ShareThisBy MARK HUME
Wednesday, November 08, 2006
As two nurses spread their hands over her swollen belly, searching for the heartbeats of rare twins within, Felicia Simms leans her head back against the wall and waits.
The external microphones being slid over her skin by Cordelia Merritt and Cathy West, members of the Antepartum Home Care team at British Columbia Women's Hospital & Health Center, are probing for a sound few people ever hear: the reverberations of two separate but linked hearts.
When it comes, insistent and urgent, it will charge the room with emotion.
The identical twins that Simms has now been carrying for 31 weeks are conjoined, which occurs only once in every 100,000 births.
The twins _ already named Krista and Tatiana, after fairies _ are joined at the head where skin, bone and possibly the brain are connected. They exist in this way because the embryo didn't separate completely when it split to form identical twins on about the 13th day after conception. The two embryos have since developed into two healthy, but partially fused, fetuses.
On Oct. 26 at BC Women's Hospital, which handles 7,000 births a year, a special team of doctors is scheduled to deliver the babies by caesarean section. Douglas Cochrane, a paediatric surgeon on the team assessing Simms, told The Canadian Press recently that a group of leading experts would be put together to handle the case.
"And if that takes us to the far corners of the world, so be it," he said.
At some future date, if both babies survive, a decision will be made as to whether surgically separate them.
Among high-risk pregnancies, few can be more extreme than conjoined twins. About 40 percent of conjoined twins are stillborn, and 75 percent are either stillborn or do not survive more than 24 hours.
But those daunting odds don't appear to be weighing heavily on Simms, a 21-year-old mother of two, with long, dark hair and a serene countenance, who is at peace with the form her babies have taken, and who says she thinks everything is going to be all right.
"I feel confident," she said just before her first of two daily checks by nurses to see whether the twins were healthy. "It's scary and you worry a lot, but I know that they are going to make it."
As the fetal monitor recorded the track lines of the twin hearts, the nurses seemed satisfied that both babies were healthy. For now.
"It's sort of like taking a picture," Merritt said. "It doesn't predict what's going to happen in the future."
Standing nearby, Louise McKay, who is Simm's mother, and Rhea McKay, her younger sister, embraced and let out a sigh.
"It makes me teary-eyed," Rhea said of the heartbeats. "Makes me want to cry whenever I hear it." A tear ran down Rhea's cheek and her mother brushed it away.
Outwardly, Ms. Simms and her family seem calm. But when her mother, Ms. McKay, was told that, she laughed.
"On the outside!" she said, before describing the inner turmoil she has experienced since learning her daughter was carrying conjoined twins.
"It's been an emotional roller coaster. I'm one day feeling okay and the next day I'm feeling anxious and panicky and you know, wondering what's going to happen. It's hard to say."
Ms. Simms, who lives on income assistance surrounded by a large and supportive extended family, has already had two normal pregnancies. She has a 3-year-old daughter, Rosa Hogan, and a 2-year-old son, Christopher McKay, with her partner, Brenden Hogan.
She was shocked when her family doctor told her the twins she was carrying were conjoined.
But she said she never considered terminating the pregnancy. "I don't think I could ever kill a child, whether it's unborn or born. It's a living thing and it deserves a chance too," she said in an earlier interview.
As the weeks of her pregnancy advanced and the big date has drawn near, Ms. Simms and her family have fallen in love with the babies, whom they have seen through ultrasound imaging and whose heartbeats they listen to daily.
