title: Termination of pregnancy for fetal abnormality: a meta-ethnography of women's experiences.
abstract: Due to technological advances in antenatal diagnosis of fetal abnormalities, more women face the prospect of terminating pregnancies on these grounds. Much existing research focuses on women's psychological adaptation to this event. However, there is a lack of holistic understanding of women's experiences. This article reports a systematic review of qualitative studies into women's experiences of pregnancy termination for fetal abnormality. Eight databases were searched up to April 2014 for peer-reviewed studies, written in English, that reported primary or secondary data, used identifiable and interpretative qualitative methods, and offered a valuable contribution to the synthesis. Altogether, 4,281 records were screened; 14 met the inclusion criteria. The data were synthesised using meta-ethnography. Four themes were identified: a shattered world, losing and regaining control, the role of health professionals and the power of cultures. Pregnancy termination for fetal abnormality can be considered as a traumatic event that women experience as individuals, in their contact with the health professional community, and in the context of their politico-socio-legal environment. The range of emotions and experiences that pregnancy termination for fetal abnormality generates goes beyond the abortion paradigm and encompasses a bereavement model. Coordinated care pathways are needed that enable women to make their own decisions and receive supportive care.
authors.affiliation: Research Assistant, School of Psychology, Social Work and Human Science, University of West London, London, UK. Electronic address: caroline.lafarge@uwl.ac.uk.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lafarge
authors.affiliation: Deputy Vice-Chancellor, Office of Vice-Chancellor, University of West London, London, UK.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Mitchell
authors.affiliation: Associate Professor, School of Psychology, Social Work and Human Science, University of West London, UK.
authors.forename: Pauline
authors.initials: P
authors.lastname: Fox
mesh_terms: D000028:Abortion, Induced / Q000523:psychology*; D000884:Anthropology, Cultural; D001601:Bereavement; D000013:Congenital Abnormalities / Q000523:psychology*; D003657:Decision Making; D004645:Empathy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011369:Professional-Patient Relations; D012649:Self Concept; D013240:Stereotyping
keywords: Brazil; Finland; Israel; Sweden; UK; USA; Viet Nam; abortion; bereavement; fetal abnormality; lived experience; meta-ethnography; systematic review