Counseling Women Who Have Terminated a Pregnancy Due to Fetal Anomaly (TOPFA): The ACCEPT Model

  • Erica Danya Goldblatt HyattEmail author
Original Paper


Women who have terminated a pregnancy due to fetal anomaly (TOPFA) may experience disenfranchised grief, societal stigmatization, and lack of support. A history of legislative attempts to criminalize TOPFA providers, public misunderstanding, and poor healthcare experiences may create reluctance in women to seek face-to-face counseling. While recent publications have assessed the grief reactions and help-seeking of women who TOPFA, few have provided an informed approach to therapeutic intervention for clinical social workers. This article attempts to provide a practice model through a composite case study utilizing the proposed ACCEPT model. The ACCEPT model incorporates elements of modern grief theory and consists of acknowledging disenfranchised grief, connecting emotions to the loss, continuing bonds, exploring distortions, practicing new skills, and telling the story. Implications and recommendations for social work engagement, awareness, and therapeutic support of this population are also provided.


TOPFA Disenfranchised grief Fetal anomaly Pregnancy loss Ending a wanted pregnancy Grief counseling 



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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Rutgers, The State University of New JerseyNew BrunswickUSA
  2. 2.DSW ProgramRutgers University School of Social WorkNew BrunswickUSA

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