Termination for Medical Reasons

Termination for medical reasons (TFMR) is when a pregnancy is terminated due to a chromosomal, structural, or fetal abnormality whereby continuing with the pregnancy would risk the health or the life of the mother.[1] TFMR is one of the least talked about types of pregnancy and baby loss, however it is more common than people think.[2]

Termination for Medical Reasons
FormationApril 2012 (2012-04)
Type
WebsiteTermination for Medical Reasons on Facebook

Often, there is no right or wrong decision in a situation involving TFMR. Everyone’s circumstances are different.

When deciding about whether to continue with the pregnancy a few areas that may be considered are:

  • The severity of the condition;
  • The life expectancy of a child with the condition;
  • The quality of life for the child;
  • The treatment options for the condition;
  • Personal values and beliefs;
  • Financial situation and job considerations
  • General family situation and availability of social support
  • Other children this may impact.

Often, religious, political, and social determinants also play a role in a person's choice. Women or birthing parents may choose to make this decision alone, with the other parent, or by speaking with others (family, friends, health professionals) depending on their situation. There is no right answer.[1]

Diagnostic Testing & Procedures

If a pregnancy is determined to be high risk for a chromosomal condition, the birthing parent will then be encouraged to undertake a diagnostic test which can conclusively identify the baby’s health.

Two diagnostic tests that are considered when a pregnancy is believed to high risk include chorionic villus sampling (CVS) or amniocentesis.

Individual states and countries vary on their restrictions for termination of pregnancy.

Psychosocial Considerations

Pregnancy termination is a stressful experience. In TFMR, the concept of "choice" does not accurately capture the true complexities of deciding to end a wanted pregnancy. Approximately 72% of parents undergoing TFMR felt that that their experience was not the same as other types of baby loss, and that they do not always feel they "fit in" with other types of baby loss support groups because of their specific experience.[3]

What to do if you are experiencing TFMR

Ask for support from friends, family, and medical personnel. When speaking with your healthcare provider, ask for resources to be provided in writing, as often times verbal information may be difficult to take in and remember during times of high stress. Parents undergoing TFMR often need practical information regarding what to expect before, during, and after their medical procedure such as what to bring to the hospital, what their delivery involves, how their bodies will react afterward, as well as ways to say goodbye or otherwise commemorate their child.[3]

Speaking with a clinical psychologist, health psychologist, or other mental health professional may help you through the grieving process. Often, you may find a provider who has special training in anxiety, grief/loss, life transitions, trauma, and perinatal distress, and professional experience working with and supporting women, birthing parents, and families during pregnancy and the postpartum period. It is not uncommon for individuals facing a TFMR decision to experience feelings of guilt, sadness, and isolation.

When involved in psychotherapy for TFMR, the process may often include cognitive and behavioral approaches aimed at improving thoughts, feelings, and behaviors, to include positive coping strategies. According to Zareba et al. (2018), coping strategies most frequently mentioned in literature are: conversation (with the partner, family, friends, psychologist, physician), internalization of one’s feelings, participation in support groups, psychotherapy, seeking information (in the literature, on the Internet, on television), denial and repression, concentrating on one’s children, trying to conceive again quickly, seeking spiritual support, waiting, memorializing rituals, going on vacation or holiday with the partner or family.[4]

What to do if you know someone experiencing TFMR

Compassion and sensitivity are especially important, as those who have had or are considering TFMR can often feel judged. Work on communicating with respect, being considerate and kind, and offering tangible and emotional support.[5]

TFMR Campaign in Ireland

Termination for Medical Reasons (TFMR) is also a campaign and support group seeking to change the law in Ireland to allow terminations in cases of fatal foetal abnormalities. Amanda Mellet (of Mellet v Ireland) is a founding member.[6][7][8] They campaign for better services for people who experience fatal foetal abnormalities. In 2016 they welcomed the Irish government's new guidelines on bereavement counselling for grieving parents.[9]

Initial meeting with politicians

In April 2012, TFMR met with a group of 25 TDs and Senators who were investigating how to reply the European Court of Human Rights judgement in A, B and C v Ireland, and to ask for a change in Ireland's abortion law. Senator Rónán Mullen, who was in attendance, was not sympathetic to their cause,[10] asking what their real agenda was.[11][12][13][14][15] He later denied being nasty to the women.[16]

Protection of Life During Pregnancy Act 2013
See also: Protection of Life During Pregnancy Act 2013

During the debate on the Protection of Life During Pregnancy Act 2013, the group called for an exception to allow termination in cases of fatal foetal abnormalities,[17][18] however Taoiseach Enda Kenny claimed it would be unconstitutional to include that.[19][20]

