very helpful post.

Life has a way of kicking us in the nuts at the worst times. I would like to think no one would judge me for having a termination (I know realistically some do) but equally I would never judge anyone for not agreeing with them.

I think that as a parent, being 'fair' to your children doesn't always mean treating them 'equally'.

In this situation you have (as I see it) only 1 viable option and it'll have different implications for your twins but is fair to, and shows your commitment and love for, both of them.

To the healthy twin you are offering the best chance of survival and to the unhealthy twin you are offering them a dignified and painless end to their suffering.

Its heartbreaking (and I have been in a similar situation), but I would view it like this and have the termination. Concentrate on keeping calm, and focusing positive attention on your baby and the healthy twin and plan a memorial for the lost twin.

Thanks, Kitty. If I ever want someone to tell me what to post, I'll let you know.