Abstract
BackgroundFoetal reduction—removal of one or more foetuses to reduce the number of foetuses in multiple conceptions—is a procedure used for improving pregnancy outcomes following assisted reproductive technology (ART) treatment. While there is a recognition of the importance of understanding the experiences of women who undergo foetal reduction to offer appropriate help and support, studies that provide relevant insights are sparse. Our aim was to gain an in-depth understanding about first-time mothers’ experiences of foetal reduction following ART treatment in Taiwan.MethodsWe adopted a qualitative design based on a phenomenological approach for this study. In-depth semi-structured interviews were conducted with seven first-time mothers who underwent foetal reduction following ART treatment at a fertility centre in Taipei, Taiwan. All interviews were recorded, transcribed and analysed using the Colaizzi strategy.ResultsThe views and experiences relating to foetal reduction reflected five key themes: hesitation, ambivalence and distress; the guilt of knowingly terminating a life; rituals and ceremonies to ease the sense of guilt; persuading oneself to consider the ‘big picture’; and wishing for a reunion in next pregnancy. Mothers often regretted that they took clinical advice to implant multiple embryos and then having had to resort to foetal reduction. There was a sense of hesitation, ambivalence and distress reflected in the views from all participants. They believed that they ended the fetuses’ lives knowingly and expressed strong feelings of guilt. Mothers often tried to persuade themselves to look at foetal reduction within the ‘big picture’ of the overall pregnancy outcome. Losing their unborn babies was as an unforgettable incident for most mothers, and they wished for a reunion with the lost baby in the next pregnancy.ConclusionFindings indicate the need for ART providers to undertake a more sensitive approach that involves detailed discussions with women and their families to tailor the embryo transfer processes to suit individual needs. Women who undergo foetal reduction should be provided with tailored interventions towards enhancing their coping strategies before and after foetal reduction taking into account the cultural and religious context.
Highlights
Assisted reproductive technology (ART) is increasingly being used as an acceptable method to enable women with untreatable infertility to conceive healthy babies.Huang et al J Health Popul Nutr (2021) 40:47More than seven million babies were born worldwide within the last four decades as a result of successful assisted reproductive technology (ART) treatment [1]
The views and experiences relating to foetal reduction reflected five key themes: hesitation, ambivalence and pain; the guilt of knowingly terminating a life; rituals and ceremonies to ease the sense of guilt; persuading oneself to consider the ‘big picture’; and wishing for a reunion in pregnancy
The women’s desire to have had the right number of the implanted embryos to avoid the difficult experiences of foetal reduction was evident in the accounts: “When receiving the implantation, the doctor told me that some may not develop into healthy embryos, he suggested to implant all of the four embryos to maximise the success rate
Summary
Assisted reproductive technology (ART) is increasingly being used as an acceptable method to enable women with untreatable infertility to conceive healthy babies.Huang et al J Health Popul Nutr (2021) 40:47More than seven million babies were born worldwide within the last four decades as a result of successful ART treatment [1]. ART treatment is often linked to the likelihood of multiple conceptions [2] that carries significant implications for the health of the mother and the foetus and a higher risk of maternal and perinatal morbidity [2]. Foetal reduction, defined as the removal of one or more foetuses to reduce their number to one or two, is a method used for improving pregnancy outcomes following ART treatment [8]. Foetal reduction is used to reduce pregnancy loss, pregnancy related-complications and morbidity and mortality of the new born, and to improve birth weight and gestational age [9]. Foetal reduction—removal of one or more foetuses to reduce the number of foetuses in multiple con‐ ceptions—is a procedure used for improving pregnancy outcomes following assisted reproductive technology (ART) treatment. Our aim was to gain an in-depth understanding about first-time mothers’ experiences of foetal reduction following ART treatment in Taiwan
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