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Tang BWJ, Ibrahim BB, Shorey S. Complex journeys of adolescents after induced abortion: A qualitative systematic review. J Pediatr Nurs 2024; 77:e67-e80. [PMID: 38553284 DOI: 10.1016/j.pedn.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 07/07/2024]
Abstract
PROBLEM Adolescents face unique challenges in accessing sexual healthcare, particularly regarding induced abortion experiences. Prior research, often quantitative or biased towards young adults, overlooks this. This review aims to address adolescents' specific post-abortion experiences to inform comprehensive reproductive healthcare needs. ELIGIBILITY CRITERIA Qualitative and mixed-methods studies exploring the experiences of adolescents following induced abortion were included. Studies reporting these experiences from third-person perspectives were excluded. SAMPLE Five electronic databases (CINAHL, PubMed, PsycINFO, Web of Science, and Embase) were searched from the databases' inception through March 2024. Of the 2834 articles retrieved, 45 studies were included in this review. RESULTS Using a meta-synthesis approach combining Sandelowski & Barroso's qualitative metasummary with Braun & Clarke's thematic analysis, three main themes emerged: Post-abortion experiences and emotions, Social dynamics and support, and Life post-abortion and future perspectives. CONCLUSIONS Adolescents who underwent abortion faced physical and emotional challenges, adopted various coping strategies, and had mixed experiences with social support and healthcare providers. To address these challenges, the provision of comprehensive reproductive health information, access to safe and legal abortion options, and support for their physical, social, and emotional well-being is necessary. Healthcare providers must ensure that adolescents are equipped with necessary skills to navigate their reproductive health journeys with informed choices and confidence. IMPLICATIONS Future research exploring adolescents' experiences, considering cultural beliefs, involving multiple stakeholders, and conducting longitudinal studies, is warranted. Healthcare providers should implement practice changes, including providing accurate information, offering tailored mental health support, and undergoing adolescent-friendly training, to enhance care for adolescents.
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Affiliation(s)
- Byoray Wen Jia Tang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Gómez-Dávila JG, Yepes-Delgado CE. Meaning of having to cope with voluntary termination of late pregnancy in women undergoing the procedure in healthcare institutions of two Colombian cities. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGIA 2023; 74:202-213. [PMID: 37937911 PMCID: PMC10652771 DOI: 10.18597/rcog.4016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/26/2023] [Indexed: 11/09/2023]
Abstract
Objectives As part of sexual and reproductive health, abortion is a woman’s right in Colombia. However, not all the members of Colombian society recognize this right. The aim of this work is to understand the transformation of meanings after having to cope with voluntary termination of late pregnancy in women living in Colombia, as well as their interaction with family and friends and the health system. Material and methods Hermeneutic research undertaken within a constructivist paradigm and analyzed from a feminist perspective using grounded theory techniques: coding, categorization and constant comparison. Nineteen semi-structured interviews were conducted among 18 women living in Colombia who underwent voluntary termination of late pregnancy defined as more than 20 weeks of gestation, accompanied by feticide and labor induction, in two Colombian cities between 2016 and 2020. Besides, two focus groups were conducted, one with some of the interviewees and another with feminist experts in order to cross-reference the information derived from the research process and delve deeper into the findings. Results Women attached a negative and opposite meaning to voluntary termination of pregnancy, but once they found themselves in a situation that forced them to put an end to gestation, they transgressed their own meanings and those of society to find justifications to help them uphold their decision. This confrontation brought them to a place of profound and intimate reflection and led them to transform their lives. Conclusions Meanings regarding abortion in women who undergo late pregnancy termination are usually contrary to this right in sexual and reproductive health. After the event, these meanings become transformed through a process of conscious reflection as women come face-to-face with their own meanings and those of society.
