Pregnancy Following a Prenatal Diagnosis of a Lethal Prognosis for the Fetus/Child (LFD) – Women's Perspective
pdf

Keywords

pregnancy
lethal fetal diagnosis
LFD
perinatal palliative care
perinatal hospice
post-traumatic grow

How to Cite

Tataj-Puzyna, U., Szlendak, B., Pięta, L., & Ryś, M. (2024). Pregnancy Following a Prenatal Diagnosis of a Lethal Prognosis for the Fetus/Child (LFD) – Women’s Perspective. Quarterly Journal Fides Et Ratio, 59(3), 35-45. https://doi.org/10.34766/fer.v59i3.1305
Keywords

Abstract

A lethal fetal diagnosis defines severe developmental disorders that lead to the death of the child either before birth or shortly after. In the global healthcare system, the issue of stillbirths has been overlooked, and care for this group of families has been neglected. As a result, the experiences of women during pregnancy following a prenatal diagnosis of a lethal prognosis for the fetus/child have not been sufficiently studied. However, in the last decade, increasing attention has been given to this issue, and the topic of caring for families who, despite a lethal diagnosis, choose to carry the pregnancy to term has become an important public health concern. Taking into account the needs of this group of women/parents, perinatal hospices have been established, providing multidisciplinary perinatal care tailored to the needs of these families. Research indicates that despite the anticipated loss of the child, parents can have positive experiences related to the period of waiting for the birth and the delivery of a lethally ill child. Through professional, empathetic medical care, parents can be provided with the space to experience prenatal parenthood, growth in personal strength, relationships with others, and an appreciation for life. Therefore, the aim of the article is to describe selected stages/issues of the pregnancy period in women following a prenatal diagnosis of a lethal prognosis for the fetus/child.

