Tiffany Campbell may be South Dakota's most reluctant media star.

The pretty, petite mother of three, with her handsome husband at her side, is the focus of a statewide television ad opposing Measure 11. But the 32-year-old Sioux Falls woman desperately wishes life hadn't cast her in the role.

"Who would want this? To be the woman who had to abort one of her twins? It's horrible," Campbell said during a visit to Rapid City in September.

"I wish I weren't sitting here right now, because that would mean that I would have two healthy babies at home, not one."

Instead, she has a 19-month-old son named Brady, and the sad, poignant memory of the role she played in the death of his twin brother, Brendan, the victim of twin to twin transfusion syndrome. The Campbells' story - part tragedy, part blessing - comes with an obligation she and her husband, Chris, both feel to speak out against Measure 11.

If approved by state voters on Nov. 4, and if upheld by the courts, Measure 11 would ban most abortions in the state, including the one that saved Brady Campbell's life by ending his brother's. "I played a role in my son's death, and I know that," Tiffany Campbell said.

It is a decision she wishes she never had to make but not one she regrets.

"If I could save one child, I was going to do that. As a mother, I wasn't going to give a death sentence to both of my babies," she said.

In September 2006, 15 weeks into her third pregnancy, the Campbells learned that Tiffany was carrying twin boys. Chris is a certified public accountant by profession, but at the first prenatal ultrasound, he could see immediately that there were two babies on the screen. And he noticed something else that seemed odd. One baby was significantly smaller than the other.

Diagnosed with twin to twin transfusion syndrome, the Campbells sought the best medical advice they could find. They traveled to Cincinnati, hoping to have a fetoscopic laser procedure that would save both twins by coagulating the blood vessels that they shared.

"I'm going to go to the ends of the earth to help my babies. If there was a cure out there, I was going to find it," Tiffany said. "Of course, if I could have two healthy babies here, I would. To have people suggest anything else is irritating, to say the least."

Officials with the VoteYes ForLife.com organization criticized the Campbells' decision.

Dr. Glen Ridder is a family practice physician in Sioux Falls who serves as the medical director of the Alpha Center, a crisis pregnancy center.

"If it's someone's advice to kill your offspring, that doesn't make a whole lot of sense," Ridder told a Sioux Falls television station recently.

Tiffany Campbell still recalls, with strong emotion, a 2006 phone conversation she had with Ridder, who called her while she was on bed rest after he learned of the situation through a mutual acquaintance. She and Chris felt intimidated and insulted by his comments.

Ridder remembers the contact in 2006 differently. "I actually had the privilege of talking to those parents prior to the procedure, but their decision had already been made, and they were not open to talking about it," he said.

"You've got a family practice physician who's never even seen our medical records purporting to know what we should have done," Chris Campbell said. "That's offensive to me. We worked with some of the premiere fetal surgeons in the world. We explored every option. We did everything you could possibly do to save Brendan."

In Cincinnati, doctors found that Brendan, the smaller, sicker twin, was malnourished and near death. They suspected he may already have suffered an in-utero stroke. Brady was in severe cardiac distress as his heart attempted to keep both babies supplied with oxygen.

Doctors advised the Campbells that the laser procedure to save both babies wasn't a viable option because they didn't expect Brendan to survive what would be major surgery for Tiffany Campbell. There was also a significant risk that an operation would trigger cardiac arrest in Brady, the healthier of the twins. For Tiffany, the procedure meant a surgical incision from her sternum to her pelvis to allow surgeons to manipulate her uterus for optimal results.

"It was not an option open to us because of the severity of the disease in our case," Chris Campbell said. "For us, it wasn't the right option."

Their other two options: Do nothing and watch both babies die, or perform a radio-frequency ablation on Brendan's umbilical cord that would lead to his death in hopes of relieving Brady's distress.

"Brendan was going to die; it was only a question of when," Tiffany said. "If we had allowed him to pass away on his own, he would have taken Brady with him."

That procedure, called selective cord coagulation, would be considered an abortion under Measure 11, both sides agree, even though Brendan's body was not delivered until Brady was born, perfectly healthy, in February 2007.

Measure 11 has no exception for fetal anomaly. Its proponents say standard fetoscopic laser surgeries, when performed to save a life, would not violate the abortion ban, even if it results in a fetal death.

"There's many different types of abortion, and this procedure, given its intent, is one of them," Tiffany Campbell said.

She knows that's what she did, because doctors insisted she repeat exactly what they planned to do prior to the surgery. "The pastor was in the operating room with me and we prayed together. A nurse was assigned to me just to wipe the tears off my face, as I cried until the anesthesia kicked in," she said.

The Campbells had their procedure done in Cincinnati, not in South Dakota, but they are adamant that the option should remain legal and accessible for other South Dakota families that may need it.

"If this passes, there's some family out there that's going to lose a child down the road because this option wasn't available to them," Chris said.

A Catholic, he is infuriated that government or others would not let people make that medical choice for their family. "Why should my son be the martyr for their cause? It's unconscionable to me. How many of them would be willing to offer up one of their children for the cause?"

Not everyone shares the same religious beliefs about abortion, he said. "I just feel very strongly now that you really need to leave it up to the families and the doctors they put their trust in. It's really not a place for government," Chris Campbell said.

Both sides agree that twin to twin transfusion syndrome is rare. It affects, to various severities, about 4,000 twin pregnancies annually in the U.S.

VoteYesForLife.com estimates that perhaps four out of 11,000 pregnancies in South Dakota each year would require an operation to treat the syndrome.

"Just because something is rare, doesn't mean you shouldn't take those situations into account when writing legislation," Tiffany Campbell said. "It's not rare if it's happening to you."

Public reaction to the Campbells' notoriety after the television ads has been largely positive. "A lot of gratitude, actually," Chris Campbell said. "They say, 'We know this is a very tough thing to do, but we're glad that you're doing it."

See related stories:

Are the abortion ban's exceptions enough?

Who gets abortions in South Dakota? A quick profile

Campbell: Reluctant face of Vote No ads

Billboard helped Rieman choose not to abort baby

Initiated Measure 11 Ballot Question