Trauma and grief 2–7 years after termination of pregnancy because of fetal anomalies – a pilot study

Abstract

The aim of the study was to obtain information on the long-term posttraumatic stress response and grief several years after termination of pregnancy due to fetal malformation. We investigated 83 women who had undergone termination of pregnancy between 1995 and 1999 and compared them with 60 women 14 days after termination of pregnancy and 65 women after the spontaneous delivery of a full-term healthy child. Women 2-7 years after termination of pregnancy were expected to show a significantly lower degree of traumatic experience and grief than women 14 days after termination of pregnancy. Contrary to the hypothesis, however, the results showed no significant intergroup differences with respect to the degree of traumatic experience. With the exception of one subscale (fear of loss), this also applied to the grief reported by the women. However, both groups differed significantly in their posttraumatic stress response from women who had given spontaneous birth to a full-term healthy child. The results indicate that termination of pregnancy is to be seen as an emotionally traumatic major life event which leads to severe posttraumatic stress response and intense grief reactions that are still detectable some years later.

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

“…Several studies report that overall psychological distress may not decrease in the first few years after the event while others imply that the psychological distress does decrease within this time frame (Salveson et al, 1997;Kersting et al, 2005;. In a longitudinal study by Korenromp et al (2009) that started at four months following the termination procedure, it was determined that poor psychological response at that initial timepoint was the most important predictor of the long-term outcome.…”

Termination of pregnancy for fetal abnormality: a meta-ethnography of women’s experiences

“…Research indicates that terminating a pregnancy for fetal abnormality is a complex decision, 3 which can have long-term psychological consequences such as depression, post-traumatic stress and complicated grief for women and their partners. [4][5][6][7][8][9] Grief reactions following this event have been likened to those experienced in other types of perinatal loss such as stillbirth or neonatal death. [10][11][12] Nevertheless, termination for fetal abnormality is distinct in that parents choose to end the pregnancy.…”

Abortion and Mental Health: Evaluating the Evidence

“…Women's levels of negative psychological experiences subsequent to a second-trimester abortion of a wanted pregnancy for fetal anomalies were not different from those of women who experienced a second-trimester miscarriage (Iles & Gath, 1993) or perinatal loss (Salveson et al, 1997;Zeanah et al, 1993). As might be expected, their levels of distress were higher than those of women who delivered a healthy child (Kersting et al, 2005;Rona et al, 1998).…”

“…All were based on non-U.S. samples: Germany (Kersting et al, 2005;Lorenzen & Holzgreve 1995), Norway (Salvesen, Oyen, Schmidt, Malt, & Eik-Nes, 1997), and the United Kingdom (Iles & Gath, 1993;Rona, Smeeton, Beech, Barnett, & Sharland, 1998). We also identified one U.S. study that examined psychological experiences among women who terminated an initially wanted pregnancy because of fetal anomaly, but the study did not include a contrast group (Zeanah, Dailey, Rosenblatt, & Saller, 1993).…”