The Process of Forsaking and Maintaining Pregnancy- Lived Experience and Coping Behaviors of Women with Multifetal Pregnancies and Fetal Reduction

Because of the progress of the reproduction techniques, the infertile problems can be solved in recent years. On the other hand, the incidence of multiple gestations has been increasing in recent years. As a result that the multiple gestations will cause the medical risk of fetus(es) and mothers, fetal reductions are recommended.
The fetus to be reduced used to be selected on technical grounds. Now, prenatal diagnosis by chorionic villus sampling on the fetus (es) before fetal reduction has been offered. Fetal reduction should be guided by the results of the genetic analyses. The women with multiple pregnancies when facing with fetal reduction would experience conflict, reluctance, guilt, and fear. Understanding their lived experience is essential to provide appropriate care. The purpose of this research, therefore, was to explore the lived experience of women with multiple pregnancies when undergoing fetal reductions.
This study adopted qualitative research design and was conducted by the field method. The setting was in one of the obstetrics, gynecology clinics in Taipei city. This clinic also offered genetic counseling and diagnosis. Ten women were chosen as the study samples by purposive sampling that became multifetal pregnant after in vitro fertilization treatment. As a primary care nurse, the researcher took care of the subject, and collected data. The data were collected between first consult to receiving fetal reduction five weeks later. Each subject took five face-to-face interviews and eight telephone interviews. The collected data were written as a narrative record. The data were analyzed based on the interpretive research strategies of phenomenology.
According to the results of this study, the main theme of the lived experience of subjects was “the process of forsaking and maintaining pregnancy”. It was put into two categories－the lived experience and coping behaviors. The lived experience comprised three stages: before fetal reduction, undergoing fetal reduction, and after fetal reduction. First, the lived experience before fetal reduction included: 1) The threatened feeling in reconfirming the fact of multiple pregnancy; 2) Difficulty in deciding whether to receive fetal reduction or not; 3) The depressed and complicated feeling when already decide to receive fetal reduction. Second, the lived experience when undergoing fetal reduction included: 1) The frightened and worried feeling when facing with the procedure of fetal reduction, 2) Increasing worried and helpless feeling when confronting doubts and blame from other family members; 3) Bearing the pain from fetal reduction physically and mentally alone. And finally, the lived experience after fetal reduction included: 1) Relieving oneself of the physical discomfort. 2) The sorrow caused by losing some fetuses; 3) Doubt about whether safe pregnancy and delivery or not when physical discomfort appears. 4) Filled with maternicity and back to normal course of pregnancy. Also, the results showed that five coping behaviors were used in order to pass the lived experience,
The results can be applied as a reference for clinical nursing staff.