I am looking into a termination for medical reasons

If you received the news that your baby has a difference in their health, development or genetics, you may have been told that your baby’s life may be limited, or that their quality of life may be affected. Often, doctors can’t be sure exactly what the outcome will be for your baby and this level of uncertainty requires parents to make incredibly difficult decisions. Medical information is sometimes incomplete or contains grey areas and this can be shock.

You may face the possibility of ending your pregnancy.

This is sometimes known as a “termination for medical reasons” (you may see this referred to as a TFMR).

You might feel a lot of mixed emotions, confusion and self-doubt if you find yourself here. It is normal to worry about whether your baby is suffering, and also worry about health risks to yourself or your partner.

As part of your decision-making, you may need to investigate what a termination involves – mothers, fathers and other parents often want to gather as much information as possible. A medical team is best placed to discuss a termination procedure with you and answer questions about the details of what it involves.

In terms of making the decision though, these are individual circumstances for each family and it is important you aren’t pressured. There is no right or wrong during these times and decisions either way can be equally painful. Sometimes parents call it making the “least worst decision”. But not even that resonates for everyone. You might change your mind repeatedly, swinging back and forth, until you come to a decision. The responsibility can feel like a very heavy burden.

Some parents want the option of continuing with a pregnancy and for their baby to receive perinatal palliative care if born alive. If you want to consider this, raise it with your medical team now. In some cases it is possible, but not all.

A parent can sometimes feel relief, or partial relief combined with other emotions, when they discover termination is possible. Keeping a baby alive can involve a lack of information about their future – their health, life expectancy, medical treatment and potential suffering. Because of this, parents sometimes know soon after a diagnosis that they will make the painfully difficult decision to terminate a pregnancy.

Sometimes, parents imagine or hope for a miscarriage or stillbirth to end their baby’s life, so they don’t carry the responsibility of making that decision. If you have thoughts or feelings like this, know that it isn’t unusual and you are not alone, or a “bad” parent, for having them.

There is a long history of stigma and judgement attached to terminations and abortions in Australia. The background to this is often political and/or religious. This can cause extra distress for some parents and make decision-making even harder. Some parents also face barriers from their health providers – for instance some doctors or hospitals don’t offer terminations on religious grounds. People seeking terminations, including for medical reasons, sometimes have to look for a different health provider to carry out the procedure if their hospital or obstetrician says they can’t do it.

A termination for medical reasons might also clash with your own values, beliefs or religion and this can be a complicated issue. It is also common to worry about your own extended family or friends judging your decisions due to their beliefs.

It is up to you how much information you share with people at this time. Some parents find themselves in a situation where one partner can be open with their family about the circumstances, while the other partner does not feel as comfortable sharing the details with their own family. Differences are common and to be expected. As much as possible, communicate with each other about any differences and try to offer support.

If partners are making a decision together, it is healthy to discuss some of the following:

  • Similar and different thoughts, beliefs and feelings about terminating or continuing a pregnancy
  • How would we both feel about having a child with health issues or disabilities?
  • What support can we give each other and who else may be available to support us through this time?

Each state and territory has different laws regarding termination depending on the stage of pregnancy.

It can be complicated to find out exactly what applies to your situation and how you will be looked after.

If you are exploring a termination, your health team must tell you how much time you have to make the decision, as well as where and how a termination can happen. Your health team may include a genetic counsellor, midwife, GP, obstetrician or fetal medicine specialist, among others.

Generally speaking, in Australia a termination can be carried out as a day medical procedure up to about 14 weeks of pregnancy. Later in pregnancy, you will usually be induced in hospital, to go through labour and give birth to your baby. Again, it is important to discuss these issues with your healthcare team so they can give you the most accurate information about your individual circumstances.

When exploring a later termination that involves labour and birth, it can be helpful to ask about services and support for bereaved parents in the hospital.

Some helpful questions include:

  • How will they induce labour?
  • How can I spend time with my baby after birth and how much time?
  • Will I be able to hold my baby if I want to?
  • Is there a bereavement midwife or social worker to support me?
  • What might my baby look like when they are born?
  • What would happen to my baby’s body after we leave them?

Across different state laws in Australia, there are different stages of pregnancy where a termination can be approved based on a single doctor’s opinion. In some circumstances, a second doctor is required to review and approve the information. This can be very difficult and confronting for parents. It does not define whether a decision to end a pregnancy is morally right or wrong – it is because of legal and medical regulations.

When pre-natal diagnoses happen late in a pregnancy, additional processes may be needed for doctors to carry out a termination, such as a psychiatric review and panel of doctors who have to approve.

It is normal to experience  waves of sadness, teariness or other grief reactions, even if you haven’t yet made a decision.

This is not the kind of decision made in everyday life. It is messy, complex and painfully confusing. It is likely you will experience some grief even before a pregnancy ends. Lots of second-guessing and “what if” thinking can dominate your headspace during this time. You might be anxious about what is happening now but also more anxious than usual about long-term outcomes, especially future pregnancies.

Some people report becoming practical – focused on the appointments, medical information and tasks ahead, as a way of coping. There is no right or wrong way to react and everyone will experience different moments where their reactions vary.

If you need extra professional support during the decision-making process, there is a Medicare item number for “non-directive pregnancy counselling”, which can be used to provide a limited number of non-judgemental counselling sessions. You can ask your GP about this. You can also find professional and peer support organisations via our Mental Health and Wellbeing page.

Reproductive coercion and abuse is when a person feels forced, manipulated, unsafe or threatened by a partner around reproductive choices. This sometimes includes circumstances around abortions and terminations.

If you think this may apply to you, please seek professional help from the Australia-wide sexual assault and family violence service: 1800 RESPECT (phone 1800 737 732).

Our resources were collaboratively written by professionals and parents with lived experience of receiving a prenatal diagnosis. To learn more about the team behind this resource, please view:

Contributors Bios
Rachel Kleinman
Author
    Meagan Donaldson
    Reviewer
      Rheann Kennedy
      Reviewer

        These resources are provided for information purposes only and should be read in accordance with the Resource Library disclaimer.

        If you or a loved one need support, speak to your care providers or see our Mental Health and Wellbeing page for contact information for urgent and/or ongoing support. 

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