Citizens' Assembly
See also: Citizens' Assembly (Ireland)

In 2016 the Irish government set up a Citizens' Assembly to discuss Ireland's abortion laws. TFMR made a submission calling for a repeal of the Eighth Amendment and the removal of abortion from criminal law.[21]: p6 

They were not invited to present to the Citizens' Assembly. Every Life Counts, a similar support/campaign group for parents of children diagnosed with fatal foetal abnormalities, but who are opposed to change in Ireland's abortion law, were invited.[22][23]

See also

See also

References
  1. "The Pink Elephants Support Network - Diagnostic Testing". The Pink Elephants Support Network. Retrieved 26 April 2022.
  2. "Break the silence around TFMR". Antenatal Results and Choices (ARC). Retrieved 26 April 2022.
  3. "A spotlight on Termination for Medical Reasons (TFMR) | Tommy's". www.tommys.org. Retrieved 26 April 2022.
  4. Zaręba, Kornelia; Makara-Studzińska, Marta; Ciebiera, Michał; Gierus, Jacek; Jakiel, Grzegorz (December 2018). "Role of Social and Informational Support while Deciding on Pregnancy Termination for Medical Reasons". International Journal of Environmental Research and Public Health. 15 (12): 2854. doi:10.3390/ijerph15122854. ISSN 1660-4601.
  5. "TFMR survey". Antenatal Results and Choices (ARC). Retrieved 26 April 2022.
  6. Sheridan, Kathy (17 April 2012). "'I believe in a loving God and that I won't be damned for what I did'". The Irish Times. p. 13.
  7. Griffin, Sam (13 November 2013). "Couple to file UN petition after being forced to travel for abortion". Irish Independent.
  8. Drohan, Freya (17 December 2014). "Parents of aborted baby: 'It's very hard for us not to be cynical' about Varadkar's claims". Irish Independent.
  9. Clarke, Vivienne (10 August 2016). "New guidelines for grieving parents welcomed". The Irish Times.
  10. @TFMRIRE (21 April 2012). "@CoraSherlock @kencurtin @MagicMumCom it is not a claim it was indeed Ronan Mullen" (Tweet) – via Twitter.
  11. @TFMRIRE (21 April 2012). "fyi re senetor ronan mullen his words were "you have a bigger agenda dont you" nasty comment to someone who had just lost their child END OF" (Tweet) – via Twitter.
  12. "The Nasty TD…The Smirking Senator". Broadsheet.ie. 21 April 2012.
  13. "TFMR The Late late Show April 20 2012". The Late Late Show. 20 April 2012. RTÉ One. Retrieved 19 December 2016.
  14. "MagicMum.com - View topic - FineGael TD : Fornication main cause of unwanted pregnancy". MagicMum.com. 19 April 2012. He told me i should of [sic] carried my baby till the end because Ireland has the best Palletive care in the world, he also said that he was sponosoring some child in africa that had one of the conditions that the other girl Ruths baby had. Then he asked one of us at the end of our session with them on the quiet he said "what is your :bomb: :bomb: :bomb: real agenda here?" this was to a girl who lost her daughter Aoife at 22 weeks
  15. Sheridan, Kathy (17 April 2012). "System 'ignores and stigmatises' women who travel for abortion". The Irish Times. p. 1.
  16. O'Carroll, Sinead (21 April 2012). "Ronan Mullen horrified at 'nasty' suggestions over abortion debate". TheJournal.ie.
  17. Minihan, Mary (26 June 2013). "Call for fatal foetal abnormalities amendment to Bill". The Irish Times.
  18. "Call on fatal foetal abnormalities". Irish Independent. 26 June 2013.
  19. O'Halloran, Marie (26 June 2013). "Unconstitutional to include fatal foetal abnormalities in legislation, Taoiseach says". The Irish Times.
  20. Brennan, Michael (27 June 2013). "Taoiseach refuses to change abortion law to cover fatal foetal abnormality". Irish Independent.
  21. "TFMR Ireland Submission to the Citizens' Assembly" (PDF). Termination for Medical Reasons. 14 December 2016.
  22. "17 Advocacy Groups to Address Citizens' Assembly on the Topic of Eighth Amendment". Citizens' Assembly. 21 February 2017.
  23. Pownall, Slyvia (26 February 2017). "Bereaved parents who lost babies due to fatal foetal abnormalities excluded from speaking at sitting of the Citizens' Assembly". Irish Mirror.
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