Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study

Abstract

Aim To determine and describe the experiences of pregnant women who receive a diagnosis of chromosomopathy and/or foetal malformation during a prenatal check‐up and who decide to legally terminate the pregnancy. Background When a pregnancy is terminated, the woman must cope with frustrated motherhood. The psychological consequences of this will largely depend on the care and support provided by health professionals. When a congenital anomaly is diagnosed, a patient‐centred communication helps understanding, influences adaptation to the new situation and ensures the person concerned has sufficient (autonomy or independence or ability) to make appropriate decisions. Methods A qualitative study, based on a phenomenological approach, was carried out through nonparticipant observation and semi‐structured interviews with 27 obstetric patients. NVivo 11 software was used, and content analysis was performed. The manuscript was developed using the COREQ guidelines to inform qualitative studies. Results The clinical relationship may be affected by communication problems such as patients' perceptions of scarce emotional involvement by obstetricians, by poor psychosocial support during the termination of the pregnancy and by insufficient follow‐up after discharge. Conclusion Nurses are in a privileged position to promote the empowerment of affected women. It is necessary to improve aspects related to the privacy of patients and the awareness and training of the interdisciplinary team in interpersonal communication. Post‐loss follow‐up is recommended to assess individual needs, thus facilitating an optimal approach to ease the grieving process. Relevance to clinical practice During the prenatal diagnosis, the existence of a fetal anomaly is emphasized, but support and follow up of the mother may be neglected; therefore, exhaustive knowledge about the obstetric history, the state of health and the expectations of patients is as important as a multidisciplinary team trained in counseling strategies and with a comprehensive care plan that covers all areas, especially those that control maternal emotions.

Men’s experiences and need for targeted support after termination of pregnancy for foetal anomaly: A qualitative study

“…The emotional impact of loss and grief men described in response to TOPFA was not dissimilar to women's descriptions in previous studies (Asplin et al, 2014; Atienza‐Carrasco et al, 2019). However, men face‐specific challenges, particularly regarding healthcare, support and follow‐up.…”

“…However, while there is a sizable body of research and recommendations relating to women's experiences of grief and support needs (e.g. Asplin et al, 2014; Atienza‐Carrasco et al, 2019; Irani et al, 2019; Pitt et al, 2016), as well as a growing body of research focusing on men's experiences of grief and care following miscarriage and stillbirth (e.g. Bonnette & Broom, 2012; Miller et al, 2019; Obst & Due, 2019a), there are few studies specifically on men's experiences of TOPFA, particularly in the Australian context (Hodgson et al, 2016).…”

‘My biggest fear is that people will forget about him’: Mothers' emotional transitions after terminating their pregnancy for medical reasons

“…The available evidence shows that the most prevalent emotions during the process are emotional distress, anxiety, depression and shock (Akdag Topal & Terzioglu, 2019; Aktürk & Erci, 2019; Atienza‐Carrasco et al, 2020; Carlsson et al, 2016; Guy, 2018; Irani et al, 2019; Ramdaney et al, 2015; Ridaura et al, 2017; Rocha et al, 2018; Sun et al, 2018), as well as grief and bereavement (Irani et al, 2019; Qin et al, 2018; Ramdaney et al, 2015; Ridaura et al, 2017; Sriarporn et al, 2017).…”

Current Status of Genetic Counselling for Rare Diseases in Spain

“…Thus, as methodology and genetic information become more complex and options in the reproductive field are increasing, other professionals, such as biologists, embryologists, clinical geneticists, genetic counsellors, and clinical laboratory geneticists need also to be involved from a clinical care perspective. For example, regarding foetal anomalies that eventually led to pregnancy termination, a recent study evaluated the importance of providing personalized counselling and support facilitating the grieving process [ 48 ] and in this case, it was a duty of obstetric-gynaecologic nurses, mainly.…”