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Critical Aspects of Decision-Making and Grieving After Diagnosis of Fetal Anomaly

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Prenatal and Preimplantation Diagnosis

Abstract

After the diagnosis of a fetal anomaly, women and their partners must make difficult decisions about whether to (1) plan to raise the child with the condition/s, (2) carry the pregnancy for as long as possible and pursue palliative care or perinatal hospice if the condition is life threatening, (3) relinquish the child for adoption, or (4) terminate the pregnancy. The decisions are highly contextual, driven by factors such as the woman’s religious views, beliefs about quality of life, availability biases, access to support networks (both formal and informal), and the woman’s sense of her own ability to cope with the selected outcome. This chapter delineates factors involved with decision-making and also addresses how grief is a part of the outcome for any of these decisions. Women benefit when they are helped to recognize that the diagnosis of a fetal anomaly (or multifetal pregnancy that is likely to have a poor outcome) is where the grief begins and that their decisions are all likely to lead to a situation where they must mourn the imagined, healthy child they intended to have. Strategies for providing care for women and their partners after fetal diagnosis are identified.

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Notes

  1. 1.

    Throughout, I will refer to the (pregnant) woman as the decision-maker, but I will also assume that she is likely to include her partner or other support people in her decision-making and grieving processes.

  2. 2.

    This phrase comes from a client I worked with who used this understanding to support her decision to terminate a pregnancy affected by triploidy (triplication of all chromosomes).

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Authors and Affiliations

  1. School of Social Work, Rutgers University, 217 N. 6th Street, Camden, NJ, 08102, USA

    Judith L. M. McCoyd Ph.D., L.C.S.W.

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Correspondence to Judith L. M. McCoyd Ph.D., L.C.S.W. .

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Editors and Affiliations

  1. New York, New York, USA

    Joann Paley Galst

  2. Department of Obstetrics and Gynecology; Department of Human Genetics, The University of Chicago, Chicago, Illinois, USA

    Marion S. Verp

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McCoyd, J.L.M. (2015). Critical Aspects of Decision-Making and Grieving After Diagnosis of Fetal Anomaly. In: Paley Galst, J., Verp, M. (eds) Prenatal and Preimplantation Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-319-18911-6_13

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