DO WOMEN GRIEVE AFTER TERMINATING PREGNANCIES BECAUSE OF FETAL ANOMALIES - A CONTROLLED INVESTIGATION

Objective: To test the hypothesis that grief responses do not differ b etween women who terminate their pregnancies for fetal anomalies and w omen who experience spontaneous perinatal losses. Methods: A case-cont rol study was conducted. Twenty-three women who underwent terminations through the genetics service of a tertiary referral obstetric hospita l from January 1991 to April 1992 were assessed psychiatrically 2 mont hs after the termination. The grief responses of these women on the Pe rinatal Grief Scale and the Beck Depression Inventory were compared to a demographically similar group of women assessed 2 months after they experienced spontaneous perinatal loss. Differences between the group s were assessed through one-way analysis of covariance. Results: After matching women in the two groups, it became clear that women who term inated for fetal anomalies were significantly older than women in the comparison group, and age was inversely correlated with intensity of g rief. Therefore, age was covaried in comparing the grief responses of women in the two groups. Neither statistically significant nor clinica lly meaningful differences were found in symptomatology between the gr oups. By the time of assessment, four of 23 women (17%) who terminated their pregnancies were diagnosed with a major depression, and five of 23 (22%) had sought psychiatric treatment. Conclusions: Women who ter minate pregnancies for fetal anomalies experience grief as intense as those who experience spontaneous perinatal loss, and they may require similar clinical management. Diagnosis of a fetal anomaly and subseque nt termination may be associated with psychological morbidity.