At 20 weeks pregnant, Ruth had no indications her baby was anything but perfect.
So they were completely unprepared for what they learned at a routine obstetrical ultrasound: Their third child, daughter Pearl Joy, was profoundly underdeveloped.
Pearl was diagnosed in utero with alobar holoprosencephaly (HPE), a neural disease in which the brain and facial features do not form completely. Usually, babies with HPE do not survive a full-term pregnancy. Or if they do, usually they die within hours or days of birth.