A British couple have shared their joy after giving birth to their ‘miracle’ one-in-two-million conjoined twins.
After a rollercoaster nine months, Hannah and Dan Bateson, from Toomebridge in Northern Ireland, welcomed Annabelle and Isabelle into the world in March.
The couple began fertility treatment last year to help them conceive and were surprised to learn Mrs Bateson had fallen pregnant within the first cycle.
But they were given a scare when a 12-week scan revealed the twins were conjoined, something that only happens once in every 2.5m or so pregnancies.
Medics knew that the girls shared several key body parts but they could not yet tell if any vital organs were affected — a key factor for their survival and long term health.
Even as their due date approached, the couple said they still knew ‘so little’ about the girls’ condition and how they would fare.
Mr and Mrs Bateson were referred to London’s University College Hospital for the babies to be delivered by a specialist team in March.
Doctors revealed Annabelle and Isabelle, now aged six weeks, were joined from the chest to the pelvis and shared a bladder, bowel and a fused leg — but crucially had sperate hearts.
‘They’re miracles. Miracle is the word we’ve used from the day we found out we were having them,’ Mrs Bateson said.
Annabelle and Isabelle Bateson were born six weeks ago at London’s University College Hospital
Their parents, Hannah and Dan Bateson, pictured here with the twins shortly after they were born, are originally from Toomebridge in Northern Ireland but made the trip to England in case the newborns needed specialist medical care after the birth
The twins are joined from the chest to the pelvis, sharing a bladder, bowel and a fused leg
The proud parents have described their newborns as ‘miracles’ who are ‘constantly hug each other
Now aged six weeks old, Annabelle and Isabelle have been born against the odds and face a lifetime of medical treatment.
This includes a crucial operation next month to begin the girls’ separation.
But new mother Mrs Bateson said: ‘The love they share and the hope they show is the spirit which keeps the family going.
‘At every stage, they’ve just been determined.’
Husband Dan added: ‘They’ve proved everyone wrong so far.’
In an interview with ITV News, Mrs Bateson described the relief felt by the couple and medical staff the moment Annabelle and Isabelle were born.
On hearing their cries for the first time, Mrs Bateson recalled: ‘It was like the weight of the world had been lifted off your shoulders.
‘It was relief and you felt that relief throughout the whole (medical) team. When you had maybe 20 plus people, that relief was just unbelievable.’
She added: ‘They’re miracles. Miracles is the word we’ve used from the day we found out we were having them.’
Annabelle and Isabelle were conceived during the Batesons’ first cycle of fertility treatment and their mother described them as ‘very long, very very long waited for wee girls’.
After they managed to conceive after just one cycle of fertility treatment, a subsequent scan showed Mrs Bateson was not only pregnant with twins but they were conjoined
The extent of the conjoining was unknown but thankfully the twins have individual hearts meaning they can be separated surgically
Annabelle and Isabelle are scheduled to undergo surgery to sperate them next month
But the parents-to-be found out something was different about the pregnancy at the 12-week scan – before which Mrs Bateson confessed to feeling apprehensive.
She said: ‘You maybe go to a scan feeling something’s wrong. I think a normal feeling is to feel very nervous going to scans, especially first pregnancies.’
On finding out they were expecting conjoined twins, she added: ‘We were both committed to the pregnancy.
‘It was just then you felt in a limbo because we knew they were conjoined but knew so little about the information, of the extent of the conjoin.’
Mr Bateson said: ‘It was (a case of) trying to piece it all together to see what to do and what’s the next step.’
The separation of conjoined twins is a high-risk operation with a low success rate
The surgical separation of conjoined twins is a delicate and risky procedure, requiring extreme precision and care.
Therefore, the decision to separate twins is a serious one.
Mortality rates for twins who undergo separation vary, depending on their type of connection, and the organs they share.
In cases of twins where the pumping chambers of their hearts are conjoined, there are no known survivors.
Although success rates have improved over the years, surgical separation is still rare.
Since 1950, at least one twin has survived separation about 75 percent of the time.
It is only after twins are born that doctors can use magnetic resonance imaging, ultrasound and angiography to find out what organs the twins share. In order to determine the feasibility of separation, doctors must carefully assess how the twins’ shared organs function.
After separation, most twins need intensive rehabilitation because of the malformation and position of their spines.
The muscles in their backs are constantly being flexed and they often have a difficult time bending their backs forward and backwards and sitting up straight.
The babies, joined from the chest to the pelvis, were born in March at London’s University College Hospital, the closest maternity unity to Great Ormond Street Hospital (GOSH).
They were immediately moved to GOSH – the leading specialist hospital in Europe for separating conjoined twins – where operations to separate them and future treatment will take place.
Annabelle and Isabelle have separate hearts but share a liver, bladder and bowel. They have one leg each and a shared fused leg.
