The impact of prior medical termination of pregnancy on the mother’s early relationship with a subsequent infant

Abstract

Objective: There is insufficient research on the mother’s early relationship with a child born subsequent to a previous medical termination of pregnancy (TOP). This study explores mother-infant interactions following prior TOP and the impact on the infant’s development.

Methods: Being an exploratory research comprising 12 mother-infant (6–7 months old) couples, following prior TOP, and five controls, this study uses a descriptive methodology and a qualitative approach. The Greenspan and Lieberman Observation Scale (GLOS) and the Stern’s “R”-Interview were employed to investigate the mother-infant relationship. We used the Brunet-Lézine’s Revised Scales (BL-R) and the Projective Kit for Early Childhood (PKEC) to assess the infant’s development. Grief resolution was taken into account (Perinatal Grief Scale, semi-structured interview).

Results: The later the perinatal loss, the less likely children are to express their emotions and respond contingently (GLOS). Their psychomotor (BL-R) and emotional (PKEC) development remains adequate. Unresolved grief is associated with more pronounced disturbances: no dyadic exchange (GLOS), language disruptions (BL-R), and withdrawal from the environment (PKEC).

Conclusions: This study suggests that mother-infant interactions following a prior late TOP could undergo disturbances, which do not lead systematically to pathogenic effect on the subsequent child. Nevertheless, unresolved grief could lead to adverse effects.

• Child development
• early interactions
• mother-infant relationship
• perinatal grief
• termination of pregnancy

Acknowledgements

We are extremely grateful to all the families who took part in this study. The contribution of Juan Tecco in comments is also gratefully acknowledged.

Declaration of interest

The authors report no conflicts of interest. Mélissa Alexandre is FRESH Grant Holder of the Fonds de la Recherche Scientifique-FNRS. The Fetal Medicine Foundation Belgium partly funded this study.