Support Desired by Women Following Termination of Pregnancy for a Fetal Anomaly

Abstract

With the rapidly evolving field of prenatal testing, there is a growing need to provide support for women pursuing termination of pregnancy following the discovery of a fetal anomaly. Previous studies have documented that women in this situation often feel unsupported, but the type of resources desired by this population remains undetermined. We studied the awareness and utilization of support resources in 51 women at the time of the procedure, at 6 weeks, and at 3 months following the event. Though largely knowledgeable of existing resources at the time of the procedure, only 50 % admitted contemplating their individualized need for support. Most expected to rely on the support of family and friends. Additionally, 50 % expressed the desire to commemorate the pregnancy, though none wanted direct contact with their healthcare provider(s). Responses from the 6 weeks and 3 months assessments were consistent with previous literature as many women indicated not coping as expected and were unprepared for the psychological consequences following the procedure. Our findings indicate that women in these situations may not realize what their long‐term support needs will be. They further indicate that guidelines for routine follow‐up care should be established among healthcare providers that respect this population's initial desires to avoid reminders of the pregnancy and promote a flexible timeframe for support uptake. Additional support resources that promote flexible uptake as well as meet the desires of anonymity and ease of access need to be developed for this population.

Termination of pregnancy for fetal anomalies: Parents' preferences for psychosocial care

“…Adjustments were made as necessary for the specific needs of the respondents in this study. These adjustments were derived from the international literature and from the clinical expertise of the researchers.…”

“…A more recent study demonstrated high levels of grief in women up to 6 months following a TOP for a fetal anomaly despite the use of adaptive coping strategies . Ramdaney et al found that at 6 weeks and 3 months after TOP, many women reported that they were not coping as well as they had anticipated. They were unaware in advance of what psychosocial support they would like to receive and felt unprepared for the psychological consequences of the TOP.…”

“…In one study, only half of a group of women who were aware of available psychosocial care (PSC) resources reported that they had contemplated their individual need for support. The other half did not anticipate any need for care and rejected this provision both during and after TOP . Lafarge et al conclude that coordinated care pathways are needed to enable women to make their own decisions regarding supportive care …”

“…Post‐TOP psychosocial support is perceived as not well organised . A study by Ramdeney et al indicated that women may not realise what their long‐term support needs will be.…”

“…Post‐TOP psychosocial support is perceived as not well organised . A study by Ramdeney et al indicated that women may not realise what their long‐term support needs will be. A suggestion has been made for the establishment of guidelines for follow‐up care in a flexible timeframe that takes into account the target population's initial decision to decline offered support …”