Surgery to begin the twins’ separation is scheduled for next month.
Mrs Bateson said: ‘Their wee bodies are different and they will be. The girls will have prosthetic legs, they’ll have one leg each and they’ll have one prosthetic leg each and ongoing surgery the rest of their days.
‘We’ll be coming back here for the next 18 years, which is a very scary thing to say but if we are coming back for the next 18 years it means the girls survive.’
The Batesons are now fundraising to help them cover the costs of constantly travelling back and forth between Northern Ireland and London. You can click here to support them.
Mr Bateson said of the couple’s experience so far: ‘Anyone else’s nightmare was our sort of dream, it was weird.
‘Hannah will give up work, not many people want to do that, but she’d love to because it means (the twins) are here.’
Mrs Bateson said the family have returned home for a few weeks before the operation at Great Ormond Street at the end of May.
‘It will be a very long day, possibly 12 to 18 hours,’ she said.
NHS senior support worker Mrs Bateson, 31, and her 32-year-old husband, who runs a fruit and vegetables business, have been told the full separation is likely to take place during that operation, details of which are still being worked out by the surgical team.
Follow-up operations may then be required ‘in the immediate days and weeks’ after the main one.
Mrs Bateson added: ‘It’s going to be very hard. We’d tried to prepare as much as we could before the girls were born that they would be born very sick, even unable to breath unaided.
‘But our girls were born so well. Both are happy wee girls, so to go back into the mindset of having sick babies again is very scary.’
HOW ARE CONJOINED TWINS FORMED IN THE WOMB?
Conjoined twins develop when an early embryo only partially separates to form two individuals.
Identical twins (monozygotic twins) occur when a single fertilized egg splits and develops into two individuals.
Eight to 12 days after conception, the embryonic layers that will split to form monozygotic twins begin to develop into specific organs and structures.
It’s believed that when the embryo splits later than this — usually between 13 and 15 days after conception — separation stops before the process is complete, and the resulting twins are conjoined.
An alternative theory suggests that two separate embryos may somehow fuse together in early development.
Although two fetuses will develop from this embryo, they will remain physically connected — most often at the chest, abdomen or pelvis. Conjoined twins may also share one or more internal organs.
Many conjoined twins die in the womb (stillborn) or die shortly after birth. Some surviving conjoined twins can be surgically separated.
The success of surgery depends on where the twins are joined and how many and which organs are shared, as well as the experience and skill of the surgical team.
Conjoined twins are typically classified according to where they’re joined, usually at matching sites, and sometimes at more than one site.
Source: Mayo Clinic
Mrs Bateson, who underwent a Caesarian section, was able to hold her daughters the day after they were born, once they had been transferred to Great Ormond Street.
The Batesons, who have been together 14 years having met as teenagers from across the sectarian divide – Hannah’s family is Protestant and Dan’s Catholic – say they are ‘focusing on the joys’ of finally having children after many years of trying, and ‘trying not to dwell’ on the surgery.
The couple, who married in 2016, sought fertility treatment more than four years ago but it was delayed due to Mrs Bateson having to lose weight and the Pandemic.
They conceived using Clomid, an oral type of fertility treatment.
Mrs Bateson spent two months before giving birth in London so she could have her ante-natal sessions at University College Hospital.
In the weeks before Annabelle and Isabelle’s birth, they also began discussions with Great Ormond Street.
‘The experience of Great Ormond Street in this field definitely reassured us. Right down to talking about feeding, they were talking about what they did with the last set of conjoined twins,’ Mrs Bateson said.
The couple say they have had ‘amazing support’ from family and friends, and also their church, Journey Community Church, in Antrim.
‘We’ve had prayers and support from both sides of the community,’ she added.
The church has helped them set up an online fundraising page, accessible via Facebook group Bateson Conjoined Twins, to help support the family.
Mrs Bateson said it is set to be a financially difficult few years ahead with her giving up work to care for the twins and the prospect of repeated trips to London.
Normally, twins are born after a single fertilised egg splits and develops into two individual embryos
The split normally occurs eight to 12 days after conception with the embryos going on to develop their own tissues and organs separately.
However, in the case of conjoined twins it is believed this split happens too late and the embryos do not separate.
Approximately 40 to 60 per cent of conjoined twins arrive stillborn, while around 35 per cent survive only one day.
The odds of longer-term survival can depend on where they are conjoined, with twins sharing a chest, abdomen or pelvis most common, though they can also be joined at the head.
If they survive some twins can be surgically separated but the success of these operations depends on exactly where the twins are joined and which organs they share.
Heartbreakingly, in some instances only one twin survives the operation.
Twins who share a heart cannot be separated successfully which is why it is critical that little Annabelle and Isabelle do not share this organ.
With 680,000 children born in the UK each year, statistically, a pair of conjoined twins would be born in Britain every four years.