title: Managing the reemergence of anguish: pregnancy after a loss due to anomalies.
abstract: OBJECTIVE
  To explore and describe parents' experiences and feelings when faced with a pregnancy subsequent to a pregnancy in which they had to choose whether or not to terminate following the diagnosis of a fetal abnormality.
  
  
  METHODS
  Exploratory/descriptive study, using the grounded theory method.
  
  
  METHODS
  Participants were recruited through physicians in northeastern Florida and throughout the United States via an Internet support network.
  
  
  METHODS
  Participants included a registered nurse, a physician, and 22 parents (13 women and 9 partners) who were interviewed during a subsequent pregnancy.
  
  
  RESULTS
  Mental anguish resulted after a loss due to fetal anomalies. Such parents felt a loss of innocence and a sense of devastation and experienced changes in spousal relationships, fear of hope, isolation, and stigma. This anguish reemerged during a subsequent pregnancy. The parents managed by developing emotional armor, limiting disclosure of the previous and present pregnancy, delaying attachment to the baby, and forming a strong attachment to health care professionals and other people with similar experiences.
  
  
  CONCLUSIONS
  Understanding how parents manage the reemergence of mental anguish during a subsequent pregnancy permits health care professionals to assist these parents. Facilitating parents' efforts to develop emotional armor, limit disclosure, delay attachment to the baby, and attach to health care professionals and support groups can mitigate social and psychologic discomfort for these parents.
authors.affiliation: School of Nursing, Jacksonville University, FL 32211, USA.
authors.forename: P
authors.initials: P
authors.lastname: Rillstone
authors.forename: S A
authors.initials: SA
authors.lastname: Hutchinson
mesh_terms: D000032:Abortion, Therapeutic / Q000523:psychology*; D000223:Adaptation, Psychological; D001294:Attitude to Health; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging*; D003657:Decision Making; D005260:Female; D006117:Grief; D006379:Helping Behavior; D006801:Humans; D008297:Male; D009013:Morale; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009769:Object Attachment; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011247:Pregnancy / Q000523:psychology*; D012657:Self-Help Groups; D012934:Social Isolation; D013240:Stereotyping; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D014463:Ultrasonography