Document Detail

What parents say about disclosing the end of their pregnancy due to fetal abnormality.
MedLine Citation:
PMID:  23026025     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: to describe men's and women's experiences of deciding whether to tell people in their social network, including their children, about their pregnancy loss following a termination for fetal abnormality.
DESIGN: secondary analysis of qualitative narrative interview data informed by a critical realist approach.
SETTING: respondents were recruited throughout the United Kingdom and interviewed at home between 2004 and 2005.
PARTICIPANTS: twenty-eight women and nine men who had ended a pregnancy diagnosed with a fetal abnormality and who talked about disclosing or not disclosing the termination to others.
FINDINGS: few respondents reported having any advice or information about whether or how to disclose their termination. None said they completely concealed their decision from adults in their social network; most said they disclosed selectively, telling close friends and family they had terminated and acquaintances they had miscarried. Most respondents reported telling their young children that the baby had died but did not reveal that they had chosen to end the pregnancy. A minority had not told their existing offspring about the pregnancy loss. Common reasons given for (partially) concealing a termination were: guilt over the decision; to avoid being judged; and to protect other people's feelings. Common reasons for disclosure were: others knew of the pregnancy; needing time off work; needing practical help and/or emotional support during diagnosis and termination; and wanting recognition of their loss. Positive consequences of disclosure were said to be getting more support and less criticism than expected; negative consequences included not getting the anticipated support and empathy; and encountering disapproval. Some respondents felt that concealing their pregnancy loss from their children had resulted in their confusion over the cause of their parents' distress. Some men said they found it hard to access emotional support from their social networks because of expectations about how men 'should' deal with emotions.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: midwives have to make difficult judgements about what, how and when to provide information when trying to support and advise parents who have ended a pregnancy due to fetal abnormality. Further education and training in this area could be of benefit. Midwives could signpost parents to existing sources of advice around disclosure, taking into account parents' individual preferences, help parents to consider the potential implications of disclosure and concealment and different ways of disclosing. They could also recommend alternative sources of emotional support, bearing in mind that men in particular may find it harder to access support from their social networks.
Emma F France; Kate Hunt; Sue Ziebland; Sally Wyke
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-09-29
Journal Detail:
Title:  Midwifery     Volume:  29     ISSN:  1532-3099     ISO Abbreviation:  Midwifery     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-21     Completed Date:  2013-12-31     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  8510930     Medline TA:  Midwifery     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  24-32     Citation Subset:  N    
Copyright Information:
Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.
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MeSH Terms
Abortion, Induced / psychology*
Congenital Abnormalities / psychology*,  surgery
Disclosure / ethics*
Fetal Diseases / psychology*,  surgery
Fetus / abnormalities,  surgery
Parents / psychology*
Professional-Patient Relations
Qualitative Research
Social Support
Stress, Psychological / etiology
Grant Support
MC_U130059811//Medical Research Council; //Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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