During your pregnancy you will be offered screening tests for a number of conditions. These tests are entirely optional. They will usually involve a blood test and/or an ultrasound scan at around 8-14 weeks and 20 weeks of your pregnancy. According to ARC (the Antenatal Results and Choices charity) of approximately 720,000 pregnancies each year, 20,000 families will be told that their baby may have a serious condition.
If your screening test indicates that your baby is at high risk of a particular condition, you may be offered a diagnostic test to tell you if you baby definitely has that condition. Concerns may also be picked up about your baby’s health later in pregnancy, for example, if they are not growing properly.
What is a termination for medical reasons and why might I be offered one?
A termination for medical reasons is when your pregnancy is ended because it is in your or your baby’s best interests. It is important to remember this, as parents can often feel a strong sense of guilt when making their decision.
If a serious condition is identified which will likely significantly impact the quality or length of your baby’s life, you should have the opportunity to discuss your options with a fetal medicine consultant – this is a doctor who specialises in conditions impacting a baby’s development. One of the options you may be offered is a termination for medical reasons (TFMR) and this can happen at any point in your pregnancy. You can also request a TFMR if your pregnancy is under 24 weeks. If you make the request after 24 weeks, you doctor can refuse.
You may also be offered a TFMR if your pregnancy continuing is causing or would cause a significant risk to your life. For example, if you need emergency treatment which would harm your baby.
When offered with the choice to terminate, it is important that you have as much information as possible. This needs to be from reliable sources and specific to you and your baby. This may include speaking to other doctors such as a paediatrician, paediatric surgeon or geneticist. Not everyone will make the same choice when in the same situation. It is important that you feel empowered to make the right choice, for you and that you are given the time to do this.
What will the process involve?
There are two main ways to end the pregnancy. A medical termination involves taking medication to end the pregnancy/start your labour and then giving birth. If you are 21 weeks into your pregnancy or later, an injection may be given to your baby to stop their heart before they are born. A surgical termination is where the baby is physically removed under anaesthetic.
Your doctor should let you choose which method to use, if possible. A medical termination is usually recommended if you are over 13 weeks because most hospitals can’t perform a surgical termination after this point. However, you can have surgery up to 23 weeks and 6 days if your hospital offers it or from a private centre (such as BPAS).
Each method will have different things you will need to think about. For example, you will only be able to see, have a photo of and hold your baby if you have a medical termination. A medical termination also means you could choose to have a post-mortem or other tests if you want more information about your baby and their condition, particularly if this may impact any future pregnancy.
You should have a follow up appointment around 6 weeks later to see how you are coping and to discuss any tests and investigations that have been performed. You may need to wait longer for the results.
What support is available?
Choosing to end your pregnancy is undoubtedly a very difficult and often distressing decision to make, just as it would be with any other type of baby loss. It can also be a very isolating experience as it can be seen by some as a taboo subject and the word ‘termination’ may imply to some that the pregnancy was unwanted. It is important that you make the decision which is right for you and try not to be pressured by friends and family one way or another, to make a decision you may regret. However, you may find it hugely beneficial to get support either whilst you are making the decision or afterwards.
Antenatal Results and Choices (ARC) is a national charity which supports parents through the screening tests and any decision they may be faced with. Their website contains a wealth of information explaining the types of screenings tests, what is involved and they have a helpline you can call. ARC offer impartial information and support at any stage during the process. Their aim is to make sure all parents have the information they need to make an informed decision, without trying to influence that decision. If you chose to terminate your pregnancy, they also provide support through your grief journey.
Tommy’s midwives are also available to answer questions Monday-Friday, 9am-5pm on 0800 014 7800 or via email midwife@tommys.org. They also have a Facebook Support Group.
How Enable Law can help you?
We have acted for parents who were given the wrong information when deciding whether or not to end their pregnancy for medical reasons. A medical negligence claim is an opportunity for parents and their families to make sure the same mistakes aren’t made again. If you have any worries or concerns about whether your baby’s condition was missed during pregnancy or you were given incorrect information which said your baby had a specific condition when it didn’t, Enable Law can work with you to help you get the answers you need. Contact us to find out how.
