Termination for medical reasons: Difference between revisions
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== Psychosocial considerations == |
== Psychosocial considerations == |
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Pregnancy termination is a stressful experience. In TFMR, the concept of "choice" does not accurately capture the true complexities of deciding to end a wanted pregnancy. Approximately 72% of parents undergoing TFMR felt that that their experience was not the same as other types of baby loss, and that they do not always feel they "fit in" with other types of baby loss support groups because of their specific experience.<ref name="tommys.org">{{Cite web |title=A spotlight on Termination for Medical Reasons (TFMR) {{!}} Tommy's |url=https://www.tommys.org/spotlight-termination-medical-reasons-tfmr |access-date=26 April 2022 |website=www.tommys.org |language=en}}</ref> |
Pregnancy termination is a stressful experience. In some respects, the aftermath of TFMR is similar to any other type of unwanted [[pregnancy loss]], including the need to grieve the lost child.<ref name=":2">{{Cite book |last=Henn |first=Fritz |url=https://books.google.co.in/books?id=Lur1CAAAQBAJ&newbks=0&printsec=frontcover&pg=RA2-PA196&dq=%22termination+for+medical+reasons%22&hl=en&redir_esc=y |title=Contemporary Psychiatry |last2=Sartorius |first2=Norman |last3=Helmchen |first3=Hanfried |last4=Lauter |first4=Hans |date=2013-11-11 |publisher=Springer Science & Business Media |isbn=978-3-642-59519-6 |pages=196 |language=en}}</ref> Parents commonly experience distress, [[Depression (mood)|depression]], and [[Guilt (emotion)|guilt]] for several months afterwards, or even longer.<ref>{{Cite book |last=Geddes |first=John |url=https://books.google.co.in/books?id=jyFoAgAAQBAJ&newbks=0&printsec=frontcover&pg=PA215&dq=%22termination+of+pregnancy+for+medical+reasons+is+especially+likely+to+cause+distress%22&hl=en&redir_esc=y |title=Psychiatry |last2=Price |first2=Jonathan |last3=McKnight |first3=Rebecca |date=2012-01-05 |publisher=OUP Oxford |isbn=978-0-19-100301-1 |pages=215 |language=en}}</ref><ref name=":2" /> In TFMR, the concept of abortion as a "choice" does not accurately capture the true complexities of deciding to end a wanted pregnancy. Approximately 72% of parents undergoing TFMR felt that that their experience was not the same as other types of baby loss, and that they do not always feel they "fit in" with other types of baby loss support groups because of their specific experience.<ref name="tommys.org">{{Cite web |title=A spotlight on Termination for Medical Reasons (TFMR) {{!}} Tommy's |url=https://www.tommys.org/spotlight-termination-medical-reasons-tfmr |access-date=26 April 2022 |website=www.tommys.org |language=en}}</ref> |
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A number of factors may influence the decision to terminate. Some common reasons are medical, such as the severity of the condition, the life expectancy and quality of life for the affected person, and available treatment options for the condition. Other common reasons are non-medical, such as personal values and beliefs, financial and employment considerations, the general family situation, including other children, and the availability of social support. |
A number of factors may influence the decision to terminate. Some common reasons are medical, such as the severity of the condition, the life expectancy and quality of life for the affected person, and available treatment options for the condition. Other common reasons are non-medical, such as personal values and beliefs, financial and employment considerations, the general family situation, including other children, and the availability of social support. |
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Revision as of 22:01, 4 May 2022
 | This article contains instructions, advice, or how-to content. (May 2022) |
 | This article is written like a personal reflection, personal essay, or argumentative essay that states a Wikipedia editor's personal feelings or presents an original argument about a topic. (May 2022) |
A termination for medical reasons (TFMR) is an induced abortion motivated by medical indications involving the fetus or mother.[1] In most countries, health risks are the only basis for obtaining a legal abortion.[2] Prenatal screening can allow early diagnosis, and abortion if desired or necessary.[3] The American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine (SMFM) advocate the offer of screening by chorionic villi sampling, and amniocentesis to all pregnant woman, as a matter of course.[3]
Given the information from screening can present women with many problems around choosing or not to abort. Responses may involve feelings of guilt, and may even lead to developing post-traumatic stress disorder.[2] TFMR is one of the least talked about types of pregnancy loss, but is more common than thought to be.[4] It is stressful, and the involved people need support during the pregnancy and after its termination.[5]
A number of factors may influence a person's decision to terminate the pregnancy, including the severity of a condition, and its impact on life expectancy and quality of life.
Prenatal testing
During prenatal care if a pregnancy is considered to be at high risk for a genetic disorder, prenatal testing can be undertaken to determine the health of the embryo or fetus. Two such diagnostic tests are chorionic villus sampling (CVS) or amniocentesis.[citation needed]
Legal considerations
Individual states and countries vary on their restrictions for termination of pregnancy.
