Abstract

Objectives: We examined the psychological consequences of termination of pregnancy for fetal abnormality (TOPFA). The impact of individual coping styles as well as a number of obstetric factors were assessed to determine their relevance in relation to the psychological impact of this event Additionally, when faced with health related decisions, individuals will have an idea about the level of input or control they wish to take (control preference).We aim to explore whether disparity between an individual’s control preference and their perceived levels of control in relation to a) their decision to terminate and b) by which method increased their levels of distress.
Design, Setting & Sample: A cross-sectional cohort study was performed on a community sample of 122 women who had terminated a pregnancy for fetal abnormality.
Methods & Outcome Measures; The construct of control preference for health related decisions was assessed in the context of a TOPFA. This, obstetric factors, social support, and coping style (predictor variables) were used to investigate psychological outcome on standardised questionnaires which measured depression, anxiety, grief, and post-traumatic symptoms. Four parallel hierarchical regression models were developed.
Results: Termination of pregnancy for fetal abnormality is associated with a range of symptoms on standardised measures of psychological morbidity. Clinically relevant determinants included social support and a range of coping styles, namely: denial, behavioural disengagement, self-blame and acceptance (protective).
Conclusion: Coping is a psychological construct of significant importance within the context of TOPFA. Behavioural disengagement, denial and self-blame all predict worse outcome. In contrast good social support and coping through acceptance predict better outcome on standardised questionnaires which measured depression, anxiety, grief, and post-traumatic symptoms.