Psychological trajectories of Chinese women undergoing pregnancy termination for foetal abnormality: A descriptive qualitative study using expressive writing

Abstract

Aims and objectives: To explore the psychological trajectories of women who have had a diagnosis of foetal abnormality from the time of receiving a definite diagnosis to one month after discharge.

Background: Foetal abnormalities are not uncommon worldwide. Such situations are devastating, and the termination of a pregnancy due to foetal abnormalities is a traumatic and stressful event for the mother.

Design: A descriptive qualitative approach using expressive writing.

Methods: The study included 20 women recruited through purposive sampling at a tertiary hospital in China. The participants were asked to write four 15-min essays related to their experiences with foetal abnormalities. Thematic analysis was used to generate themes. The COREQ checklist (see Supporting Information Appendix S1) was used.

Results: Four themes that reflected the women's psychological trajectories were identified: (a) traumatic response, (b) ruminant meditation, (c) positive coping and (d) post-traumatic growth stages. The psychological trajectories were dynamically shaped, and different responses were displayed in each stage.

Conclusions: Various responses were observed during each of the four psychological trajectories, which indicated that awareness regarding the psychological impacts associated with foetal abnormalities should be increased. The present findings suggest that healthcare services should be made accessible for women who have had a diagnosis of foetal abnormality to allow them to receive targeted nursing care at different stages and improve their psychological well-being.

Relevance to clinical practice: Midwives, nurses and other healthcare professionals should pay more attention to the mental health of women pregnant with foetuses diagnosed with abnormalities. Interventions designed based on women's worries and demands during various phases should be offered. In terms of the present research method, expressive writing possesses unique advantages that can be applied for relevant qualitative research.

Keywords: experiences; mental health nursing; psychological well-being; qualitative study; women's health.