In the UK, abortions after 24 weeks' gestational age are only legal to protect the mother's physical or mental health, or if the fetus is "seriously handicapped" due to "physical or mental abnormalities".[6]
TMRF has been legal since 1927 in Germany.[7] In 1975, West German abortion law changed to permit abortions at any time if there was a serious danger to the mother's health and in case of fetal abnormalities through 22 weeks, in addition to permitting some abortions for non-medical reasons before 12 weeks.[7] The law changed again during German reunification. In 2013, 4% of legal abortions in Germany were due to either medical reasons or because the pregnancy was the result of a crime, and 96% were for personal or social reasons.[7]
Psychosocial considerations
Pregnancy termination is a stressful experience. In some respects, the aftermath of TFMR is similar to any other type of unwanted pregnancy loss, including the need to grieve the lost child.[8] Parents commonly experience distress, depression, and guilt for several months afterwards, or even longer.[9][8] In TFMR, the concept of abortion as a "choice" does not accurately capture the true complexities of deciding to end a wanted pregnancy. Approximately 72% of parents undergoing TFMR felt that that their experience was not the same as other types of baby loss, and that they do not always feel they "fit in" with other types of baby loss support groups because of their specific experience.[10]
A number of factors may influence the decision to terminate. Some common reasons are medical, such as the severity of the condition, the life expectancy and quality of life for the affected person, and available treatment options for the condition. Other common reasons are non-medical, such as personal values and beliefs, financial and employment considerations, the general family situation, including other children, and the availability of social support.
Support
Ask for support from friends, family, and medical personnel. When speaking with your healthcare provider, ask for resources to be provided in writing, as often times verbal information may be difficult to take in and remember during times of high stress. Parents undergoing TFMR often need practical information regarding what to expect before, during, and after their medical procedure such as what to bring to the hospital, what their delivery involves, how their bodies will react afterward, as well as ways to say goodbye or otherwise commemorate their child.[10]
Speaking with a clinical psychologist, health psychologist, or other mental health professional may help you through the grieving process. Often, you may find a provider who has special training in anxiety, grief/loss, life transitions, trauma, and perinatal distress, and professional experience working with and supporting women, birthing parents, and families during pregnancy and the postpartum period. It is not uncommon for individuals facing a TFMR decision to experience feelings of guilt, sadness, and isolation.[citation needed]
When involved in psychotherapy for TFMR, the process may often include cognitive and behavioral approaches aimed at improving thoughts, feelings, and behaviors, to include positive coping strategies. According to Zareba et al. (2018), coping strategies most frequently mentioned in literature are: conversation (with the partner, family, friends, psychologist, physician), internalization of one's feelings, participation in support groups, psychotherapy, seeking information (in the literature, on the Internet, on television), denial and repression, concentrating on one's children, trying to conceive again quickly, seeking spiritual support, waiting, memorializing rituals, going on vacation or holiday with the partner or family.[11]
Compassion and sensitivity are especially important, as those who have had or are considering TFMR can often feel judged. Work on communicating with respect, being considerate and kind, and offering tangible and emotional support.[5]
References
- ^ "The Pink Elephants Support Network - Diagnostic Testing". The Pink Elephants Support Network. Retrieved 26 April 2022.
- ^ a b González-Ramos, Z; Zuriguel-Pérez, E; Albacar-Riobóo, N; Casadó-Marín, L (December 2021). "The emotional responses of women when terminating a pregnancy for medical reasons: A scoping review". Midwifery. 103: 103095. doi:10.1016/j.midw.2021.103095. PMID 34320417.
- ^ a b Grossman, TB; Chasen, ST (January 2020). "Abortion for Fetal Genetic Abnormalities: Type of Abnormality and Gestational Age at Diagnosis". AJP reports. 10 (1): e87–e92. doi:10.1055/s-0040-1705173. PMID 32190411.
- ^ "Break the silence around TFMR". Antenatal Results and Choices (ARC). Retrieved 26 April 2022.
- ^ a b "TFMR survey". Antenatal Results and Choices (ARC). Retrieved 26 April 2022.
- ^ Gordon, Olivia (13 June 2019). The First Breath: How Modern Medicine Saves the Most Fragile Lives. Pan Macmillan. ISBN 978-1-5098-7121-6.
- ^ a b c Lewis, Derek; Zitzlsperger, Ulrike (18 October 2016). Historical Dictionary of Contemporary Germany. Rowman & Littlefield. ISBN 978-1-4422-6957-6.
- ^ a b Henn, Fritz; Sartorius, Norman; Helmchen, Hanfried; Lauter, Hans (11 November 2013). Contemporary Psychiatry. Springer Science & Business Media. p. 196. ISBN 978-3-642-59519-6.
- ^ Geddes, John; Price, Jonathan; McKnight, Rebecca (5 January 2012). Psychiatry. OUP Oxford. p. 215. ISBN 978-0-19-100301-1.
- ^ a b "A spotlight on Termination for Medical Reasons (TFMR) | Tommy's". www.tommys.org. Retrieved 26 April 2022.
- ^ Zaręba, Kornelia; Makara-Studzińska, Marta; Ciebiera, Michał; Gierus, Jacek; Jakiel, Grzegorz (December 2018). "Role of Social and Informational Support while Deciding on Pregnancy Termination for Medical Reasons". International Journal of Environmental Research and Public Health. 15 (12): 2854. doi:10.3390/ijerph15122854. ISSN 1660-4601.
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