Antenatal Screening

The experience of ending a pregnancy

Many medical, practical and emotional issues are involved in ending a pregnancy, and Healthtalk has produced a website devoted specifically to this topic 'Ending a pregnancy for fetal abnormality'.

Here we discuss key concerns for women and their partners.

People's experience of ending a pregnancy is affected by many factors, including how well informed they are about what will happen, what kind of care and support they are offered, and how confident they feel in the decision they have taken.

Of course, even if parents are convinced this is the right thing for them to do, they will be grieving for the loss of their baby. As one mother said, “I thought it would be losing a pregnancy, and it was losing a baby. And I didn't know it was going to be like that” 

Many people said how they valued non-judgmental emotional support from staff, who must find this a difficult job.

On the other hand, one woman contrasted care after a miscarriage with less sympathetic care during her termination.

The Royal College of Obstetricians and Gynaecologists (RCOG) have produced a report on ‘Termination of Pregnancy for Fetal Abnormality in England, Scotland and Wales’ (May 2010). Within it are a number of recommendations. One of these is that staff should adopt a non-judgemental and supportive approach. 

Most NHS hospitals can only offer a surgical termination under general anaesthetic until 13 weeks of pregnancy. After this point, labour is usually induced so that the woman gives birth vaginally. Many women had not fully realised they would be giving birth, and some wondered whether they could have chosen a surgical procedure instead.

Most felt glad afterwards, however, to have given birth. Reasons included being able to see and hold the baby, having mementoes such as hand and footprints and photographs, and having a grave to visit afterwards. (See also 'Feelings and reflections afterwards').

One woman chose a surgical termination because she did not want to become too attached to the baby. Even so, she was upset that no-one at the hospital seemed to acknowledge her distress. This woman and others felt that comments such as 'it will all be over soon' were insensitive.

Before admission for induced labour, the mother will usually be given mifepristone tablets, which prepare the cervix and block the action of progesterone, to make the induction easier. For many people we talked to, taking these tablets was a big step, and some were uncertain exactly what the effect of the tablets was.

As this couple described, the wait between taking the tablets and admission to hospital could be a difficult time, but one woman described how it became a positive time for her and her partner. Her family came with her to the hospital for the birth, and staff supported them in making it as positive and peaceful an occasion as possible.

In the later stages of pregnancy the baby may be given an injection so that the baby dies before the induction (known medically as 'feticide'). One couple would have preferred this. Another woman whose baby had this injection found it less traumatic than she feared, but still very upsetting.

Not knowing what to expect during the termination or how long it would take made some people feel very anxious. One woman almost did not take her husband with her because she did not realise what it would be like, until she talked to another woman who had been through the experience. Another women said she had had a good description of what to expect.

Some women were cared for by midwives in a maternity department, while others had nursing-led care in a gynaecology department. Views were divided about which was preferable, depending on how sympathetically parents felt they had been treated.

Some thought midwives were better equipped to give support with labour and pain relief, while others felt nurses, who do not usually deal with birth and healthy babies, could more easily be non-judgemental. One woman described mixed attitudes from different doctors, as well as from midwives and nurses.

Being around other pregnant women could be difficult, and some people were upset by having to go to the main maternity reception. Many hospitals set aside a special room for people ending a pregnancy or expecting a stillbirth. Most parents valued this, as part of a supportive experience for both mother and father (see Interview 36 above).

Some women felt their partners had not been so well involved, and one woman said her husband was treated almost as a 'bystander', there to support his wife but not himself in need of support. Another couple arrived at the hospital at the agreed time but then frustratingly had to wait for someone to come and start the process.

Pain and pain relief was a common concern. Particularly in a first pregnancy, people had no experience of birth and had not yet learnt about pain relief in antenatal classes, so support and explanation from staff was vital (see Interview 31, Interview 32, Interview 17 above ).

In addition to the usual types of pain relief, morphine may be offered. Some people found this a real help, but others found it made them feel disorientated or ill.

Immediate reactions after birth and longer term reflections on the experience are discussed in the 'Feelings and reflections afterwards'.

Last reviewed July 2017.
Last updated July 2017.


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