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Disi ES, Okpaise OO, Akpanobong MAU, Eyinfunjowo SO, Ukwandu SA, Alabintei MO. Effects and Proposed Countermeasures of Abortion Bans and Restrictions on People With Uteruses and Society. Cureus 2022; 14:e29906. [PMID: 36348848 PMCID: PMC9632542 DOI: 10.7759/cureus.29906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
With the recent overturning of Roe V. Wade by the Supreme Court, access to abortions in many regions across the United States will become very limited as laws regarding fetal termination will be determined by state legislators rather than on a federal level. This article highlights the effects of Roe V. Wade's abolishment on individuals that can get pregnant, how unwanted pregnancies will affect society in general, and reasonable steps forward following the ban. We conducted an electronic search using PubMed, Google, and Google Scholar. The search was retrospective, and the preliminary results focused on articles about the rationale behind pregnancy termination and the overall effects of abortion and the ban. Review papers, original papers, and newspaper articles were eligible for use. Sample size and region of publication were not exclusionary criteria. Each author independently reviewed and extracted data to write up each assigned section, and group collaborations occurred to create the final draft. Out of the 93 resources reviewed, 32 sources were deemed eligible and used in this article. These resources included 23 journal articles, eight websites, and one book.. The data gathered showed that while abortions have many potential complications even when performed under regulated conditions, taking away the choice of those with a uterus is also not without consequence. The economic, familial, and societal implications should be considered moving forward as safety nets will need to be implemented for people with uterus and children involved.
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Affiliation(s)
- Efe S Disi
- College of Medicine, Madonna University, Elele, NGA
- Biology, University of Kentucky, Lexington, USA
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Hendriks S, Grady C, Wasserman D, Wendler D, Bianchi DW, Berkman B. A New Ethical Framework for Assessing the Unique Challenges of Fetal Therapy Trials: Response to Commentaries. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:W1-W3. [PMID: 37180307 PMCID: PMC10181859 DOI: 10.1080/15265161.2022.2044563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Saskia Hendriks
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Christine Grady
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - David Wasserman
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - David Wendler
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Diana W. Bianchi
- Section on Prenatal Genomics and Fetal Therapy, Center for Precision Health Research, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Benjamin Berkman
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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Taype-Rondán A, Zafra-Tanaka JH, Guevara-Rios E, Chávez-Alvarado S. Incidencia acumulada de anomalías fetales incompatibles con la vida en Perú. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.15446/revfacmed.v68n1.71589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. Las anomalías fetales incompatibles con la vida (AFIV) son aquellas que se asocian con la muerte temprana del feto o del recién nacido. En la actualidad, se desconoce la magnitud de este problema en Perú.Objetivos. Estimar la incidencia acumulada de AFIV en Perú, en el departamento de Lima y en seis hospitales de la ciudad de Lima, y describir las características de este tipo de anomalías reportadas entre 2012 y 2016 en el Instituto Nacional Materno Perinatal (INMP) de Lima, Perú.Materiales y métodos. Se determinó la incidencia acumulada de las AFIV reportadas en un período de cinco años en Perú, el cual varió dependiendo de la disponibilidad de los datos (2011-2015 y 2012-2016). Además, se revisaron las historias clínicas de los neonatos con AFIV registradas en el INMP para obtener sus características.Resultados. La incidencia acumulada de AFIV en todo el Perú fue de 0.89 por cada 10 000 recién nacidos y en el INMP fue 7.19. De los 48 recién nacidos con AFIV atendidos en el INMP, 54.2% nacieron con depresión neonatal y 83.3% fallecieron en el hospital.Conclusión. Las incidencias acumuladas de AFIV encontradas fueron menores a las reportadas por los sistemas internacionales de vigilancia epidemiológica, lo que podría deberse a falencias en su registro en las instituciones de salud y registros analizados.
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Cacique DB, Passini Junior R, Duarte Osis MJM, Oliveira HC, Padilha KM, Tedesco RP, Vettorazzi J, Nascimento DJ, Coutinho PR, Coutinho IC, Feitosa FEDL. Perspectives of healthcare workers on the morality of abortion: a multicenter study in seven Brazilian public hospitals. Health Care Women Int 2019; 41:761-776. [PMID: 31580777 DOI: 10.1080/07399332.2019.1672169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We used the questionnaire "Mosaic of Opinions on Induced Abortion" to conduct a multi-centered study to evaluate the perspectives of physicians, nurses, social workers, psychologists and pharmacists on the morality of abortion. In all, 254 participants constituted the sample. The inadequate knowledge on Brazilian abortion laws was the only determinant negatively associated with the construct "Sexual and Reproductive Rights", corroborating the hypothesis that a better understanding of abortion legislation could mitigate the opposition of some professionals to the ethical perspective that access to safe abortion should be seen as a sexual and reproductive right.
