Lafarge Caroline, Mitchell Kathryn, Fox Pauline
Research Assistant, School of Psychology, Social Work and Human Science, University of West London, London, UK.
Deputy Vice-Chancellor, Office of Vice-Chancellor, University of West London, London, UK.
Reprod Health Matters. 2014 Nov;22(44):191-201. doi: 10.1016/S0968-8080(14)44799-2.
Due to technological advances in antenatal diagnosis of fetal abnormalities, more women face the prospect of terminating pregnancies on these grounds. Much existing research focuses on women's psychological adaptation to this event. However, there is a lack of holistic understanding of women's experiences. This article reports a systematic review of qualitative studies into women's experiences of pregnancy termination for fetal abnormality. Eight databases were searched up to April 2014 for peer-reviewed studies, written in English, that reported primary or secondary data, used identifiable and interpretative qualitative methods, and offered a valuable contribution to the synthesis. Altogether, 4,281 records were screened; 14 met the inclusion criteria. The data were synthesised using meta-ethnography. Four themes were identified: a shattered world, losing and regaining control, the role of health professionals and the power of cultures. Pregnancy termination for fetal abnormality can be considered as a traumatic event that women experience as individuals, in their contact with the health professional community, and in the context of their politico-socio-legal environment. The range of emotions and experiences that pregnancy termination for fetal abnormality generates goes beyond the abortion paradigm and encompasses a bereavement model. Coordinated care pathways are needed that enable women to make their own decisions and receive supportive care.
由于胎儿异常产前诊断技术的进步，越来越多的女性面临基于这些理由终止妊娠的情况。现有的许多研究聚焦于女性对这一事件的心理调适。然而，对于女性的经历缺乏全面的理解。本文报告了一项对关于因胎儿异常而终止妊娠的女性经历的定性研究的系统综述。截至2014年4月，对八个数据库进行了检索，以查找同行评审的英文研究，这些研究报告了原始或二手数据，采用了可识别和解释性的定性方法，并为综合分析做出了有价值的贡献。总共筛选了4281条记录；14条符合纳入标准。使用元民族志对数据进行了综合分析。确定了四个主题：破碎的世界、失去与重新获得控制、医疗专业人员的角色以及文化的力量。因胎儿异常而终止妊娠可被视为一种创伤性事件，女性在个人层面、与医疗专业人员群体接触以及政治社会法律环境背景下都会经历这种事件。因胎儿异常而终止妊娠所产生的情感和经历范围超出了堕胎范式，涵盖了丧亲模型。需要有协调一致的护理途径，使女性能够做出自己的决定并获得支持性护理。
