Men's experiences and need for targeted support after termination of pregnancy for foetal anomaly: A qualitative study

Abstract

Aims and objectives: To explore men's experiences of termination of pregnancy for life-limiting foetal anomaly, including how healthcare providers, systems and policies can best support men and their families. Background: While there is a sizable body of research and recommendations relating to women's experiences of grief and support needs following a termination of pregnancy for foetal anomaly, very few studies specifically examine men's experiences. Methods: Semi-structured interviews were completed with ten Australian men who had experienced termination of pregnancy for life-limiting foetal anomalies with a female partner between six months and 11 years ago. Interviews were completed over the telephone, and data were analysed using thematic analysis. COREQ guidelines were followed. Results: Thematic analysis resulted in the identification of three over-arching themes, each with two sub-themes. First, participants described the decision to terminate their pregnancy as The most difficult choice, with two sub-themes detailing ‘Challenges of decision-making’ and ‘Stigma surrounding TOPFA’. Second, participants described that they were Neither patient, nor visitor in the hospital setting, with sub-themes ‘Where do men fit?’ and ‘Dual need to support and be supported’. Finally, Meet me where I am described men's need for specific supports, including the sub-themes ‘Contact men directly’ and ‘Tailor support and services’. Conclusions: Findings indicated that termination of pregnancy for life-limiting foetal anomaly (TOPFA) is an extremely difficult experience for men, characterised by challenges in decision-making and perceived stigma. Men felt overlooked by current services and indicated that they need specific support to assist with their grief. Expansion of existing infrastructure and future research should acknowledge the central role of fathers and support them in addressing their grief following TOPFA. Relevance to clinical practice: Nursing/midwifery professionals are well situated to provide men with tailored information and to promote genuine inclusion, acknowledgement of their grief, and facilitate referrals to community supports. What does this paper contribute to the wider global clinical community? • This research provides new insights into the grief, healthcare and support experiences of men following termination of pregnancy for life-limiting foetal anomaly. Men experience unique challenges in comparison to women and require tailored information, direct support and active assessment and follow-up to both manage their grief and support their partner. • Midwifery/nursing staff and other healthcare professionals need to consider men's experiences and needs throughout the processes of decision-making, birth and follow-up. In addition, healthcare systems and policies require a family-centred and father-inclusive approach to promote genuine inclusion and acknowledgement of men as equal partners in pregnancy and childbirth.