Women generating narratives after an unwanted prenatal diagnosis result: randomized controlled trial


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).

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Correspondence to José Rocha.

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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.

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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

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  • Abortion
  • Termination of pregnancy
  • Prenatal diagnosis
  • Perinatal Grief
  • Depression
  • Anxiety
  • Decisions
  • Narratives
  • RCT