Emotional and cognitive experiences during the time of diagnosis and decision-making following a prenatal diagnosis: a qualitative study of males presented with congenital heart defect in the fetus carried by their pregnant partner

Tommy Carlsson,Elisabet Mattsson

doi:10.1186/s12884-017-1607-y

Tommy Carlsson, Elisabet Mattsson

Open Access

https://doi.org/10.1186/s12884-017-1607-y

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Abstract

BackgroundExpectant fathers consider the second-trimester obstetric ultrasound examination as an important step towards parenthood, but are ill prepared for a detection of a fetal anomaly. Inductive research is scarce concerning their experiences and needs for support. Consequently, the aim of this study was to explore the emotional and cognitive experiences, during the time of diagnosis and decision-making, among males presented with congenital heart defect in the fetus carried by their pregnant partner.MethodsTwelve expectant fathers were consecutively recruited through two tertiary referral centers for fetal cardiology in Sweden, after they had been presented with a prenatal diagnosis of congenital heart defect in the fetus carried by their pregnant partner. The respondents were interviewed via telephone, and the interviews were analyzed using inductive qualitative content analysis.ResultsThe respondents experienced an intense emotional shock in connection with detection. However, they set their own needs aside to attend to the supportive needs of their pregnant partner, and stressed the importance of an informed joint decision regarding whether to continue or terminate the pregnancy. When terminating the pregnancy, they experienced a loss of a wanted child, an emotionally intense termination procedure, needs of support neglected by professionals, and worries about the risk of recurrence in future pregnancies. When continuing the pregnancy, they tried to keep a positive attitude about the coming birth, but were simultaneously worried about the postnatal situation.ConclusionsThe findings illustrate the importance of inclusive care and adequate follow-up routines for both expectant parents following a prenatal diagnosis. This includes the initial emotional shock, the decisional process, and depending on decision reached, the termination or continuation of the pregnancy. Expectant fathers presented with a fetal anomaly need adequate follow-up routines to address worries about risk of recurrence in future pregnancies and worries about the postnatal situation.

Highlights

Expectant fathers consider the second-trimester obstetric ultrasound examination as an important step towards parenthood, but are ill prepared for a detection of a fetal anomaly
The aim of this study was to explore the emotional and cognitive experiences, during the time of diagnosis and decisionmaking, among males presented with congenital heart defect in the fetus carried by their pregnant partner
The expectant fathers mentioned the importance of supporting their pregnant partner, and because of this set their own needs aside to be attentive to the needs of their partners

Summary

Introduction

Expectant fathers consider the second-trimester obstetric ultrasound examination as an important step towards parenthood, but are ill prepared for a detection of a fetal anomaly. Expecting a child is a life-transforming event [1], and expectant fathers go trough a process of adaptation to a parental role during the course of pregnancy, with increased emotional involvement as the pregnancy progresses [2,3,4] This process of adaptation may be experienced as a stressful period, involving a number of psychological difficulties. The lack of tangible evidence of the pregnancy may make it feel unreal, resulting in attachment difficulties for expectant fathers. They experience a change in the relationship with their pregnant partner, with a discrepancy of the expectations and needs within the couple.

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