PASTORAL CARE UTILIZATION AMONG WOMEN ELECTING PREGNANCY TERMINATION FOR FETAL ANOMALIES

Objective: To identify determinants of requesting pastoral care (PC) a t the time of pregnancy termination for fetal anomalies. Methods: PC w as provided by a hospital-based chaplain. Data were reviewed for 88 wo men who elected pregnancy termination. Nominal logistic regression and Kruskal-Wallis and Student t tests were used as appropriate. Results: None of 37 women who underwent dilatation and curettage (D&C) or dila tation and evacuation (D&E) requested PC as compared with 40 of 51 pat ients who underwent prostaglandin induction of labor (p < 0.001). The decision to seek PC was related to gestational age (p < 0.001), but no t to maternal age, prior termination of pregnancy, gravidity, parity, racial background, or insurance status. The gestational age was also a significant predictor of the procedure performed (p < 0.001). D&C/D&E were significantly more likely to be performed at earlier gestational ages. Women seeking PC were less likely to have experienced previous pregnancy loss or the death of a child. Among women who sought PC, 20% had experienced previous pregnancy loss or the death of a child, as o pposed to 54% of women in the prostaglandin group who did not seek PC (p = 0.03). In the D&C/D&E group, the figure was 46%. Conclusions: Uti lization of PC is much more frequent among women undergoing prostaglan din induction of labor than D&C/D&E. Determinants of seeking PC are re lated to issues congruent with choices of the termination procedure. P atients who experienced a previous pregnancy loss or the death of a ch ild are also less likely to feel the need, or do not want, chaplaincy involvement.