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Affiliation(s)
- Denis Barbosa Cacique
- Department of Obstetrics and Gynecology, University of Campinas School of Medicine, Campinas, Brazil.,Woman's Hospital Prof. Dr. J. A. Pinotti-CAISM, Campinas, Brazil
| | - Renato Passini Junior
- Department of Obstetrics and Gynecology, University of Campinas School of Medicine, Campinas, Brazil.,Woman's Hospital Prof. Dr. J. A. Pinotti-CAISM, Campinas, Brazil
| | | | | | | | | | - Janete Vettorazzi
- Hospital of Clinics of Porto Alegre (HCPA) - UFRGS. Rua Ramiro Barcelos, Porto Alegre, Brazil
| | - Denis José Nascimento
- Hospital of Clinics of Federal University of Paraná. Rua General Carneiro, Curitiba, Brazil
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Blakeley C, Smith DM, Johnstone ED, Wittkowski A. Parental decision-making following a prenatal diagnosis that is lethal, life-limiting, or has long term implications for the future child and family: a meta-synthesis of qualitative literature. BMC Med Ethics 2019; 20:56. [PMID: 31395047 PMCID: PMC6688313 DOI: 10.1186/s12910-019-0393-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Information on the factors influencing parents' decision-making process following a lethal, life-limiting or severely debilitating prenatal diagnosis remains deficient. A comprehensive systematic review and meta-synthesis was conducted to explore the influencing factors for parents considering termination or continuation of pregnancy following identification of lethal, life-limiting or severely debilitating fetal abnormalities. METHODS Electronic searches of 13 databases were conducted. These searches were supplemented by hand-searching Google Scholar and bibliographies and citation tracing. Thomas and Harden's (2008) thematic synthesis method was used to synthesise data from identified studies. RESULTS Twenty-four papers were identified and reviewed, but two papers were removed following quality assessment. Three main themes were identified through systematic synthesis. Theme 1, entitled 'all life is precious', described parents' perception of the importance of the fetus' life, a fatalistic view of their situation alongside moral implications as well as the implications decisions would have on their own life, in consideration of previous life experiences. Theme 2 ('hope for a positive outcome') contained two sub-themes which considered the parent's own imagined future and the influence of other people's experiences. Finally, Theme 3 ('a life worth living') presented three sub-themes which may influence their parental decision-making: These described parental consideration of the quality of life for their unborn child, the possibility of waiting to try for another pregnancy, and their own responsibilities and commitments. CONCLUSION The first review to fully explore parental decision-making process following lethal, life-limiting, or severely debilitating prenatal diagnosis provided novel findings and insight into which factors influenced parents' decision-making process. This comprehensive and systematic review provides greater understanding of the factors influential on decision-making, such as hope, morality and potential implications on their own and other's quality of life, will enable professionals to facilitate supported decision-making, including greater knowledge of the variables likely to influence parental choices.
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Affiliation(s)
- Claire Blakeley
- The University of Manchester, Faculty of Biology, Medicine and Health, School of Health Sciences, Division of Psychology and Mental Health, 2nd Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
- Greater Manchester Mental Health Foundation Trust, Trust Headquarters, Bury New Road, Prestwich, Manchester, M25 3BL, UK
| | - Debbie M Smith
- The University of Manchester, Faculty of Biology, Medicine and Health, School of Health Sciences, Division of Psychology and Mental Health, 2nd Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
- Leeds Trinity University, Brownberrie Lane, Horsforth, LS18 5HD, Leeds, UK
| | - Edward D Johnstone
- The University of Manchester, Faculty of Biology, Medicine and Health, School of Health Sciences, Division of Psychology and Mental Health, 2nd Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
- Central Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - Anja Wittkowski
- The University of Manchester, Faculty of Biology, Medicine and Health, School of Health Sciences, Division of Psychology and Mental Health, 2nd Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK.
- Greater Manchester Mental Health Foundation Trust, Trust Headquarters, Bury New Road, Prestwich, Manchester, M25 3BL, UK.
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Aktürk Ü, Erci B. The Effect of Watson’s Care Model on Anxiety, Depression, and Stress in Turkish Women. Nurs Sci Q 2019; 32:127-134. [DOI: 10.1177/0894318419826257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was designed to determine the effect of the care, given according to Watson’s model, on depression, stress, and anxiety levels of women who underwent medical abortion. This study was conducted between 2016 and 2017 as a real test model with a pretest-posttest control group. The data were collected by the researcher in women’s homes. Watson’s model decreased DAS levels of the women in the experimental group after the medical abortion.
