The travesty of choosing after positive prenatal diagnosis.
OBJECTIVE
To integrate the findings of qualitative studies of expectant parents receiving positive prenatal diagnosis.


METHODS
Seventeen published and unpublished reports appearing between 1984 and 2001 and retrieved between December of 2002 and March of 2003. The electronic databases searched include Academic Search Elite, AIDS Information Online (AIDSLINE), Anthropological Index Online, Anthropological Literature, Black Studies, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Digital Dissertations, Dissertation Abstracts Index (DAI), Educational Resource Information Center (ERIC), MEDLINE, PsycInfo, Public Affairs Information Service (PAIS), PubMed, Social Science Abstracts (SocSci Abstracts), Social Science Citation Index, Social Work Abstracts, Sociological Abstracts (Sociofile), Women's Resources International, and Women's Studies.


METHODS
Qualitative studies involving expectant parents living in the United States of any race, ethnicity, nationality, or class who learned during any time in pregnancy of any fetal impairment by any means of diagnosis were eligible for inclusion.


METHODS
Metasummary techniques, including the calculation of frequency effect sizes, were used to aggregate the findings. Metasynthesis techniques, including constant comparison analysis and the reciprocal translation of concepts, were used to interpret the findings.


RESULTS
The topical emphasis in the findings is on the termination of pregnancy following positive diagnosis. The thematic emphasis is on the dilemmas of choice and decision making. Positive prenatal diagnosis was for couples an experience of chosen losses and lost choices. Couples managed information to minimize stigmatization and cognitive dissonance.


CONCLUSIONS
Existing guidelines for caring for couples after perinatal losses must accommodate the chosen loss experientially defining positive prenatal diagnosis.
Sandelowski
Margarete
M
University of North Carolina at Chapel Hill, School of Nursing, NC 27599, USA. msandelo@email.unc.edu
Barroso
Julie
J
D000028:Abortion, Induced / Q000451:nursing / Q000523:psychology*; D000328:Adult; D002755:Choice Behavior; D005260:Female; D005313:Fetal Death / Q000175:diagnosis; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D010290:Parents / Q000523:psychology*; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards; D011296:Prenatal Diagnosis / Q000451:nursing / Q000523:psychology*; D011369:Professional-Patient Relations; D012107:Research Design / Q000592:standards; D035501:Uncertainty