An exploration of women's reasons for termination timing in the setting of fetal abnormalities.
BACKGROUND
Over 3% of pregnancies are complicated by a fetal abnormality, of which, approximately 80% are terminated. Despite early screening options, women often present at the cusp of legal limits for termination.


METHODS
A qualitative study was conducted with women terminating pregnancies for fetal abnormalities. Semi-structured interviews explored reasons for termination timing. Analysis utilized latent content and constant comparative methods.


RESULTS
Of 30 participants between 13+4 and 23+5 weeks gestation, their median age was 35 years, 73.3% were white, 70% were religiously affiliated, and 60% had children. The median time from abnormality identification until termination was 16.5 days (range 2-73). The major themes for termination timing included (1) an abrupt shift in "low-risk" pregnancy perception; (2) challenging medical interactions; (3) an emotional decision-making process; and (4) termination access barriers.


CONCLUSIONS
Timing of termination for fetal abnormalities is attributable to multiple issues. Future research should identify optimal prenatal counseling strategies, address systemic barriers, and identify patient decision-making resources.
Section of Family Planning and Contraception, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. lgawron@northwestern.edu
Lori M
LM
Gawron
Kenzie A
KA
Cameron
Ava
A
Phisuthikul
Melissa A
MA
Simon
D000025:Abortion, Eugenic; D000029:Abortion, Legal; D000328:Adult; D002641:Chicago; D003657:Decision Making; D005260:Female; D058015:Health Communication; D006297:Health Services Accessibility; D006785:Hospitals, University; D006801:Humans; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D012944:Social Support