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Affiliation(s)
- Ümmühan Aktürk
- Assistant Professor, Department of Public Health Nursing, School of Health, Inonu University, Malatya, Turkey
| | - Behice Erci
- Professor, Department of Public Health Nursing, School of Health, Inonu University, Malatya, Turkey
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Qin C, Chen WT, Deng Y, Li Y, Mi C, Sun L, Tang S. Cognition, emotion, and behaviour in women undergoing pregnancy termination for foetal anomaly: A grounded theory analysis. Midwifery 2019; 68:84-90. [DOI: 10.1016/j.midw.2018.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 09/22/2018] [Accepted: 10/16/2018] [Indexed: 11/30/2022]
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Graziani RNA, Nemzer L, Kerns J. The Experience of Genetic Counselors Working with Patients Facing the Decision of Pregnancy Termination after 24 Weeks Gestation. J Genet Couns 2017; 27:626-634. [PMID: 28956221 DOI: 10.1007/s10897-017-0151-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/31/2017] [Indexed: 11/25/2022]
Abstract
Prenatal genetic counselors are health care professionals who counsel women making reproductive decisions which include decisions such as terminating pregnancies due to fetal anomalies. Little is known about the experiences and practices of prenatal genetic counselors working with women who have the option of termination after 24 weeks gestation. In this national survey of 168 genetic counselors who have practiced prenatal genetic counseling, we asked about their general practice patterns, including indications for which termination is offered and types of abortion care services that are coordinated by genetic counselors. We report respondents' self-assessments of level of understanding of federal abortion law and abortion procedures. Seventy-six percent of respondents have offered and counseled on termination after 24 weeks and 93% of respondents believe it is the responsibility of the counselor to discuss this option with patients. However, one-third report that they have some or no understanding of the procedures and three-quarters report that they have some or no understanding of federal abortion law. The results of this study provide insight into knowledge and experiences of genetic counselors working with these patients, allowing for improved genetic counselor training and continuing education to provide better guidance and develop more effective means of assisting patients.
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Affiliation(s)
- Rachel N A Graziani
- Genetics Department, Kaiser Permanente, Fresno, CA, USA. .,, 2071 Herndon Avenue, Clovis, CA, 93611, USA.
| | - Laurie Nemzer
- Genetics Department, Kaiser Permanente, Oakland, CA, USA
| | - Jennifer Kerns
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA
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Jones K, Baird K, Fenwick J. Women's experiences of labour and birth when having a termination of pregnancy for fetal abnormality in the second trimester of pregnancy: A qualitative meta-synthesis. Midwifery 2017; 50:42-54. [PMID: 28388456 DOI: 10.1016/j.midw.2017.03.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/18/2017] [Accepted: 03/25/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE to explore women's experiences of labour and birth in the context of a termination of pregnancy for fetal abnormality in the second trimester of pregnancy. DESIGN meta-synthesis of 10 qualitative studies which included the experiences of 581 women. Data analysis was informed by van Manen's four lifeworld existentials (lived body, lived space, lived time and lived human relationships) and focused only on women's experiences of their labour and birth when terminating a pregnancy in the second trimester for fetal abnormality. KEY FINDINGS eight themes were generated by the analysis. In my head: a storm of emotion reflected the lived or felt space. In this space women make meaning of the experience. Too late to turn back time and Living and escaping the moment considered lived time; it is lived time that enables a woman to reinterpret who they once were and who they are becoming. The existential concept of lived body represented the women's physical or bodily presence and was reflected in the themes; The language of labour: un-describable torture, The meaning of pain; punishment and protection and Being a mother in the space where birth meets death. Relational or the lived human relationship is reflected in See me… talk to me…hear me… be with me and Sorry baby. These themes describe the women's lived sense of others in the interpersonal space that they share with them. KEY CONCLUSIONS the findings of this meta-synthesis provide insight into how emotionally and physically traumatic a woman's labour and birth experiences can be in this context. Women wanted to spend time with their baby constructing lasting memories that they could hold onto and share. They needed acknowledgment that their baby existed and their loss was tangible and real. What happened within the space of the relationship women shared with care providers was seen as vital, especially when respectful and dignified interaction was experienced. The women's need for human contact and support through their experience was also seen as critical. IMPLICATIONS FOR PRACTICE the need for greater understanding and acknowledgement of the woman's experience by all caregivers is required. Woman-centred and situation sensitive care provision should be prioritised. Further research that acknowledges and prioritises the feminine voice and the lived experience of women is required.
