We have defined a psychological intervention based on cognitive narrative therapy and the Ottawa decision framework to reduce adjustment problems following a termination of pregnancy (TOP) after a positive prenatal diagnosis (PND). The intervention is composed of four sessions: decision, subjectivation, metaphorization, and projecting. This study aims to assess the effectiveness of a cognitive narrative intervention to prevent depression and anxiety symptoms after TOP. The intervention was accepted by 24 participants. The outcome is compared with a control group of 67 women who also terminated a pregnancy after PND. Participants were from several Portuguese institutions; 64.4% had a genetic and 35.6% had ultrasound diagnosis; the mean age was 30.0 years and the mean gestational age was 19 weeks. There are two evaluations: a baseline at the 15th day and a sixth month follow-up after TOP, using Beck Depression Inventory, Zung Anxiety Scale, Perinatal Grief Scale, and an instrument capturing participant satisfaction. Six months after TOP, there is a lower mean of anxiety and depression (p < 0.05), between groups, with effect sizes on the follow-up of 0.54 for depression, 0.41 for anxiety, and 0.23 for perinatal grief. This intervention has very positive effects on women mental health, and we emphasize the importance of the meaning-making process in the context of terminating a wanted pregnancy.
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This study was funded by CESPU, Portugal (02-UNIPSA/CICS-11n).
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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Rocha, J., Nunes, C., Leonardo, A. et al. Women generating narratives after an unwanted prenatal diagnosis result: randomized controlled trial. Arch Womens Ment Health 21, 453–459 (2018). https://doi.org/10.1007/s00737-018-0822-5
- Termination of pregnancy
- Prenatal diagnosis
- Perinatal Grief