Imagine you go in for what you think is a routine ultrasound exam. With a grim face, the doctor says, “I’m so sorry to have to tell you this about the pregnancy. We ran several tests, and unfortunately, a fatal condition has been diagnosed and confirmed. There is a medical certainty that this child will die a month or two after birth, if not sooner. We can schedule a termination for you on Tuesday morning.”
The diagnosis of a lethal fetal condition can transform the joy of pregnancy into the devastation of loss. Some people believe abortion is the only reasonable choice to be made after a fetal life-limiting diagnosis. If the baby is doomed to die within months or sooner, why not perform an abortion to spare the mother the grief of having to continue a pregnancy and give birth? If expectant mothers do not choose abortion after lethal fetal diagnosis, so the argument goes, they will regret their decision.
This defense of abortion depends in part on an empirical claim about the likely consequences of continuing a pregnancy when the baby has a life-limiting diagnosis. Yet the evidence suggests that almost all women do not regret giving birth, even if their baby is doomed to die, and that abortion in such cases leads to less positive outcomes.
The Experience of Women Giving Birth After Fatal Fetal Diagnosis
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A 2018 article from the Journal of Clinical Ethics, entitled “‘I Would Do It All Over Again’: Cherishing Time and the Absence of Regret in Continuing a Pregnancy after a Life-Limiting Diagnosis,” examines these cases. The authors write, “Some—or perhaps many—people assume that ending a pregnancy shortly after a diagnosis of an LLFC [Life Limiting Fetal Condition] would subsequently relieve regret and lessen the grief parents anticipate from carrying a baby with severe problems.” In fact, however, data “from this study and others suggest that more profound regret comes from failure to spend as much time with their children as they would like, even during pregnancy.”
When asked, “Do you have any regrets about continuing the pregnancy?” the study found an overwhelming and emphatic lack of regret:
Absence of regret was articulated in 97.5 percent of participants. Parents valued the baby as a part of their family and had opportunities to love, hold, meet, and cherish their child. Participants treasured the time together before and after the birth. Although emotionally difficult, parents articulated an empowering, transformative experience that lingers over time.
Mothers described multiple factors leading to a strong lack of regret. The first was an experience of love. In the words of one mother, “All my son knew was love.” Another wrote, “We are rich in love because of her.” A second dimension was the cherishing of time with the short-lived son or daughter, “We would not trade those six hours for anything in the world.” Another mother said, “I will always cherish the time I had with her.” A third dimension involves meeting the child, “My family was able to be present when she was born and everyone got to meet her and hold her while she was alive.” And finally, mothers spoke of the joy of holding their child, “I got to hold my baby for an hour… no regrets.” “I got the chance to see her, hold her and honor her sweet life.”
Parents also reported self-transformation and growth. In the words of one parent, “This became perhaps the most profoundly positive experience of family has ever had. I think nothing else has ever strengthened our faith or drawn us closer together.”
Another study, from the Journal of Prenatal and Perinatal Psychology and Health, found similar results for parents who chose to continue a pregnancy after a lethal fetal diagnosis. The authors found that “After the birth, and at the time of the baby’s death, parents expressed thankfulness that they were able to spend as much time with their baby as possible.” For example,
During pregnancy Melissa was not ready to plan his birth/death, she just wanted to enjoy the pregnancy and feeling Caleb alive inside. Even after birth of her stillborn son this mother enjoyed being with her baby, “It was wonderful. We had him all wrapped in a special blanket and I held him. We had some family come in and our priest came in. I got to like show him off. I was kind of like introducing people to him and everybody has said to me that like they were kind of in shock. I promise you. I was gloriously happy.”
Another study, this one in the Journal of Palliative Medicine, notes that
One surprising finding was that many couples felt that their baby’s birth was joyful, even if the baby was stillborn or died shortly after birth. One mother: “I promise you, I was gloriously happy. I felt his angel glow or something.” Several participants in this study described their baby as “perfect,” and enjoyed looking at all of the baby’s features for family resemblance.
Researchers in this study were
surprised to find that the majority of parents were so happy to meet their baby, even joyful and at peace, even if he/she was stillborn or died within a few hours. No obvious pattern of parent characteristics, such as their religiosity, were associated with this response. In fact, only 12 of the 30 parents spoke specifically about their religious faith as impacting their pregnancy experience and decisions directly.
Though incredibly difficult, women who continued their pregnancies despite a lethal fetal diagnosis did not regret giving birth but found joy and peace.
Contrasting Outcomes of Abortion
The consequences of abortion in cases of fetal incompatibility with life and other fetal anomalies do not show the same positive results. A meta-analysis appearing in the Journal of Obstetric, Gynecologic & Neonatal Nursing, entitled “The Travesty of Choosing after Positive Prenatal Diagnosis,” summarized numerous studies on the effects of abortion following prenatal diagnosis of fatal as well as non-fatal impairments. This study found that “Couples experienced selective termination as traumatic, regardless of the prenatal test revealing the fetal impairment or stage in pregnancy in which the termination occurred.” Moreover, the study found that, “Women who terminated pregnancies following positive prenatal diagnosis, especially by CVS [chorionic villus sampling], wanted to mourn but felt they did not deserve to mourn.”
In contrast to the feelings of peace, joy, and love felt by those who had continued pregnancies despite fetal life limiting diagnosis, women who chose abortion felt conflicted by inner disharmony:
The strategies women used to reconcile conflicts engendered by selective termination—denying the personhood of the baby, limiting the information they sought about the baby, transferring agency for choice to others, adopting a stance of moral relativity, avoiding disclosing or selectively disclosing the event to others—worked briefly but the women ultimately felt as if they were betraying themselves and their babies.
The meta-study found: “Couples, health care providers, family, and friends underestimated the intensity and duration of feelings of loss following selective termination.”
Finally, a study out of Duke University found: “Women who terminated reported significantly more despair, avoidance and depression than women who continued the pregnancy. Organizational religious activity was associated with a reduction in grief in both women and men. Conclusion: There appears to be a psychological benefit to women to continue the pregnancy following a lethal fetal diagnosis.”
What to Do
Women who receive a lethal fetal diagnosis deserve our compassion and support. Fortunately, organizations such as Caring to Term and Perinatal Hospice & Palliative Care provide information and support for these tremendously difficult situations. Unfortunately, doctors sometimes pressure women into getting abortions and do not share with them the information that is necessary to make an informed choice. Those who receive a lethal diagnosis deserve to know the truth that 97.5 percent of women who continue pregnancies when the baby is doomed to die have no regrets about doing so—and that abortion does not have similar outcomes. Numerous studies have come to the same conclusion: giving life rather than aborting is likely to lead to greater psychological benefit for women whose baby is doomed to die.