Long term follow‐up of emotional experiences after termination of pregnancy: women’s views at menopause

Abstract

The objective was to explore women’s long‐term experiences and perspectives on their terminations of pregnancy (TOP) when perimenopausal. Eight women attending a menopause clinic who had experienced termination a minimum of 10 years previously (mean 24 years) completed semi‐structured interviews. Transcripts were analysed using Template Analysis. Five TOP themes were identified: ‘Impression left’ involved sadness, regret, and guilt which affected women’s self‐perceptions. ‘Judgement’ encompassed judgement on themselves and how censure was feared from others. ‘Growth and development’ noted the development of resilience and compassion for others. ‘Coming to terms and managing effects’ identified beliefs in the correctness of the decision, but effortful avoidance of thoughts still intruding into life. ‘Contradictions’ identified dramatic inconsistencies within almost all individual accounts indicating lack of resolution and full acceptance. Considering menopause and TOP together revealed a further three themes; Changes to thinking, Menopause as a time of reflection and Linkages or separateness. For some women termination may be continually reappraised in their changing life context and remain an active yet hidden feature managed through active avoidance. Menopause was viewed as a time of vulnerability to TOP‐related negative thoughts, especially where wishes for more children were unfulfilled. Accessibility of post‐termination counselling throughout life is recommended.

Keywords:

• termination
• pregnancy
• long‐term follow up
• menopause
• psychological
• qualitative

Notes

1. Individually itemised information about participants is not included to ensure the anonymity of participants recruited from a small clinical setting.

2. One participant was unsure of the exact number so, with her consent, this was verified.

3. Dates are those reported by participants. Where a woman had more than one TOP the individual mean is used in calculating the overall mean.

4. Highest order codes are written in bold underlined uppercase text, the next level are written in underlined uppercase text, the third order codes in uppercase text.

5. Please note all names used are pseudonyms and the age of each woman is written after their name for each first included quote.

6. This quote contradicts Tina’s previous quote. Such contradictions occurs in all transcripts and are discussed later.