Ending a pregnancy for fetal abnormality

Finding out how the pregnancy will end

Understanding the details of how and when to end the pregnancy can be as difficult and upsetting for people as accepting that the baby has a serious abnormality. Many women said that they had never thought about how the baby would be born, and people had different views about how much detail they wanted to hear at such a traumatic time. 

There are several options for women depending how far the pregnancy has progressed. Up until around 13 weeks most NHS hospitals can offer surgical terminations of pregnancy (see 'Ending the pregnancy surgically'). Later in pregnancy women in NHS hospitals will most often have to go through labour to deliver the baby. (see 'Ending the pregnancy by induction').

Unless they had given birth before, most women were shocked to discover they had to go through an induced labour and normal (vaginal) birth. Most had expected to have a D & E (dilatation and evacuation) or Caesarean section. Several women said that their partners had been shocked and angry when they found out about the process of termination - and one man said he had expected doctors 'could just magically whisk it out somehow'. 

The kind of questions women felt had been left unanswered by health professionals were details about what they should expect during labour and birth, at what point the baby died, and what effect the medication they were given to induce labour would have on the baby. Several women said they had only thought about difficult questions after the termination, others had not wanted to voice them at the time. However a few people said that being given too many details about procedures had upset them. 

Some women said that health professionals had been supportive and willing to talk to them about labour and birth - one woman chose to have a normal delivery though she could have opted for surgical termination - and another woman definitely wanted to have a surgical termination even though she suspected she had been almost beyond the limit permitted at her hospital. Other women said they had not been told very much by hospital staff and had received nothing to take home and read before the termination took place.

Some expressed the view that once they had decided to end the pregnancy, health professionals had rushed them to 'get on with it'. Several people said they needed more time to think about what they wanted. 

Many women had been given a booklet written by ARC (Antenatal Results and Choices) which was highly recommended because it explained all the various procedures and described the kinds of things that might happen during and after the termination. Others who had not been given the ARC booklet or any other written information about termination procedures afterwards said that hospitals should provide the booklet as a matter of course. 

Several women whose babies were unlikely to survive birth, said that health professionals had mentioned the possibility of carrying the pregnancy to term and 'letting nature take its course' without medical intervention. Everyone who had considered this as an option felt it would be more upsetting to lose a baby having carried him/her to term, than it was to end the pregnancy earlier.  

Several women talked about how a medical, as opposed to a surgical termination, kept the baby's body intact and also his/her 'dignity'. Some women felt that going through labour pain was a small price to pay for the baby, and one woman said that in her opinion the termination was in effect a premature birth.

Some were confused about what would happen if a baby more than 24 weeks gestation was born alive and whether health professionals would have to resuscitate the baby and give him/her medical treatment.

See also 'the impact of the decision'.
Last reviewed June 2014.
L
ast updated June 2014.

  

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