The dilemmas of pregnant women diagnosed with lethal fetal malformation

Abstract

This study aimed to understand the factors that influenced the decision of pregnant women diagnosed with a fetal malformation incompatible with postnatal life, to either maintain or terminate the pregnancy, as well as to assess the emotional impact of this experience. This qualitative study was conducted with 11 pregnant women at a benchmark public service on fetal medicine. Interviews were carried out to collect sociodemographic and clinical data and trigger questions were audio-recorded. The narratives were analyzed, and categories emerged from them, illustrated by excerpts from the interviews. Waiting for a miracle, the perception of motherhood and values against termination influenced the choice to keep the pregnancy. The lack of hope of having a living child, the belief that termination would bring relief from suffering and the legal right to abortion influenced the choice to terminate. Regardless of the decision, the women’s perplexity at the diagnosis, as well as feelings of guilt, anguish and sadness stand out. Because this type of grief is still rarely acknowledged, it is crucial for healthcare teams to implement humanized and technically competent approaches that support women’s decisionmaking processes, uphold their rights, and assist them in coping with the grief of their loss.