VANCOUVER — Felicia Simms, a pregnant Vernon woman who is carrying conjoined twins, wasn't able to sit through a press conference yesterday at which doctors discussed the one in 200,000 birth that will take place at BC Women's Hospital this week.
Ms. Simms, who sat at a table flanked by her mother, Louise McKay, and her sister, Rhea McKay, choked up when asked how she felt after hearing doctors calmly describe the challenges ahead.
"Just trying . . . I don't know . . . just trying to get ready for this - and it's hard," she said while fighting back tears.
Her sister, who held her hand throughout much of the press conference, seemed just as emotional, crying at times.
When asked how her daughter was holding up, Ms. McKay, gave a one word reply: "Fantastic." But she was too overwhelmed to say any more than that.
The three women left the press conference early, leaving the heads of the medical team to answer questions about the birth, which will take place Thursday.
Ms. Simms, a 21-year-old mother of two children aged two and three, is in the 34th week of an extremely rare pregnancy.
The twins she is carrying, named Krista and Tatiana, are conjoined at the head.
Doug Cochrane, a pediatric neurosurgeon at BC Children's Hospital, where the twins will be cared for after birth, said the situation is "extremely rare" and predicting what will happen is difficult.
Asked what the chances of survival are for the twins, Dr. Cochrane replied: "I don't think we know that. They've been very healthy inside the womb but how they make the transition to outside the womb -- we're all having to await that."
Although doctors have been studying the babies through magnetic resonance imaging, Dr. Cochrane said much more research is needed before any decisions can be made about separating them.
"I think the journey is only beginning," he said.
He said it might turn out that the twins are so intricately conjoined they can't be operated on.
"Some conjoined twins are not separable without substantial risk to one or both and that, of course, creates a series of ethical dilemmas," he said.
Tests so far have indicated the babies are joined at the occipital lobe, the visual processing centre for the brain that is located at the back of the skull, and at the parietal lobe, which merges with the occipital lobe and which is the language centre for the brain.
Dr. Cochrane said the sharing of the vascular system, the arteries and veins, may also complicate any possible separation.
"So I would anticipate that discussions about and planning for and, perhaps, recommendations about whether separation is feasible will occur over several months and then, of course, if that was to be deemed feasible and safe and was the choice of the family, then that process will likely occur over many, many further months," he said.
The babies will be delivered by cesarean section on Thursday, but a press conference will not be held until the family approves.
Ms. Simms and her mother have made themselves readily available to the media over the past few months, but were clearly showing the signs of strain yesterday.
"Felicia is feeling the pressure of what's happening," said Brian Lupton, clinical director of neonatology at BC Women's Hospital.
Dr. Lupton said the delivery of conjoined twins is no more difficult than other complex births. But he added: "There's always a little bit of an unknown when dealing with conjoined twins."
Deborah Money, head of the division of maternal fetal medicine at BC Women's Hospital, said both mother and babies appear to be in good health so far.
"In terms of their general condition, their growth has been remarkably normal and their size is appropriate in terms of how far along Felicia is. They've been moving. We've been monitoring their heart rates and they've been very, very assuring," Dr. Money said.
The twins are being delivered this week, she said, because at the 32-to-34-week mark the risks of the babies dying from tangled cords or other complications, start to rise.
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