Marijke J. Korenromp

Adjustment to termination of pregnancy for fetal anomaly: a longitudinal study in women at 4, 8, and 16 months.

OBJECTIVE We studied psychological outcomes and predictors for adverse outcome in 147 women 4, 8, and 16 months after termination of pregnancy for fetal anomaly. STUDY DESIGN We conducted a longitudinal study with validated self-completed questionnaires. RESULTS Four months after termination 46% of women showed pathological levels of posttraumatic stress symptoms, decreasing to 20.5% after 16 months. As to depression, these figures were 28% and 13%, respectively. Late onset of problematic adaptation did not occur frequently. Outcome at 4 months was the most important predictor of persistent impaired psychological outcome. Other predictors were low self-efficacy, high level of doubt during decision making, lack of partner support, being religious, and advanced gestational age. Strong feelings of regret for the decision were mentioned by 2.7% of women. CONCLUSION Termination of pregnancy for fetal anomaly has significant psychological consequences for 20% of women up to > 1 year. Only few women mention feelings of regret.

Termination of pregnancy on genetic grounds; coping with grieving

This study describes reactions of couples to the termination of their pregnancies because of a fetal anomaly. Forty women and 31 men were interviewed twice after the termination, 6 weeks and 6 months, respectively. Factors found to be of influence on decision-making and coping include: whether the anomaly was found by chance or through directed search; whether or not the anomaly was compatible with life; how far the pregnancy had progressed, and by which method the pregnancy was terminated. The feelings these couples faced were in some ways comparable to those perceived after a stillbirth or neonatal death, but the authors also encountered other, entirely different feelings. The latter include guilt, doubt, failure, and feelings of moral and social pressure. Recommendations for clinical practice are given at the end of the paper.ZusammenfassungDie vorliegende Studie beschreibt die Reaktionen von Paaren auf den Abbruch einer Schwangerschaft aufgrund einer fotalen Anomalie. Vierzig Frauen und 31 Manner wurd...