The psychological effects of selective termination in multifetal pregnancies.
Item
-
Title
-
The psychological effects of selective termination in multifetal pregnancies.
-
Identifier
-
AAI9417492
-
identifier
-
9417492
-
Creator
-
McKinney, Mary Kathryn.
-
Contributor
-
Adviser: Steven Tuber
-
Date
-
1994
-
Language
-
English
-
Publisher
-
City University of New York.
-
Subject
-
Psychology, Clinical
-
Abstract
-
Selective termination is a medical procedure performed on women who have conceived multifetal pregnancies, usually after infertility treatment, in which some of the fetuses are aborted while others are left to be carried to term. Although physical risks associated with carrying more than two fetuses may be reduced with first-trimester pregnancy reduction, this is the first controlled study to assess the psychological risks to the mother incurred by the medical intervention.;The rates of depression and psychiatric symptoms of 42 women who underwent selective termination (ST) were compared with those of 44 women who had also become pregnant after infertility evaluation and/or treatment but who conceived only a single fetus or twins, and thus did not need to undergo a pregnancy reduction. Of the ST patients, 34 were still pregnant or had given birth at the time of the interview, while 8 had aborted the entire pregnancy subsequent to the ST. In the control group, 34 were pregnant or postpartum when interviewed, and 10 had spontaneously aborted the pregnancy.;Among ST patients and controls with a successful pregnancy outcome there were no significant differences in rates of depression or psychiatric symptom levels. For example, 14.7% of both ST patients and controls with successful pregnancies reported depressive episodes which met criteria for Major Depressive Disorder (MDD). While multifetal reduction did not appear to put women at significant risk for MDD, miscarriage of the entire pregnancy was highly associated with depression: 75% of the miscarrying ST patients and 60% of the miscarrying controls reported MDD.;When pregnancy outcome is successful, most women appear to cope well with ST and feel that they have made the best decision for themselves and their families. Only one successful ST patient regretted having undergone the procedure. On the other hand, most women experienced the multifetal pregnancy as a distressing life event, and reported anxiety, grief and guilt at the abortion of a wanted child. Detailed examples of subjective reactions to ST are provided, and the psychodynamic implications of the procedure are examined.
-
Type
-
dissertation
-
Source
-
PQT Legacy CUNY.xlsx
-
degree
-
Ph.D.
