Fetal medicine specialist experiences of providing a new service of termination of pregnancy for fatal fetal anomaly: a qualitative study

The implementation of termination services for fatal fetal anomaly is complex, challenging and requires institutional support.

Stacey Power Walsh, Sarah Meaney, Keelin O'Donoghue
Journal Name
British Journal of Obstetrics and Gynecology (BJOG)
Journal Article
Experience, Fatal fetal anomaly, Staff support, Termination of pregnancy
Experiences of pregnancy with major fetal anomalies
Full Citation
Power S, Meaney S, O’Donoghue K. Fetal medicine specialist’ experiences of providing a new service of termination of pregnancy for fatal fetal anomaly: a qualitative study. British Journal of Obstetrics and Gynaecology. 2021; 128: 676-684.
Link to Publication


Termination of pregnancy (TOP) for fatal fetal anomaly (FFA) was legislated for the first time in Ireland in 2018. This study aimed to explore the experiences of Fetal Medicine Specialists (FMS) in implementing this new service. We conducted one to one interviews with FMS from five of the six fetal medicine units. FMS faced many challenges with the ‘rapid’ introduction of TOP for FFA, particularly in the absence of institutional support and lack of additional resources. They feared getting a diagnosis of a FFA wrong because of media scrutiny and criminal liability attached to the legislation. The legislation was a challenge for them as it was unclear and open to interpretation regarding what constitutes a FFA. FMS reported the need for teamwork however experienced conflict with colleagues relating to the provision of feticide and palliative care. Additionally, FMS experienced psychological burden providing TOP for FFA but did so to provide this care to women. Our study identified a multitude of challenges experienced by FMS resulting from the suitability of the Irish legislation for TOP for FFA and its rapid introduction to practice. It suggests the need for peer and institutional support in the provision of a new service.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,