Together forever. Until death do us 'part... That's often the reality for conjoined twins. Sometimes they can be separated. But it's not always possible, easy or affordable.
If the twins share vital organs, it's often too risky for them to undergo separation surgery. It could either be life-threatening or come with major complications and future medical issues.
According to Cleveland Clinic, only about 45% of conjoined twins are live births. And their outlook is not very positive. "Often, one twin won’t live very long after they’re born because they have life-threatening medical issues," reads the site. "Experts estimate that about 8% of conjoined twins survive."
Conjoined babies are likely to be born prematurely, adds Mayo Clinic, with one or both possibly being stillborn or dying shortly after birth.
"Severe health issues for twins can occur immediately, such as trouble breathing or heart problems," the clinic notes. "Later in life, health issues such as scoliosis, cerebral palsy or learning disabilities may occur."
As you might expect, the birth of conjoined twins isn't straightforward. Most will need to be delivered by C-section to lower the risk of complications for mom and the babies. There are also likely to be lots of doctors and other professionals in the room.
WebMD notes that each twin will have their own medical team, led by a neonatologist. And everyone needs to be extremely well-prepared. "The medical teams will rehearse the delivery beforehand to make sure everything goes smoothly," explains that site.
Once the babies are delivered, their umbilical cords need to be clamped fast to prevent blood circulation problems. There could be emergency surgery if one twin is stillborn or unlikely to survive. Otherwise, doctors will often wait a few months before deciding whether future separation surgery can be done.
Only around a quarter of conjoined twins who survive will live long enough to be candidates for surgery. And even then, the outlook isn't great. WebMD reports that only about 60% of surgically separated twins survive.
Interesting, conjoined twins are almost always the same s*x. "That's because they come from a single fertilized egg that didn't split completely," explains WebMD. But there have been a few times where the twins have been different sexes.
The oldest pair of conjoined twins ever to live were Lori and George Schappell. They died in 2024 at age 62. Both were assigned female at birth. But George came out as transgender in 2007. Despite their skulls being fused, the two managed to lead independent lives.
"They were connected at the sides of their foreheads and looked in opposite directions," reported the New York Times. "Lori was able-bodied and pushed George, who had spina bifida, on a stool that had wheels."
The twins wanted to be seen as two distinct people. “We’re two human beings who were brought into the world connected at one area of the body,” Lori once said in a 1997 documentary.
“This is a condition that happened through birth, and people have to learn to understand that. When they see this” — she gestured to their conjoined heads — “all they see is this.”
