Psychological trajectories of Chinese women undergoing pregnancy termination for foetal abnormality: A descriptive qualitative study using expressive writing

Abstract

Aims and objectives To explore the psychological trajectories of women who have had a diagnosis of foetal abnormality from the time of receiving a definite diagnosis to one month after discharge. Background Foetal abnormalities are not uncommon worldwide. Such situations are devastating, and the termination of a pregnancy due to foetal abnormalities is a traumatic and stressful event for the mother. Design A descriptive qualitative approach using expressive writing. Methods The study included 20 women recruited through purposive sampling at a tertiary hospital in China. The participants were asked to write four 15‐min essays related to their experiences with foetal abnormalities. Thematic analysis was used to generate themes. The COREQ checklist (see Supporting Information Appendix S1) was used. Results Four themes that reflected the women's psychological trajectories were identified: (a) traumatic response, (b) ruminant meditation, (c) positive coping and (d) post‐traumatic growth stages. The psychological trajectories were dynamically shaped, and different responses were displayed in each stage. Conclusions Various responses were observed during each of the four psychological trajectories, which indicated that awareness regarding the psychological impacts associated with foetal abnormalities should be increased. The present findings suggest that healthcare services should be made accessible for women who have had a diagnosis of foetal abnormality to allow them to receive targeted nursing care at different stages and improve their psychological well‐being. Relevance to clinical practice Midwives, nurses and other healthcare professionals should pay more attention to the mental health of women pregnant with foetuses diagnosed with abnormalities. Interventions designed based on women's worries and demands during various phases should be offered. In terms of the present research method, expressive writing possesses unique advantages that can be applied for relevant qualitative research.

Exploring interactions between women who have experienced pregnancy loss and obstetric nursing staff: a descriptive qualitative study in China

“…In contrast, task-based communication, disrespectful words, neglecting women’s needs and delayed responses may lead to undesirable interactions and even conflicts, which should be avoided. The emphasis on women’s needs varied in different stages [ 14 , 48 ]. Therefore, prompt feedback and targeted care should be given to women based on their needs and psychological responses.…”

“…Stillbirth is related with a number of negative psychological symptoms including social phobia, agoraphobia, anger, a sense of failure and long-term guilt [ 11 ]. The discovery of a foetal abnormality is a shock for pregnant women and they may have psychological responses including denial of reality, reaction avoidance and self-punishing thinking [ 14 ]. In addition, the experiences of pregnancy loss may not only lead to negative psychological issues but also generate positive psychological changes.…”

“…Positive psychological experiences included new life attitude, feelings of gratitude and so on [ 15 ]. Women undergoing pregnancy termination for foetal abnormality described feelings of unprecedented ease and relief of the body and mind after induced abortion [ 14 ].…”

“…Previous qualitative studies merely focused on women’s or healthcare providers’ broad emotional experiences [ 33 – 35 ]. Little attention has been given to the interaction process from both the perspectives of women and the nursing staff to comprehensively reflect the interaction issues and influencing factors in the context of pregnancy loss.…”

Nonpharmacological pain management interventions in medical and surgical abortion: A scoping review

“…Psychological pain, complicated grief, anxiety and depression are closely associated with abortion (Akdag & Terzioglu, 2019; Kulathilaka et al, 2016). Women report fear of pain and anxiety pertaining to the procedure (Qian et al, 2020; Wilson et al, 2017). The psychological distress of women leads to a higher demand for pain management and adequate support in abortion (Georgsson & Carlsson, 2019).…”