Developing Patient Information for Women and Their Whanau Choosing to Electively End Their Second-Trimester Pregnancy Because of Foetal Abnormality
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Medical terminations in the first trimester of pregnancy are one of the most commonly performed medical procedures undertaken in New Zealand. It is, however, far less common to electively end a pregnancy in the second trimester on the grounds of foetal abnormality. New Zealand data obtained in 2018 suggests that 238 women chose to electively end their pregnancy because of foetal abnormality. The diagnosis of a foetal abnormality presents the parents with a difficult and often traumatic decision ... to proceed with the pregnancy and give birth to a child with known disabilities, or to electively end the life of the foetus by terminating the pregnancy. When faced with a diagnosis of severe foetal abnormality, most women choose to electively end the pregnancy. A review of the current literature suggests that the incidence of medical terminations of pregnancy for foetal abnormality is increasing. This is thought to relate to advancing maternal age, the increased availability of antenatal screening, and the advances in diagnostic testing. Medical termination of pregnancy for foetal abnormality was considered a major life event for most women. The psychological consequences of making this decision came with a range of emotional consequences including (but not limited to) grief, sadness, doubt, anger, and regret. Research showed that written information given to women making this decision was considered inappropriate, did not support their emotional requirements, and failed to prepare them for the ordeal ahead. Providing sensitive and relevant patient literature can improve their psychological well-being, reduce the impact of their decision and improve their journey. Scrutiny of local literature revealed it to be inadequate, unsuitable, and insensitive. This quality improvement project aimed to develop a sensitive, informative, and supportive pamphlet to support women and their families/whanau through the labour and delivery of their pregnancy. The psychological consequences of choosing to end a wanted pregnancy because of foetal abnormality require specific regard to the development of a patient-centered resource to support women and their families/whanau as they navigate this difficult and isolating event in their lives.