Ending a pregnancy for fetal abnormality

Ending the pregnancy by induction

The physical and emotional demands of ending a pregnancy, which ever method was used, were usually intense and unforgettable - even for women who had gone through childbirth before. Though several women said they preferred to go through labour and delivery because it preserved the baby's dignity, other couples were shocked to discover they could not have the baby removed surgically or by caesarean section. (See also 'Finding out how the pregnancy will end'.)

Women who are more than 12 or 13 weeks' pregnant are likely to be artificially induced so that they go through labour and deliver the baby vaginally. When women felt supported by medical staff - that is when they were prepared for what was likely to happen, when they were looked after by skilful and experienced staff, and when they had already thought about what they wanted to happen to the baby afterwards - they were more likely to feel they coped well with a difficult and traumatic experience.  

Induction means that women will be being given a pill (usually mifepristone) which will begin to soften the cervix over a two day period. Some women found it difficult to swallow the pills because they marked the final point of the pregnancy and there was 'no turning back'. 

Some women found the delay between taking mifepristone and going into labour was unsettling and 'surreal' because having taken the pills they were then sent home to wait for labour to begin. Most women couldn't stop thinking about the baby and wondering if s/he was still alive. They felt they didn't know how the pill affected the baby.

Few women knew the name of the pill they were given or understood exactly what it was for. Most were told the pills 'prepared the body for labour' but interpreted this information differently - some thought the pills softened the cervix, others that the pills stopped the baby's heart beating. Several said that mifepristone changed their hormone balance. Mifepristone is a hormone and “It works by blocking the effects of the hormone progesterone” which is needed to maintain a pregnancy (NHS Choices August 2016).

Some people may experience heavy bleeding after an induction to end the pregnancy because part of the placenta had been left behind in the womb. This usually means returning to hospital or staying in the hospital for more treatment - usually D & Cs – and this can add to the distress a women may be feeling.

Injecting the baby and inducing the delivery

Women expecting a baby whose anomalies were discovered at the 18-20 week scan or later and have reached 21 weeks 6 days or more will be offered an injection to end the baby's life before induction and labour begins. The injection (known medically as feticide) stops the baby's heartbeat and means s/he will not be born alive. Some women were sent home for two days after the injection and returned to hospital for labour and delivery. One woman said that her body changed afterwards and that her stomach seemed 'flat and sunken'. Another woman who wanted her baby to be born alive so that s/he could die in her arms refused the offer of an injection and decided to be induced.  

For some parents, the thought of a 'lethal injection' going into the baby was almost unbearable, however several others compared the feticide procedure with having an amniocentesis. Most women acknowledged that the procedure was handled with as much professionalism and sensitivity as possible by doctors and other healthcare professionals, but said that no matter how well they were treated they were still deeply upset by the experience. 

Some health professionals used the word 'feticide' in their explanations which some women found upsetting because the word made them think of 'homicide' or 'infanticide'. Some felt that feticide was too brutal or cruel a word and was inappropriate in their case. Most parents knew of the word or had read it on consent forms, but several used the word 'injection' instead.

When the injection took place - usually in a specialist fetal medicine centre - women valued being in a quiet, darkened room and appreciated it when doctors didn't try to talk to them. A woman who had gone through a selective termination of one of her twin babies, described how crowded the room had seemed at the time and how difficult it had been to cope with other people watching her at such a difficult time.

People generally preferred not to say much about how they thought the injection worked. Several wondered if it hurt the baby. Understandably most parents found the procedure extremely upsetting however skilfully and sympathetically they were cared for. They also recognised that it must be a difficult job for doctors, but couldn't think of any way to make it better.

Consultant obstetricians have different ways of carrying out the procedure - some inject the baby's heart, others inject the umbilical cord where there are no nerve endings. Also some consultants sedate the woman before injecting her and ask partners to leave the room - but in other hospitals partners were permitted to stay in the room and women were not sedated before the injection.

Last reviewed July 2017.
Last updated June 2014.

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