Pregnancy Termination for Fetal Abnormality: Psychosocial Consequences

Abstract

Short‐ and longer‐term emotional and social sequelae are to be expected after a termination of pregnancy for fetal abnormality. It may be possible to identify couples who need extra support or intervention in order to learn to live with their decision.

Decision‐making and future pregnancies after a positive fetal anomaly screen: A scoping review

“…(Gammeltoft et al, 2008; Menary, 1987). In contrast, men in two studies reported fewer fears and vulnerabilities, and a shorter duration of negative emotions compared to women (Leuthner et al, 2003; White‐Van Mourik, 1989). Parents' willingness to only consider a future pregnancy if there is zero probability of fetal anomalies coupled with the limitations of current medicine to predict and control risks inherent to reproduction with absolute certainty, was another reason they reported for not embarking on a subsequent pregnancy (Kelly, 2009; Rillstone, 1999).…”

“…Nineteen studies (Baillie et al, 2000; Brandenburg et al, 1992; Bryar, 1997; Carolan & Hodnett, 2009; Dallaire et al, 1995; Evers‐Kiebooms et al, 1988; Fernandes et al, 2020; Gammeltoft et al, 2008; Hammond et al, 2021; Irani et al, 2019; Jones et al, 1984; Kelly, 2009; Leuthner et al, 2003; Menary, 1987; Ndjapa‐Ndamkou et al, 2013; Pelly, 2003; Rillstone, 1999; White‐Van Mourik, 1989; Wollenschein et al, 2007) highlighted the reasons why parents were reluctant to become pregnant again following a diagnosis of a fetal anomaly in a previous pregnancy. For these parents, the fear of the anomaly recurring and reliving the trauma was sufficient to prevent them from becoming pregnant again (Baillie et al, 2000; Brandenburg et al, 1992; Bryar, 1997; Carlsson & Mattsson, 2018; Fernandes et al, 2020; Ferreira da Costa et al, 2005; Gammeltoft et al, 2008; Hammond et al, 2021; Irani et al, 2019; Kelly, 2009; Leuthner et al, 2003; Menary, 1987; Rillstone, 1999; White‐Van Mourik, 1989). This fear also persisted in parents whose children received a normal diagnosis following detailed investigations (Baillie et al, 2000).…”

“…Additionally, parents felt that choosing not to become pregnant again would allow them to ultimately avoid the difficult decisions associated with another screen positive result, that is whether to do a test at all, terminate or continue the pregnancy, or ‘choose’ to bring a child with anomalies into the world (Kelly, 2009; Rillstone, 1999). Parents who previously believed a diagnosis of fetal anomaly only happen to others were left feeling vulnerable to a sense of the arbitrariness of a diagnosis, particularly when they had done all they could to ensure a healthy pregnancy (Baillie et al, 2000; Bryar, 1997; Carolan & Hodnett, 2009; Gammeltoft et al, 2008; Kelly, 2009; Leuthner et al, 2003; Menary, 1987; Rillstone, 1999; White‐Van Mourik, 1989). A previous positive diagnosis of fetal anomaly caused women to lose confidence in their reproductive capacity to produce a healthy baby (Carolan & Hodnett, 2009; Fernandes et al, 2020; Hammond et al, 2021; Pelly, 2003), and sowed doubts about their worth as wives and mothers.…”

“…Nine studies (Gammeltoft et al, 2008; Irani et al, 2019; Kelly, 2009; Menary, 1987; Pelly, 2003; Rillstone, 1999; Samango‐Sprouse et al, 2020; Smith et al, 2021; White‐Van Mourik, 1989) highlighted how parents navigated the period before or immediately after a screen positive result for a potential or actual fetal anomaly. Parents who wanted a future pregnancy reportedly had unprotected sex and copulated more frequently to reinforce closeness and to conceive, while parents who were against a future pregnancy abstained from intercourse (Kelly, 2009; Menary, 1987; White‐Van Mourik, 1989). Parents who abstained from copulation did not trust contraceptives to avert an unplanned pregnancy, and their depression and sadness contributed to their lack of interest in a future pregnancy (Menary, 1987; White‐Van Mourik, 1989).…”

“…Parents who wanted a future pregnancy reportedly had unprotected sex and copulated more frequently to reinforce closeness and to conceive, while parents who were against a future pregnancy abstained from intercourse (Kelly, 2009; Menary, 1987; White‐Van Mourik, 1989). Parents who abstained from copulation did not trust contraceptives to avert an unplanned pregnancy, and their depression and sadness contributed to their lack of interest in a future pregnancy (Menary, 1987; White‐Van Mourik, 1989). Parents in three studies underwent invasive permanent birth control (e.g.…”