Women with Correctable Fetal Anomaly Participating in Perinatal Team Counseling: An Exploratory Study

Abstract

Fetal anomalies are the second leading cause of infant death, and a major cause of long-term infant disability. Approximately 3% of U.S. births are complicated by major fetal anomalies. Advances in prenatal technologies, changes to universal screening standards, and changes in maternal characteristics have increased the likelihood of fetal anomaly detection. However, currently, we lack the research necessary to evaluate current intervention strategies used to assess what women need to effectively cope with the emotional turmoil that accompanies a prenatal diagnosis. Likened to a significantly traumatic life-event, women diagnosed with a fetal anomaly describe negative emotional responses such as anxiety, anger, and guilt, perceptions of inadequacy, social isolation, and grief-like reactions. Perinatal and pediatric interdisciplinary team counseling, a novel approach to counseling women with a fetal anomaly, involves use of perinatal and pediatric sub-specialists gathered to discuss and counsel on a specific fetal condition; offering women an opportunity to meet with the perinatal and pediatric sub-specialist, obtain information of the fetal diagnosis, prognosis, and anticipated post-natal course. Using Lazarus and Folkman’s Stress, Appraisal and Coping framework, this research was intended to explore the perceptions of women diagnosed with a correctable fetal anomaly, who participated in perinatal and pediatric interdisciplinary team counseling. Described in chapter II is an exploration of the perceived effectiveness of this method of counseling, assessing the effects on maternal anxiety, effects on coping, knowledge of the fetal anomaly diagnosis and prognosis, with perceptions of provider sensitivity. An integrative review of the literature is described in chapter III. A qualitative descriptive, semi-structured interview approach was used to explore the experiences of fourteen women, currently pregnant with a correctable fetal anomaly that completed interdisciplinary perinatal and pediatric interdisciplinary team counseling. Participants were recruited from a Midwest referral center, specializing in team counseling (Fetal Concerns Program of Wisconsin). Interviews were digitally recorded, transcribed verbatim and analyzed using content analysis. This study’s descriptive findings support interdisciplinary team counseling in helping women facing a prenatal diagnosis. Nurses play a key role in this process. Joining specialties during one-day and multiple day sessions was positively accepted and helped women in their journey.