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evidence based medicine, pregnancy, prematurity

A fetus can’t “hold hands” with its twin

The story is a sad one, a set of twins where one is not expected to survive due to complex anomalies. As the mother of a set of triplets where one did not survive I understand this kind of pain.

A couple in such a situation spoke with their local news about their ultrasound which they feel shows the twin who is not expected to live “holding hands” with the other.

I don’t feel it’s my role to directly promote the image, so if you want to see a larger version click on the link above or Google it as many news sites don’t agree with me.

Screen shot 2016-02-18 at 11.22.26 AM

 

A fetus is not capable of purposeful movement.

This is not holding hands as we know it.

The 2nd of my triplets kicked the 3rd one almost constantly for 3 weeks. This was not “kicking” as we know it (i.e. to hurt or any purposeful movement), it was a reflex movement.

Fetuses also open and close their hands all the time. This is a sign of normal tone. Doctors use this movement as part of a test called a biophysical profile to assess fetal well being. When a fetus opens and closes its hand it might sometimes grab something, such a the umbilical cord, its other hand (and even give the appearance of “clapping”), or in the case of multiples the body part or umbilical cord of another fetus. None of this touching is is comfort, or joy, or soothing, or malice, it’s a reflex.

People get to think whatever they want to make their personal tragedy more bearable. My narrative is that by delivering extremely prematurely my first son, Aidan, “saved” his two brothers. At times I comfort myself with the thought that Aidan somehow “knew” my uterus was over stretched and that it was either him delivering now and dying versus death for all three in a week or so. I feel he heroically let go to save Oliver and Victor. Not that he consciously knew, but somehow he felt his. It’s difficult to explain. I am an OB/GYN and I know this idea is preposterous scientifically, but it comforts me and that’s ok. If someone interviewed me about my delivery experience I would probably even share it, but I would expect the reporter to know that was an idea that comforted a grieving mother and helped her reframe a tragedy not take it as proof that a 22 week fetus is capable of heroism.

What’s the harm, you say? To the parents, nothing. Many doctors and ultrasound technicians try to find images that they hope will be the most comforting. We say words that we hope will be soothing. However, those who oppose choice use these kinds of images as “proof” that a fetus can feel pain and have emotions. That somehow “ultrasounds are powerful proof of the humanity of the preborn child.” This story is already all over the anti-choice sites (I’m including Fox here) as well as many more sites as “proof” of fetal emotions and purposeful movement (either explicitly stated or implied). However, ultrasound images of fetal movements are really just a Rorschach test.

Many of our politicians don’t care about facts and science, they care about sound bites and images that fit a narrative. The Planned Parenthood video sting is proof of that on a large scale. I can just hear Cruz or Rubio talking about a tiny hand clinging for comfort and receiving it from a fetal twin.

I thought a lot about whether I should post something. I wish nothing but the best for the family involved. It’s a difficult road with complex emotions and they get to think whatever they want, but news agencies should know better than to assign any other meaning to the images of this personal tragedy.

 

 

 

 

 

 

 

Discussion

7 thoughts on “A fetus can’t “hold hands” with its twin

  1. Reblogged this on A Dose of Andrew and commented:
    Another great post, thanks again Dr. Jen

    Posted by Andersays | February 18, 2016, 1:08 pm
  2. Don’t take this the wrong way, but I totally love you. Or, at least your blogging self. It’s not often enough that someone of composure, compassion, capability and knowledge make those qualities available to everyone. I regularly share your stuff. Thank you for standing up for your view

    Posted by Andersays | February 18, 2016, 1:12 pm
  3. What a brilliant, empathetic, informative post about an incredibly difficult subject.

    Posted by bevthebodysurfer | February 18, 2016, 4:12 pm
  4. Reblogged this on Dead Wild Roses and commented:
    Medical facts? The real question is can we use ‘x’ to curtail woman’s rights, if so, run that story…

    Posted by The Arbourist | February 19, 2016, 8:56 am
  5. So you are proabortion?

    Posted by Question | February 22, 2016, 8:14 am

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