https://doi.org/10.34766/fer.v59i3.1305
pdf

References

Blakeley, C., Smith, D. M., Johnstone, E. D., & Wittkowski, A. (2019). 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 Medical Ethics, 20(1), 56. https://doi.org/10.1186/s12910-019-0393-7
Breeze, A. C. G., Lees, C. C., Kumar, A., Missfelder-Lobos, H. H., & Murdoch, E. M. (2007). Palliative care for prenatally diagnosed lethal fetal abnormality. Archives of Disease in Childhood - Fetal and Neonatal Edition, 92(1), F56–F58. https://doi.org/10.1136/adc.2005.092122
Buczek, M. (2015). Hospicjum w łonie matki. Edukacja Etyczna, 10, 27–35.
Burden, C., Bradley, S., Storey, C., Ellis, A., Heazell, A. E. P., Downe, S., Cacciatore, J., & Siassakos, D. (2016). From grief, guilt pain and stigma to hope and pride – a systematic review and meta-analysis of mixed-method research of the psychosocial impact of stillbirth. BMC Pregnancy and Childbirth, 16(1), 9. https://doi.org/10.1186/s12884-016-0800-8
Cacciatore, J., Rådestad, I., & Frederik Frøen, J. (2008). Effects of Contact with Stillborn Babies on Maternal Anxiety and Depression. Birth, 35(4), 313–320. https://doi.org/10.1111/j.1523-536X.2008.00258.x
Coleman, P. K. (2015). Diagnosis of Fetal Anomaly and the Increased Maternal Psychological Toll Associated with Pregnancy Termination. Issues in Law & Medicine, 30(1), 3–23.
Cope, H., Garrett, M. E., Gregory, S., & Ashley-Koch, A. (2015). Pregnancy continuation and organizational religious activity following prenatal diagnosis of a lethal fetal defect are associated with improved psychological outcome: Psychological outcome following prenatal diagnosis of a lethal fetal defect. Prenatal Diagnosis, 35(8), 761–768. https://doi.org/10.1002/pd.4603
Côté-Arsenault, D., & Denney-Koelsch, E. (2011). “My Baby Is a Person”: Parents’ Experiences with Life-Threatening Fetal Diagnosis. Journal of Palliative Medicine, 14(12), 1302–1308. https://doi.org/10.1089/jpm.2011.0165
Côté-Arsenault, D., & Denney-Koelsch, E. (2016). “Have no regrets:” Parents’ experiences and developmental tasks in pregnancy with a lethal fetal diagnosis. Social Science & Medicine (1982), 154, 100–109.
Dangel, T. (2015). Hospicjum perinatalne – polski model. Informator Fundacji Warszawskie Hospicjum dla Dzieci. Fundacja Warszawskie Hospicjum Dla Dzieci, OPP, 71(1), 37–40.
Dangel, T., & Szymkiewicz-Dangel, J. (2016). Perinatal hospice—The Polish model. https://hospicjum.waw.pl/phocadownload/hospicjum-perinatalne/hospicjum-perinatalne-polski-model.pdf
Denney-Koelsch, E. M., Côté-Arsenault, D., & Jenkins Hall, W. (2016). Feeling Cared For Versus Experiencing Added Burden: Parents’ Interactions With Health-Care Providers in Pregnancy With a Lethal Fetal Diagnosis. Illness, Crisis & Loss, 26(4), 293–315. https://doi.org/10.1177/1054137316665817
Downe, S., Schmidt, E., Kingdon, C., & Heazell, A. E. P. (2013). Bereaved parents’ experience of stillbirth in UK hospitals: A qualitative interview study. BMJ Open, 3(2), e002237. https://doi.org/10.1136/bmjopen-2012-002237
Erlandsson, K., Warland, J., Cacciatore, J., & Rådestad, I. (2013). Seeing and holding a stillborn baby: Mothers’ feelings in relation to how their babies were presented to them after birth—Findings from an online questionnaire. Midwifery, 29(3), 246–250. https://doi.org/10.1016/j.midw.2012.01.007
Flenady, V. J., Middleton, P., Wallace, E. M., Morris, J., Gordon, A., Boyle, F. M., Homer, C. S., Henry, S., Brezler, L., Wojcieszek, A. M., Davies-Tuck, M., Coory, M., Callander, E., Kumar, S., Clifton, V., Leisher, S. H., Blencowe, H., Forbes, M., Sexton, J., & Ellwood, D. A. (2020). Stillbirth in Australia 1: The road to now: Two decades of stillbirth research and advocacy in Australia. Women and Birth, 33(6), 506–513. https://doi.org/10.1016/j.wombi.2020.09.005