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Affiliation(s)
- Kay Jones
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University, Queensland, Australia.
| | - Kathleen Baird
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University & Gold Coast University Hospital, Queensland, Australia.
| | - Jenny Fenwick
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University & Gold Coast University Hospital, Queensland, Australia.
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Embodied experiences of prenatal diagnosis of fetal abnormality and pregnancy termination. REPRODUCTIVE HEALTH MATTERS 2016; 24:168-77. [DOI: 10.1016/j.rhm.2016.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/05/2016] [Accepted: 04/20/2016] [Indexed: 02/08/2023] Open
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Lafarge C, Mitchell K, Fox P. Termination of pregnancy for fetal abnormality: a meta-ethnography of women’s experiences. REPRODUCTIVE HEALTH MATTERS 2014; 22:191-201. [DOI: 10.1016/s0968-8080(14)44799-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Nazaré B, Fonseca A, Canavarro MC. Trauma Following Termination of Pregnancy for Fetal Abnormality: Is This the Path From Guilt to Grief? JOURNAL OF LOSS & TRAUMA 2014. [DOI: 10.1080/15325024.2012.743335] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lafarge C, Mitchell K, Fox P. Perinatal grief following a termination of pregnancy for foetal abnormality: the impact of coping strategies. Prenat Diagn 2013; 33:1173-82. [PMID: 23943597 DOI: 10.1002/pd.4218] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 07/23/2013] [Accepted: 08/10/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Caroline Lafarge
- School of Psychology, Social Work & Human Sciences; University of West London; Brentford UK
| | - Kathryn Mitchell
- Office of the Vice-Chancellor; University of West London; London UK
| | - Pauline Fox
- School of Psychology, Social Work & Human Sciences; University of West London; Brentford UK
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France EF, Locock L, Hunt K, Ziebland S, Field K, Wyke S. Imagined futures: how experiential knowledge of disability affects parents' decision making about fetal abnormality. Health Expect 2012; 15:139-56. [PMID: 21624022 PMCID: PMC5060609 DOI: 10.1111/j.1369-7625.2011.00672.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Knowledge of disability is considered key information to enable informed antenatal screening decisions by expectant parents. However, little is known about the role of experiential knowledge of disability in decisions to terminate or continue with a pregnancy diagnosed with a fetal abnormality. OBJECTIVE To explore the role that expectant parents' experiential knowledge of disabilities and conditions can play in real-life decisions to continue or end a pregnancy with a fetal abnormality. DESIGN Secondary analysis of qualitative narrative interview data informed by contextual systems framework. SETTING Participants were recruited throughout the United Kingdom and interviewed between 2004 and 2006. PARTICIPANTS Twenty-four women and four of their male partners who had direct or indirect experience of disability or illness and who had proceeded with or ended a pregnancy diagnosed with a fetal abnormality. FINDINGS Most respondents recounted using their experiential knowledge of disability, whether of their unborn baby's condition or of a different condition, to try to imagine the future for their unborn child, themselves and their family when making their decision. Some, who were considering continuing their pregnancy and had little or no experience of their unborn baby's specific disability, sought out others' experiences of the condition following antenatal diagnosis.The nature of a parent's experiential knowledge did not predict whether they continued with or terminated their pregnancy. DISCUSSION Prospective parents may find it helpful to discuss their existing knowledge of their unborn baby's condition with health professionals who are aware of the influence this might have on parents' decisions.
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Affiliation(s)
- Emma F France
- School of Nursing, Midwifery and Health, Alliance for Self Care Research, University of Stirling, Stirling, UK.
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Canário C, Figueiredo B, Ricou M. Women and men’s psychological adjustment after abortion: a six months prospective pilot study. J Reprod Infant Psychol 2011. [DOI: 10.1080/02646838.2011.592974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
There will always be women who need abortions after 12 weeks of pregnancy, and their reasons are often compelling. Although second trimester abortions carry relatively more risks than first trimester abortions, abortion is still very safe throughout the second trimester if done in safe conditions. This paper is about law and policy on second trimester abortions, which are allowed on more restrictive grounds than first trimester abortions in most countries, if at all. It focuses on countries where most or at least some second trimester abortions are allowed, including in Europe, where many women are still forced to travel for second trimester abortions, and countries in the developing world, where most second trimester abortions remain unsafe. The need for second trimester abortion should be met in a safe, timely and sympathetic manner. Abortion should be legal at the woman's request up to 24 weeks and on therapeutic grounds after that, and no other barriers or hurdles should be imposed on women seeking second trimester abortion. In-depth, country-based research is needed, to bring out the facts on second trimester abortion, as evidence of why it should be treated as a legitimate form of women's health care and supported in public health policy.
