A qualitative exploration of delay in pregnancy termination for fetal indications
Awarded 2011
Complex Family Planning Fellowship Research
Lori Gawron, MD, MPH
Northwestern University

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.
Study Design: 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.

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