Conjoined Twins

Birth is one of the miracles of this world. It can be regarded as ritualistic, creating beauty, or simply procreation for the continuation of the species. Regardless of genus group, gender, or ethnicity, birth is an amazing occurrence. However, even age old incidences such as creating and producing new life is known to have its issues associated with it. Human life and formation is not infallible, and at times, complications arise. Even aside from this, some couples are lucky enough to produce more than one child at once. These two happenings simultaneously cause the anomaly known as conjoined twins. Causes of this are still not one hundred percent acknowledged at this time, even due to today's amazing levels of scientific and medical technological advances. Even so, conjoined twins are one of the most remarkable possibilities associated with reproduction (5).

Conjoined twins are a variation of identical twins. There has never been a case of conjoined fraternal twins, and it is regarded as an impossible occasion. Conjoined twins can be identified by their obviously connected bodies. There are a number of differing types of conjoinment known to man, defined and categorized by the attached region of the bodies. It is extremely rare, only happening in approximately one out of 75,000 to 100,000 births. It is estimated that in every 200 pairs of identical twins brought into the world, one pair of them will be conjoined. Now that medical science is so incredibly sophisticated, many twins are carried to term. Be that as it may, between forty and sixty percent of conjoined twins are delivered stillborn, and thirty-five percent of those who live through birth die within the first twenty-four hours of life outside the womb. Seventy percent of conjoined twins that survive are females, and they are more likely to occur in Africa or India than China or the United States (3).

The most often asked question when it comes to conjoined twins is, how does it happen? First, the creation of normal twins must be addressed. The birth of twins can occur in two different ways, the fertilization of a single egg or the fertilization of two eggs. In the case of dizygotic twins, the woman's ovaries release two eggs about the same time instead of one, with each being fertilized by the male's sperm, fraternal twins begin to develop. The two zygotes develop differently, each having a different genetic coding. They can be both boys, both girls, or a single boy and a single girl. Because each embryo develops on its own from different genetic characteristics, dizygotic twins resemble family characteristics as do brother and sister. The birth of monozygotic twins takes place much differently than do the births of fraternal twins. Identical twins originate from a single egg, fertilized similarly to that of a single pregnancy. A change transpires early in the pregnancy that causes the development of identical twins. The change from a single birth to the birth of monozygotic twins occurs when the zygote ruptures into two separate structures. These two parts begin to develop into individual fetuses, sharing a similar genetic code and developing in a similar manner. Identical twins are of the same sex, resemble each other very closely, and have similar fingerprints and blood types (1). Conjoined twins have been known to appear in triplet and quadruplet births, but no cases of conjoined triplets or conjoined quadruplets have ever been reported (4).

Conjoined twins, however, develop in a similar fashion as do monozygotic twins. Conjoined twins are identical twins with the difference that the zygote did not divide completely during their development. Such twins are usually joined at the hip, chest, abdomen, buttocks, or head. About half of the women who become pregnant with conjoined twins will develop excess fluid surrounding the babies, which often may lead to premature labor and an increased risk of miscarriage. With current monitoring equipment, conjoined twins can be detected maturing in the mother and during birth a Cesarean section is sometimes needed to deliver the children safely. As if the babies were not going to endure enough challenges throughout the rest of their lives, they have a lot to deal with even before being born. It has been known that conjoined twins can be born with a complication called hydrops, which causes excessive fluid to build up in an infant's body, which can be life-threatening. Those who live to be born often experience congenital heart disease, liver or kidney disease, physical or mental disabilities, and intestinal blockages later in life (4).

Many people to this day still refer to conjoined twins as "Siamese twins". This term was coined from Eng and Chang Bunker, the famous conjoined twins from Siam (now Thailand) who earned their living in the U.S. as a circus attraction in the Barnum and Bailey Circus. Scientists of that time argued over whether the brothers could be successfully separated, since the twins were joined at the chest by a thick band of tissue. Had the Bunker twins been born in this day and age, they could be successfully separated in a surgery with very few if any complications. This was not an option back in 1811 when they were born. When the twins were born, none of the midwives would touch them for fear of becoming cursed. This kind of birth had hardly ever been heard of in those days, and nobody knew how to deal with it. When the king of Siam heard of the boys, he was outraged and condemned them to death. Siam at the time was a feudal society, steeped in superstition. The king's rule was absolute, as was his unquestioned ownership of his subjects. Luckily, their mother refused to abandon them at birth, and the king never acted on his impulsive death sentence (2).

Chang and Eng were discovered by Robert Hunter, a British merchant, who convinced their mother that her boys' future and prosperity lay beyond Siam. It took another three years to secure the king's permission for his vassals to leave Siam. Whether she realized it or not, Chang and Eng's mother had all but sold the boys to Hunter for $3,000. Happily, the terms of bondage would expire in two-and-a-half years, upon their 21st birthday. Unhappily, their mother only received $500 of the promised sum (2).

While touring, the Siamese twins were treated respectfully for the most part. When their managers proposed touring in France; however, the government refused, explaining that such an exhibit "might deprave the minds of children" and cause deformities in unborn children. Of course, there were also occasional stupid or indelicate questions, but the twins tried to maintain their manners and good humor throughout (6).

It is perhaps fortunate for the twins that their managers were merely exploitative rather than criminal. It is not entirely unreasonable