Flenady, V., Middleton, P., Smith, G. C., Duke, W., Erwich, J. J., Khong, T. Y., Neilson, J., Ezzati, M., Koopmans, L., Ellwood, D., Fretts, R., & Frøen, J. F. (2011). Stillbirths: The way forward in high-income countries. The Lancet, 377(9778), 1703–1717. https://doi.org/10.1016/S0140-6736(11)60064-0
Fonseca, A., Nazaré, B., & Canavarro, M. C. (2011). Patterns of parental emotional reactions after a pre- or postnatal diagnosis of a congenital anomaly. Journal of Reproductive and Infant Psychology, 29(4), 320–333. https://doi.org/10.1080/02646838.2011.634398
Frates, M. C., Kumar, A. J., Benson, C. B., Ward, V. L., & Tempany, C. M. (2004). Fetal Anomalies: Comparison of MR Imaging and US for Diagnosis. Radiology, 232(2), 398–404. https://doi.org/10.1148/radiol.2322030504
Frøen, J. F., Cacciatore, J., McClure, E. M., Kuti, O., Jokhio, A. H., Islam, M., & Shiffman, J. (2011). Stillbirths: Why they matter. The Lancet, 377(9774), 1353–1366. https://doi.org/10.1016/S0140-6736(10)62232-5
Gruszka, M., Kudela, G., Wolny, A., Koszutski, T., & Hyla-Klekot, L. (2019). Perinatal hospice care in the opinion of nurses and midwives. Ginekologia Polska, 90(12), 702–706. https://doi.org/10.5603/GP.2019.0120
Guon, J., Wilfond, B. S., Farlow, B., Brazg, T., & Janvier, A. (2014). Our children are not a diagnosis: The experience of parents who continue their pregnancy after a prenatal diagnosis of trisomy 13 or 18. American Journal of Medical Genetics Part A, 164(2), 308–318. https://doi.org/10.1002/ajmg.a.36298
Horning, M., & Braun, C. (2006). The lived experience of families who are told their child will die at or shortly after birth. 2006;8. J Undergraduate Nurs Scholarsh, 8. http://juns.nursing .arizona.edu/articles/fall%202006/horning.htm
Jalowska, A., Krzeszowiak, J., Stembalska, A., Szmyd, K., Zimmer, M., Jagielska, G., Raś, M., Pasławska, A., Szafrańska, A., Paluszyńska, D., Fuchs, T., Pesz, K., Sąsiadek, M., Królak-Olejnik, B., & Śmigiel, R. (2019). [Perinatal palliative care performed in obstetrics and neonatology wards and hospices for children—Own experience]. Developmental Period Medicine, 23(4), 253–262.
Jones, K., Baird, K., & Fenwick, J. (2017). 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, 50, 42–54. https://doi.org/10.1016/j.midw.2017.03.014
Kamranpour, B., Noroozi, M., & Bahrami, M. (2019). Supportive needs of women who have experienced pregnancy termination due to fetal abnormalities: A qualitative study from the perspective of women, men and healthcare providers in Iran. BMC Public Health, 19(1), 507. https://doi.org/10.1186/s12889-019-6851-9
Kelley, M. C., & Trinidad, S. B. (2012). Silent loss and the clinical encounter: Parents’ and physicians’ experiences of stillbirth–a qualitative analysis. BMC Pregnancy and Childbirth, 12(1), 137. https://doi.org/10.1186/1471-2393-12-137
Lathrop, A., & VandeVusse, L. (2011). Affirming Motherhood: Validation and Invalidation in Women’s Perinatal Hospice Narratives. Birth, 38(3), 256–265. https://doi.org/10.1111/j.1523-536X.2011.00478.x
Latos-Bieleńska, A., Materna-Kiryluk, A., Badura-Stronka, M., & Wiśniewska, K. (2010). Wrodzone wady rozwojowe w Polsce w latach 2003-2004. Dane z Polskiego Rejestru Wrodzonych Wad Rozwojowych. In Dane z Polskiego Rejestru Wrodzonych Wad Rozwojowych.: Vol. Wydanie II poprawione. (pp. 11–15). Ośrodek Wydawnictw Naukowych.
Lawn, J. E., Blencowe, H., Pattinson, R., Cousens, S., Kumar, R., Ibiebele, I., Gardosi, J., Day, L. T., & Stanton, C. (2011). Stillbirths: Where? When? Why? How to make the data count? The Lancet, 377(9775), 1448–1463. https://doi.org/10.1016/S0140-6736(10)62187-3
