title: Pastoral care utilization among women electing pregnancy termination for fetal anomalies.
abstract: OBJECTIVE
  To identify determinants of requesting pastoral care (PC) at the time of pregnancy termination for fetal anomalies.
  
  
  METHODS
  PC was provided by a hospital-based chaplain. Data were reviewed for 88 women who elected pregnancy termination. Nominal logistic regression and Kruskal-Wallis and Student t tests were used as appropriate.
  
  
  RESULTS
  None of 37 women who underwent dilatation and curettage (D&C) or dilatation and evacuation (D&E) requested PC as compared with 40 of 51 patients who underwent prostaglandin induction of labor (p < 0.001). The decision to seek PC was related to gestational age (p < 0.001), but not to maternal age, prior termination of pregnancy, gravidity, parity, racial background, or insurance status. The gestational age was also a significant predictor of the procedure performed (p < 0.001). D&C/D&E were significantly more likely to be performed at earlier gestational ages. Women seeking PC were less likely to have experienced previous pregnancy loss or the death of a child. Among women who sought PC, 20% had experienced previous pregnancy loss or the death of a child, as opposed to 54% of women in the prostaglandin group who did not seek PC (p = 0.03). In the D&C/D&E group, the figure was 46%.
  
  
  CONCLUSIONS
  Utilization of PC is much more frequent among women undergoing prostaglandin induction of labor than D&C/D&E. Determinants of seeking PC are related to issues congruent with choices of the termination procedure. Patients who experienced a previous pregnancy loss or the death of a child are also less likely to feel the need, or do not want, chaplaincy involvement.
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, Mich 48201, USA.
authors.forename: T B
authors.initials: TB
authors.lastname: Brady
authors.forename: S
authors.initials: S
authors.lastname: Lidums
authors.forename: Y
authors.initials: Y
authors.lastname: Yaron
authors.forename: M I
authors.initials: MI
authors.lastname: Evans
authors.forename: M P
authors.initials: MP
authors.lastname: Johnson
authors.forename: R L
authors.initials: RL
authors.lastname: Kramer
mesh_terms: D000028:Abortion, Induced / Q000523:psychology*; D000328:Adult; D002869:Chromosome Aberrations; D000013:Congenital Abnormalities / Q000175:diagnosis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D010327:Pastoral Care; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012067:Religion