Supporting families after the termination of a pregnancy due to foetal anomaly

In 2015 my parents were told their baby had Trisomy 18, a fatal foetal chromosomal disorder. They debated all the options but it was very unlikely the foetus would survive to full term, let alone birth. As well as their 4 already existing children to consider, they ultimately decided to terminate at 17 weeks and named her Daisy.

This was a pregnancy my parents had longed for for more than 2 years, and undoubtedly grieved for. While it may seem deeply obvious individuals grieve after a loss of a pregnancy, baby or child, many do not associate abortion with grief.

Whenever we talk about our loss, we always call it that – a baby loss. Very rarely, if ever, do any of us say it was a termination, even though it was. Because it doesn’t feel that way.

The experience we had doesn’t feel like one that is typically associated with abortion care. Yes, it was a decision we made, it didn’t happen naturally on it’s own, but it certainly wasn’t something that my parents wanted to do. It also wasn’t something that was over as soon as my parents walked out of the hospital.

There is currently no opportunity to recognise a pregnancy loss before 24 weeks gestation. We have to understand this may be very distressing for some parents who would like a legal recognition of their baby.

Sands, the leading stillbirth and neonatal death charity, believe it should be up to individual parents to decide if they want to recognise and commemorate the pregnancy loss. All parents whose baby is lost before 24 weeks’ gestation should be offered an unofficial “certificate of birth” from the hospital or clinic. Sands offer five different templates to ensure healthcare staff can choose the form template that is most appropriate for each family.

Maria Huant, Bereavement Support Services Manager, Sands, explained to me that the certificate ‘recording a baby’s name, date of birth and other important information can help parents feel their baby’s life is validated’ and they ‘can give parents much-needed acknowledgement or their baby’s existence’.

With 1 in 4 pregnancies ending in a loss and around 5,000 of those ending by terminations on the grounds of fetal anomaly in the UK, many individuals who end pregnancies for this reason find themselves excluded from both conversations of abortion and baby loss. Lizzie D’Angelo, Policy & Research Director, Tommy’s explains that “families who experience termination for medical reasons often feel excluded from the wider baby loss community, increasing their isolation.”

Despite being legally available for over 50 years in the UK, the stigma surrounding abortion is sometimes overwhelming for individuals accessing treatment. As a society, we perceive abortions to be something that an individual or couple decided on, and ultimately wanted to do. We also still believe that abortion is always the worst and last option for an individual.

Yet when we hear of someone losing a pregnancy, our initial thoughts are very different. We sympathise with them, and almost grieve with them. We offer them support in every way we think they could need, and rightly so.

Many individuals who end a pregnancy with fetal anomalies feel guilty, stigmatised or fearful of how others will react to their decision. This persistent taboo means many people find themselves keeping their experiences to themselves.

We need to open ourselves to learning more about how people who have abortions feel so that we can better support them. Abortion will always be a unique, individual experience that is of course different for everyone. While some may want to close the door behind them as they leave the clinic, others may acknowledge their experience as a loss and want or need appropriate support afterwards.

P.S. The graphic used to promote this blog post is not correct. Not all people who have abortions make a free 'choice' to have one, for some abortion is planted in their hands as the only option.

Our job is to ensure there are always multiple options available legally. Without legal choice, families in these awful situations have no way out.