Lawn, J. E., Blencowe, H., Waiswa, P., Amouzou, A., Mathers, C., Hogan, D., Flenady, V., Frøen, J. F., Qureshi, Z. U., Calderwood, C., Shiekh, S., Jassir, F. B., You, D., McClure, E. M., Mathai, M., Cousens, S., Flenady, V., Frøen, J. F., Kinney, M. V., … Draper, E. S. (2016). Stillbirths: Rates, risk factors, and acceleration towards 2030. The Lancet, 387(10018), 587–603. https://doi.org/10.1016/S0140-6736(15)00837-5
Lotto, R., Armstrong, N., & Smith, L. K. (2016). Care provision during termination of pregnancy following diagnosis of a severe congenital anomaly – A qualitative study of what is important to parents. Midwifery, 43, 14–20. https://doi.org/10.1016/j.midw.2016.10.003
Martín-Ancel, A., Pérez-Muñuzuri, A., González-Pacheco, N., Boix, H., Espinosa Fernández, M. G., Sánchez-Redondo, M. D., Cernada, M., & Couce, M. L. (2022). Perinatal palliative care. Anales de Pediatría (English Edition), 96(1), 60.e1-60.e7. https://doi.org/10.1016/j.anpede.2021.10.003
Marty, C. M., & Carter, B. S. (2018). Ethics and palliative care in the perinatal world. Seminars in Fetal and Neonatal Medicine, 23(1), 35–38. https://doi.org/10.1016/j.siny.2017.09.001
McKechnie, A. C., Pridham, K., & Tluczek, A. (2015). Preparing Heart and Mind for Becoming a Parent Following a Diagnosis of Fetal Anomaly. Qualitative Health Research, 25(9), 1182–1198. https://doi.org/10.1177/1049732314553852
Power, S., Meaney, S., & O’Donoghue, K. (2020). The incidence of fatal fetal anomalies associated with perinatal mortality in Ireland. Prenatal Diagnosis, 40(5), 549–556. https://doi.org/10.1002/pd.5642
Rådestad, I., Westerberg, A., Ekholm, A., Davidsson-Bremborg, A., & Erlandsson, K. (2011). Evaluation of care after stillbirth in Sweden based on mothers’ gratitude. British Journal of Midwifery, 19(10), 646–652. https://doi.org/10.12968/bjom.2011.19.10.646
Ratislavová, K. (2015). Visual and haptic contact of women with a stillborn baby. Journal of Nursing, Social Studies, Public Health and Rehabilitation, 135–140.
Rutkowska, M., & Szczepaniak, S. (2018). Postępowanie paliatywne w opiece perinatalnej, praktyka kliniczna, etyka, prawo, psychologia. PZWL.
Sandelowski, M., & Barroso, J. (2005). The Travesty of Choosing After Positive Prenatal Diagnosis. Journal of Obstetric, Gynecologic & Neonatal Nursing, 34(3), 307–318. https://doi.org/10.1177/0884217505276291
Tataj‐Puzyna, U., Baranowska, B., Szlendak, B., Szabat, M., & Węgrzynowska, M. (2023). Parental experiences of prenatal education when preparing for labor and birth of infant with a lethal diagnosis. Nursing Open, nop2.1928. https://doi.org/10.1002/nop2.1928
Tataj-Puzyna, U., Szlendak, B., Szabat, M., Krzeszowiak, J., & Sys, D. (2023). This birth is difficult but beautiful—Parents’ experience of giving birth to a baby with a lethal foetal diagnosis. Palliative Medicine in Practice, 0(0), Article 0. https://doi.org/10.5603/PMPI.a2023.0017
Tataj-Puzyna, U., Węgrzynowska, M., Ryś, M., Sys, D., Bączek, G., & Baranowska, B. (2022). “This pregnancy makes sense”: Experiences of women who have decided to continue pregnancy after lethal fetal diagnosis. Death Studies, 0(0), 1–10. https://doi.org/10.1080/07481187.2022.2038310
Warland, J., O’Leary, J., McCutcheon, H., & Williamson, V. (2011). Parenting paradox: Parenting after infant loss. Midwifery, 27(5), e163–e169. https://doi.org/10.1016/j.midw.2010.02.004
Wool, C. (2011). Systematic Review of the Literature: Parental Outcomes After Diagnosis of Fetal Anomaly. Advances in Neonatal Care, 11(3), 182–192. https://doi.org/10.1097/ANC.0b013e31821bd92d
Wyrok Trybunału Konstytucyjnego z dnia 22 października 2020 r. Sygn. Akt K 1/20. (n.d.). http://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20210000175

Downloads

Download data is not yet available.