Cognition, emotion, and behaviour in women undergoing pregnancy termination for foetal anomaly: A grounded theory analysis

Objective: To understand the cognition, emotions, and behaviour of women who had recently undergone termination due to a foetal anomaly. In this study, we developed and tested a theoretical model to describe how women went through the process after termination.

Study design: A grounded theory study.

Setting: Three general hospitals and one special hospital in Changsha, Hunan, China.

Participants: 41 women who had recently undergone a pregnancy termination.

Methods: In-depth interviews were conducted from May to September 2017. A combination of convenience sampling and theoretical sampling was used, and conceptual depth criteria were used to measure the progress of the theoretical sampling.

Findings: This study developed a cognitive-behavioural experience framework of women undergoing pregnancy termination due to a foetal anomaly. The model included 4 phases: 1. Denial Phase, 2. Confirmation Phase, 3. Decision-making Phase and 4. Recovery Phase. Different cognitive appraisal, emotional, and behavioural reactions were included in each phase, and the different reactions influenced one another.

Key conclusions & implications for practice: We built and tested a theoretical framework by interviewing women who had gone through a pregnancy termination. The framework describes their experiences more clearly from three dimensions, including cognitive appraisal, emotional reaction, and behavioural response in the different phases. This framework provides a basic understanding of the women's emotional process and, therefore, provides baseline data for developing an effective intervention to help women cope with termination stresses.