Termination for fetal anomaly: Are women in England given a choice of method?

Abstract

Choice of a medical or surgical method of termination for fetal anomaly (TFA) is advocated in national guidelines based on a similar risk profile. We investigated whether women are offered a choice of method, by surveying members of a UK parent support organisation. An online questionnaire was designed to examine respondents’ experience of TFA. A total of 351 responses were included in the final analysis. TFAs after 24 weeks’ gestation and selective reductions were excluded. Mean gestational age at TFA was 17 weeks; 14% (n = 50) were offered a choice of method, falling to 8% (n = 19) after 14 weeks’ gestation. Overall, 78% (n = 275) underwent medical TFA with 88% stating they chose it because it was the only method offered; 60% (n = 30) of those offered a choice had a surgical TFA. Our survey suggests that women having TFA are not offered a choice of method. Service delivery should be improved to meet national guidance and women's needs.

Keywords::

• Antenatal screening
• informed choice
• prenatal diagnosis
• termination for fetal anomaly
• women's preferences

Acknowledgements

We are very grateful to all the women who responded to the survey and were prepared to revisit such a difficult experience. We also greatly appreciate the invaluable input of the Expert Advisory Group.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Supplementary material available online

Supplementary Appendix 1 to be found online at http://informahealthcare.com/doi/abs/10.3109/01443615.2014.940291