Grief after second-trimester termination for fetal anomaly: a qualitative study.

MedStar author(s):
Citation: Contraception. 91(3):234-9, 2015 Mar.PMID: 25499590Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and GynecologyForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, N.I.H., ExtramuralSubject headings: *Abortion, Eugenic/px [Psychology] | *Grief | *Guilt | *Pregnancy Trimester, Second/px [Psychology] | Abortion, Eugenic/mt [Methods] | Adaptation, Psychological | Adult | Female | Humans | Interviews as Topic | Longitudinal Studies | Pregnancy | Qualitative Research | Social Isolation/px [Psychology] | Social Stigma | Social Support | TimeLocal holdings: Available online from MWHC library: 1995 - presentISSN:
  • 0010-7824
Name of journal: ContraceptionAbstract: CONCLUSIONS: Pregnancy termination in this context is experienced as a significant loss similar to other types of pregnancy loss and is also associated with real and perceived stigma. Women choosing termination for fetal anomalies may benefit from tailored counseling that includes dispelling misconceptions about cause of the anomaly. In addition, efforts to decrease abortion stigma and increase social support may improve women's experiences and lessen their grief response.IMPLICATIONS: The nature and course of grief after second-trimester termination for fetal anomaly are, as of yet, poorly understood. With improved understanding of how women grieve over time, clinicians can better recognize the significance of their patients' suffering and offer tools to direct their grief toward positive coping.Copyright � 2015 Elsevier Inc. All rights reserved.OBJECTIVES: We aimed to qualitatively evaluate factors that contribute to and alleviate grief associated with termination of a pregnancy for a fetal anomaly and how that grief changes over time.RESULTS: Of the 19 women in the overall study, 13 women's interviews were eligible for analysis of the grief experience. Eleven women completed all three interviews, and two completed only the first interview. Themes that contributed to grief include self-blame for the diagnosis, guilt around the termination decision, social isolation related to discomfort with abortion and grief triggered by reminders of pregnancy. Social support and time are mechanisms that serve to alleviate grief.STUDY DESIGN: We conducted a longitudinal qualitative study of decision satisfaction, grief and coping among women undergoing termination (dilation and evacuation or induction termination) for fetal anomalies and other complications. We conducted three post-procedure interviews at 1-3 weeks, 3 months and 1 year. We used a generative thematic approach to analyze themes related to grief using NVivo software program.All authors: Dalton VK, Kerns JL, Kuppermann M, Light A, Maguire M, Steinauer JEDigital Object Identifier: Date added to catalog: 2016-01-13
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 25499590

Available online from MWHC library: 1995 - present

CONCLUSIONS: Pregnancy termination in this context is experienced as a significant loss similar to other types of pregnancy loss and is also associated with real and perceived stigma. Women choosing termination for fetal anomalies may benefit from tailored counseling that includes dispelling misconceptions about cause of the anomaly. In addition, efforts to decrease abortion stigma and increase social support may improve women's experiences and lessen their grief response.

IMPLICATIONS: The nature and course of grief after second-trimester termination for fetal anomaly are, as of yet, poorly understood. With improved understanding of how women grieve over time, clinicians can better recognize the significance of their patients' suffering and offer tools to direct their grief toward positive coping.Copyright � 2015 Elsevier Inc. All rights reserved.

OBJECTIVES: We aimed to qualitatively evaluate factors that contribute to and alleviate grief associated with termination of a pregnancy for a fetal anomaly and how that grief changes over time.

RESULTS: Of the 19 women in the overall study, 13 women's interviews were eligible for analysis of the grief experience. Eleven women completed all three interviews, and two completed only the first interview. Themes that contributed to grief include self-blame for the diagnosis, guilt around the termination decision, social isolation related to discomfort with abortion and grief triggered by reminders of pregnancy. Social support and time are mechanisms that serve to alleviate grief.

STUDY DESIGN: We conducted a longitudinal qualitative study of decision satisfaction, grief and coping among women undergoing termination (dilation and evacuation or induction termination) for fetal anomalies and other complications. We conducted three post-procedure interviews at 1-3 weeks, 3 months and 1 year. We used a generative thematic approach to analyze themes related to grief using NVivo software program.

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