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Abstract
About a third of anencephalic fetuses are born alive, but they are not conscious or viable, and soon die. This neural tube defect can be limited by dietary consumption of foliates, and detected prenatally by ultrasound and other means. Many laws permit abortion, on this indication or on the effects of pregnancy and prospects of delivery on a woman's physical or mental health. However, abortion is limited under some legal systems, particularly in South America. To avoid criminal liability, physicians will not terminate pregnancies, by induced birth or abortion, without prior judicial approval. Argentinian courts have developed means to resolve these cases, but responses of Brazilian courts are less clear. Ethical concerns relate to late-term abortion, meaning after the point of fetal viability, but since anencephalic fetuses are nonviable, many ethical concerns are overcome. Professional guidance is provided by several professional and institutional codes on management of anencephalic pregnancies.
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Affiliation(s)
- Rebecca J Cook
- Faculty of Law, Faculty of Medicine and Joint Centre for Bioethics, University of Toronto, Toronto, Canada
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Silva LV, Cecatti JG, Pinto e Silva JL, Amaral E, Barini R. Feticide does not modify duration of labor induction in cases of medical termination of pregnancy. Fetal Diagn Ther 2008; 23:192-7. [PMID: 18417977 DOI: 10.1159/000116740] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2006] [Accepted: 12/05/2006] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To compare the general characteristics and clinical outcome of women who underwent medical termination of pregnancy preceded or not by feticide. METHODS A total of 146 women of diverse gestational ages, who had received a sonographic or genetic diagnosis of fetal abnormality incompatible with postnatal life and chose to legally terminate their pregnancy, had labor induced following feticide (n = 82) or without having feticide performed (n = 64). RESULTS The number of obstetrical procedures was higher (p = 0.001) in the feticide group. Time of labor induction and complications were similar in both groups. CONCLUSION Feticide does not alter the clinical obstetrical course of women undergoing medical termination of pregnancy, and poses no risk to maternal health regardless of gestational age.
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Affiliation(s)
- Luciana Vivas Silva
- Department of Obstetrics and Gynecology, School of Medicine, Universidade Estadual de Campinas, Campinas, Brazil
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Shepard BL, Casas Becerra L. Abortion Policies and Practices in Chile: Ambiguities and Dilemmas. REPRODUCTIVE HEALTH MATTERS 2007; 15:202-10. [DOI: 10.1016/s0968-8080(07)30328-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gordon L, Thornton A, Lewis S, Wake S, Sahhar M. An evaluation of a shared experience group for women and their support persons following prenatal diagnosis and termination for a fetal abnormality. Prenat Diagn 2007; 27:835-9. [PMID: 17600863 DOI: 10.1002/pd.1786] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Support after fetal diagnosis of abnormality (SAFDA), is a facilitated shared experience group for women and their partners or support person, in Victoria, Australia, who have had a pregnancy termination for a fetal abnormality. The objective of this study was to evaluate the SAFDA-facilitated group. METHODS A questionnaire-based study was undertaken between 2001 and 2005 to evaluate SAFDA. A deidentified self-completed questionnaire was given to participants at the end of each group and included questions relating to the referring professional, participants' prior expectations of the group, helpfulness of participation, preferred group format, length, and venue. In addition, there was also opportunity for participants to make general comments on their experiences of participating in SAFDA. RESULTS A total of 85 participants (100% response) completed the questionnaire. Seventy-one participants (84%) considered it 'very helpful' to participate in the group. Seventy-eight participants (92%) considered that a shared-experience group was the most beneficial format. Comments written by participants affirmed that the present format of SAFDA was a highly valued opportunity to listen to and share experiences in a confidential small group. CONCLUSION SAFDA is a beneficial forum for women and their partners or support person to share their experiences after having had a pregnancy termination for a fetal abnormality. Further, SAFDA provides information and insights for health professionals who are considering how best to support women.
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Affiliation(s)
- L Gordon
- Royal Women's Hospital Melbourne, Australia
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