When Heartless Babies Are Disposable Tissue
Maternal Reactions To Acardiac Twinning
This article investigates maternal reactions to the rare fetal condition, acardiac twinning, in which one identical twin develops properly while the other twin develops without a fully formed heart and, at times, without arms or a head. Unfortunately the existence of the malformed twin (the acardius) endangers the co-twin (here also called fetus) because the two are unable to exchange blood in the appropriate proportions through the shared placenta. In essence the viable co-twin’s heart acts as a pump for the two which leads to the deterioration of the fetus. If the condition is not abated, the likelihood of the demise of the co-twin is increased. To save the viable twin physicians use fetoscopy (in utero fetal surgery) at the mid-gestation stage to ligate (tie-off or otherwise separate) the umbilical cord leading to the malformed twin. Following surgery, both twins remain in utero until their eventual birth. Based upon my eleven month fieldwork at a US hospital developing fetoscopy (for acardiac twinning as well as other rare fetal conditions) and on interviews with patient-mothers who underwent surgery, I reached the conclusion that it was not always clear what an acardius meant to the patient-mother, to her family, and even to the ethnographer.