Parents talk about what it’s like when their babies undergo surgery in the womb.

Last week, Kourtney Kardashian Barker, who is pregnant with her first child together and rocker husband Travis Barker, shared that she underwent “urgent fetal surgery” and credited doctors with “saving our baby’s life.” “saved”. The reality star did not share what necessitated the in-utero procedure, although fetal surgeries are common Treating a range of health conditions.

What is it like to carry a child who needs fetal surgery? Two families share their emotional experiences while an expert explains what the procedure involves.

What is Fetal Surgery?

Fetal surgery is a procedure performed on an unborn child or fetus in the womb. Dr. Magdalena Sanz Cortes, a fetal surgeon at Texas Children’s Pavilion for Women, tells Yahoo Life that fetal surgeries are “not that common,” but because “the indications for surgery are so heterogeneous” or mixed, it is difficult to determine how many patients are actually going through it. The most common reason for fetal surgery is treatment Twin transfusion syndrome, a rare pregnancy condition in which the shared placenta of identical twins does not function equally, leaving one twin with too much fluid and the other not enough. Without fetal surgery, “babies will die or suffer permanent damage,” Cortes says.

Another example of a “life-saving” situation that may require fetal surgery is fetal anemia, in which a baby urgently needs a blood transfusion in the uterus. However, there are some fetal procedures that are not considered life-saving, Cortes notes. For example, babies diagnosed with spina bifida may have surgery in the womb to repair their spinal cord.

“We’re not saving these babies’ lives, but we’re hopefully giving them a better quality of life and a better chance of being able to walk independently as they get older,” she says, for example. “So we use the same term ‘fetal surgery,’ but there are different types of indications and different purposes.”

The criteria for fetal surgery are “minimally restrictive” when a baby’s life is at stake. “If it’s a life-saving procedure, we basically just have to do it,” Cortes says. “It doesn’t matter if the mother has a disease, if there is a risk of premature birth… If you don’t do the surgery, the babies die.”

However, if the situation is not life or death, other factors must be considered before surgery can be performed. “We have to make sure that it is a good case that actually benefits from an improvement in quality of life,” she explains, pointing out that fetal surgery increases the risk of preterm birth. “So if the mother has spina bifida, we wouldn’t offer it if she has an underlying condition. If the mother has had a previous premature birth, we would not offer it. If the baby has several other anomalies, the same thing applies – we wouldn’t do it. … We need to make sure that this is a good candidate and that we’re not doing more harm than good when it’s just about improving the quality of life. If it’s life-saving, “We’ll go all out and get the patient in right away.”

The procedure itself can also vary. Some life-saving surgeries are performed using lasers and are therefore minimally invasive and require little downtime for the patient. Other operations may be more complex; An open repair of spina bifida, for example, requires a larger incision, which Cortes compares to a cesarean section.

“I was just in survival mode, doing what I had to do for my child.”

When Alisha Staten When she was about 19 weeks pregnant, she learned that the baby she was carrying had spina bifida. The first mother spent the next few weeks meeting with doctors at Intermountain Primary Children’s Hospital and University of Utah Health and having tests done to determine whether she was a good candidate for fetal surgery.

“I was just in survival mode, doing what I had to do for my child,” Staten, who lives in Idaho Falls, Idaho, but was being treated at the Utah Fetal Center, tells Yahoo Life.

On April 6, 2021, exactly 24 weeks and two days into her pregnancy, she underwent the first fetal surgery in the state of Utah. She and her baby, a girl she and her husband later named Abigail, each had their own team of specialists during the procedure. Doctors used an ultrasound scan to determine exactly where the baby was. They then opened Staten’s uterus and amniotic sac to expose Abigail’s spinal cord and perform an open repair. While the baby was otherwise submerged in the womb and the amniotic fluid was replenished with a warm saline solution, his buttocks and back were exposed during the operation. April 6th has therefore become known as Abigail’s “butt birthday.”

Abigail’s actual birthday is May 9, 2021, Mother’s Day. About a week and a half after surgery, Staten lost her mucus plug — the premature rupture of membranes that Cortes cited as a risk of fetal surgery — and began leaking amniotic fluid. She spent the rest of her pregnancy in the hospital.

“It was a long healing process and it was uncomfortable,” she says of that time. “There were moments when I thought: I can’t do this anymore. My body can’t do that anymore.”

Staten lasted until 29 weeks – a full-term pregnancy lasts 40 weeks – and gave birth to Abigail via emergency cesarean section. She was released from the hospital a few days later, while her daughter remained in the neonatal intensive care unit (NICU) until July 23 – her original due date.

Abigail, who has a heart-shaped scar on her back from her fetal surgery, is now 2 1/2 years old. Due to spina bifida and premature birth, Staten’s daughter suffers from health issues such as mobility and bladder control. “There are just some things we have to adapt to… but we meet her where she is and we treat her the same way we would a neurotypical two-and-a-half-year-old,” Staten says. “But she’s funny, she’s charismatic and there’s just something about her that attracts people.”

Fetal surgery, she adds, “was the best decision” she and her husband ever made. “She is happy, she is doing well. Yes, we have our setbacks. However, the fetal surgery gave her so much and if I had to do it again, I would.”

“Anything you can do to save our child, we are there.”

The gynecologist Samantha and Joey Paris visited last Christmas for their anatomy exam was an old family friend, so the Dallas-based couple quickly realized something was wrong when he looked at the ultrasound.

“He’s very thorough, but cheerful and always in a good mood,” Joey tells Yahoo Life. “And within a few minutes of the appointment, his face turned pale white and he took on a very calm tone.”

Ultrasound showed signs of pleural effusion or fluid collection; His “lungs were completely caked up and his body was just completely filled with fluid,” says Samantha, who was 23 weeks pregnant. The baby was diagnosed with hydrops fetalis, a life-threatening problem in which excess fluid can lead to heart failure, and Samantha was booked in for fetal surgery Texas Children’s Hospital in Houston within a few days.

“They simply told us the only option was to either do nothing but probably lose the child very quickly or have a stillbirth, or we can do this operation and have the best chance of saving your child’s life. ” says Samantha. “And we said, ‘Okay, how fast can you do it?’ Even though it was scary, it was a given to say, “Anything you can do to save our child, we’re on it, we’re going to do it.” It was definitely a whirlwind. And I think before that day it had been I have no idea [fetal surgery] was even a thing.

While the couple raves about the hands-on care, the situation was delicate. Samantha went into labor for a few hours after her first operation, which involved placing shunts in her baby’s chest to relieve the buildup. “We were so stressed…we thought, ‘It’s not time for the baby yet, keep the baby in the house,'” she recalls. Due to complications with the shunts, Samantha underwent additional surgeries and was required to remain on bed rest for the duration of her pregnancy and temporarily relocate to her parents’ home in Houston. Samantha went to the doctor twice a week and had a total of 61 ultrasounds.

But there were also highs. Despite the risk of premature labor, Samantha made it to 39 weeks when she gave birth vaginally to a baby boy. Somehow the couple had managed to keep their child’s gender a mystery throughout the process, and they named him Richard Joseph Paris IV, or “Archie” for short. After three days in the NICU, the family returned to Dallas.

Archie is now 4 1/2 months old, his shunts were recently removed and he will be monitored routinely for the first few years of his life.

Otherwise, “he’s just living his happy baby life – eating, sleeping and pooping like any other baby,” says Samantha. “It really is such a gift and a miracle.”