University of Wisconsin–Madison Medical College of Wisconsin

Qualitative Pilot Study: Longitudinal Perspectives From People Who Had Second Trimester Abortions for Fetal Anomaly

Elise S. Cowley, BS*; Taryn M. Valley, MA*; Kelsey Christianson, BA; Suzanne Walczak, MD; Jessica A. Greenblatt, MD; Laura Jacques, MD

WMJ. 2024;123(3); published online in advance June 3, 2024.

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Background: We investigated patient experience with abortion for fetal anomaly, about which little is known.

Methods: This qualitative, longitudinal pilot study surveyed 7 patients twice after abortion for fetal anomaly, initially 4 to 5 days after the abortion and a follow-up 3 months post-abortion, at a single Wisconsin hospital from July 2012 to February 2014.

Results: Patients indicated that having a choice to have an abortion and choose the modality is imperative, and they remained certain in their decision-making over time. They also described initially strong, then lacking, social support; processed grief; and identified resource constraints.

Discussion: Patients emphasized the importance of having the choice to choose abortion and the abortion modality, remaining confident in their decision-making over time. This qualitative pilot study provides areas for future intervention to improve care for people undergoing abortion for fetal anomaly.

Author Affiliations: Department of Bacteriology, University of Wisconsin-Madison (UW-Madison), Madison, Wisconsin (Cowley); Microbiology Doctoral Training Program, UW-Madison, Madison, Wisconsin (Cowley); Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health (UWSMPH) Madison, Wisconsin (Valley, Jacques); Department of Anthropology, UW-Madison, Madison, Wisconsin (Valley); UWSMPH, Madison, Wisconsin (Christianson); Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin (Walczak, Greenblatt). *These authors contributed equally to this work.
Corresponding Author: Laura Jacques, MD, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, McConnell Hall, 4th Floor, 1010 Mound St, Madison, WI 53715; phone 608.890.2053; email; ORCID ID 0000-0003-2343-8358
Acknowledgements: The authors wish to thank the patients for making this study possible and their individual funding sources, as well as Andrea Zorbas and Amanda Wildenberg for administrative support.
Funding/Support: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Elise Cowley is a Medical Scientist Training Program (MSTP) student and was supported by a National Library of Medicine training grant to the Computation and Informatics in Biology and Medicine Training Program (NLM 5T15LM007359) at UW-Madison, and in part by MSTP grant T32GM140935. Taryn Valley is an MSTP student who was, during the work on this paper, funded in part by the CORE Lab, funded by a large, anonymous family foundation, and in part by MSTP grant T32GM140935. Kelsey Christianson was supported by the Herman and Gwendolyn Shapiro Foundation through a summer research award and UW-Madison Department of Obstetrics and Gynecology. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Financial Disclosures: None declared.
Ethics Approval and Consent to Participate: The project has been approved by the Medical College of Wisconsin Institutional Review Board (ID# IRB PRO00016460). Written consent was obtained from the original primary investigators, Jessica Greenblatt, MD, and Suzanne Walczak, MD, stating that only deidentified data are being provided for analysis by current investigators.
Availability of Data and Materials: The datasets generated and analyzed during the current study are not publicly available due to the specific nature of the content discussed and possible identifiability of participants from their data but are available from the corresponding author on reasonable request.
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