French midwives' practice of termination of pregnancy for fetal abnormality. At what psychological and ethical cost?

Abstract:

OBJECTIVES:To study the clinical, emotional and moral difficulties that French midwives encounter in the labor ward while performing termination of pregnancy (TOP) for fetal abnormality. SETTING:Six public maternity hospitals located in the Ile de France region, two of which were referral centers for prenatal diagnosis (PND) and TOP. METHOD:Questionnaire survey RESULTS:Ninety-two of 115 midwives responded. Sixty-five percent of the midwives reported that their role in the labor ward during TOP was difficult. Aspects contributing substantially to the perceived difficulties were the midwives' responsibility to provide psychological support to patients and the emotional distress of the midwives themselves. Seventy-five percent reported that they were concerned about the child being alive in cases of late TOP. Twenty-five percent of the midwives reported moral conflicts due to personal, cultural or religious background, mainly for particular indications. There was a consensus about the clinical management of TOP. Overall, midwives with professional experience, training, and those who worked in a referral center reported fewer difficulties. CONCLUSION:It is necessary to improve institutional support available within maternity units to alleviate the difficulties midwives face in their roles. The need for training/updating midwives about psychological and ethical aspects of TOP should also be considered.

journal_name

Prenat Diagn

journal_title

Prenatal diagnosis

authors

Garel M,Etienne E,Blondel B,Dommergues M

doi

10.1002/pd.1755

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

622-8

issue

7

eissn

0197-3851

issn

1097-0223

journal_volume

27

pub_type

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