The psychosocial sequelae of a second-trimester termination of pregnancy for fetal abnormality
White-van Mourik, M.C.; Connor, J.M.; Ferguson-Smith, M.A.
Prenatal Diagnosis 12(3): 189-204
1992
ISSN/ISBN: 0197-3851 PMID: 1589421 DOI: 10.1002/pd.1970120308Document Number: 575734
84, or 87% of all women from West Scotland who had second trimester termination of pregnancy for fetal abnormalities in 1986, and 68 spouses, participated in a study of psychosocial sequelae. A structured questionnaire was administered during a home visit 2 years after the termination. Gestations ranged from 12 to 27 weeks (median 19). The women's ages ranged from 17 to 46 years (median 27), that of their partners was 17-48 (median 29). Indications for the abortions were tabulated. Only 5% of the women were without partners. 15% were unemployed. 33% of the pregnancies were the couples' 1st. 76% of the abnormal pregnancies were directed by the West of Scotland Alpha-fetoprotein screening program. 72% of the pregnancies had been planned, 26% had been unplanned but were welcome, and only 2% of women were still ambivalent. 2 couples regretted their decision. At 2 years 20% of women were having crying spells, sadness, and irritability. Husbands reported listlessness, poor concentration, and irritability up to 1 year afterward. 12% of couples marital problems resulting in separation of 2% and 1 divorce. Physical symptoms such as palpitations and panic attacks were only reported by those under 25. 1 woman and 1 man required in-patient treatment; 11 women received counseling; 5 took anti depressants. 3 men had counseling and 3 took antidepressants. A majority of men reported confusing and conflicting reactions to their wives' feelings which may have led to social isolation and lack of communication. 55% of the women and 58% of the men said they had not discussed their feelings with anyone. There were no specific psychological sequelae linked to specific fetal abnormalities or religious beliefs. Immaturity, inability to communicate needs, low self-esteem, lack of social support, and secondary infertility all were associated with dysfunctional grieving. It was concluded that such grief and emotional turmoil could be shortened by skilled preparatory counseling.
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