Facing the Decision Whether to Have a Termination for Medical Reasons (TFMR)?
🩺 Considering a TFMR? Take the Test.
- A Termination for Medical Reasons (TFMR) is the ending of a pregnancy due to the diagnosis of a foetal defect. This is also known as a medically based or medically indicated termination. TFMRs are also performed to save the mother’s life.
- In most cases, the baby’s birth was eagerly anticipated, but the diagnosis of foetal anomalies is leading to the consideration of a late-term abortion.
- Birth defects are genetic or structural conditions present at birth. These affect the shape or function of body parts.
- It is common to experience shock, disbelief, despair, anger or guilt when receiving a positive diagnosis after antenatal testing. These feelings matter because you matter! 💚
📖 This page aims to provide you with helpful information about foetal defect abortions.
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TFMR — Your Self-Evaluation
When a Antenatal Screening Comes Back Positive...
Birth Defect Abortion (TFMR) Regulations
What are Foetal Defect Abortion Methods
Foetal Defect Diagnosis — Where to Go from Here
Worrying About Birth Defects Without Diagnosis?
Palliative Birth: An Option to Consider?
The Reaction of Others
TFMR — Your Self-Evaluation
Wondering whether to terminate your pregnancy because of possible foetal health problems? Answer three multiple-choice questions about your situation and receive an immediate evaluation!
When an Antenatal Screening Comes Back Positive...
During your first or second trimester, you will be offered screening tests to check for genetic conditions. These are non-invasive blood tests that use the baby’s genetic information within your blood. You will also be offered ultrasound scans to check the baby’s development.
- For more information, go to Antenatal Screening.
If the antenatal screening shows an increased likelihood of a genetic condition, diagnostic tests are necessary if you want to evaluate whether an abnormal genetic makeup is present. This is done via amniocentesis.
- For more information, go to Positive Screening Result — Probabilities and Follow-up Tests?
While diagnostic tests have a higher accuracy rate than screenings, they cannot determine the severity of the condition.
- For more information, go to Common Antenatal Diagnoses.
- Read more about Down Syndrome (Trisomy 21).
Take a deep breath! In most cases, you will have several weeks before a decision must be made.
- Wondering until when you can have an elective abortion for foetal defects? Find out HERE.
Before deciding whether to terminate your pregnancy, seek a second opinion from a genetic counsellor, a developmental paediatrician or a high-risk obstetrician.
Here are some questions to ask your health care specialist:
- What is the percentage rate of false positives?
- Is further testing possible?
- What would life look like with this disability?
- What kind of resources are available?
Seeking answers is key to making a decision that leaves you free of regret.
Birth Defect Abortion (TFMR) Regulations
Antenatal screenings are commonly offered between weeks 11 and 14. The anatomy ultrasound scan is given around week 20. Therefore, most foetal defects are diagnosed after the first trimester.
Threshold restrictions that apply to a healthy baby are often extended in cases of foetal abnormality. This can ease the pressure of having to make a quick decision. The regulations that apply in the UK are listed in the table below.
- The numbers listed under your region are the weeks of pregnancy, counting from your last menstrual period (LMP).
Region | Regular Limit | Restriction for Foetal Defect Abortion |
GB | 24 Weeks LMP | unlimited |
N. Ireland | 24 Weeks LMP | unlimited |
Ireland | 12 Weeks LMP | unlimited |
- Surgeons usually consider the severity of foetal defects when determining abortion eligibility. They often limit terminations to defects that would drastically shorten the child's lifespan or consitute a 'significant handicap'. In the UK, this is known as 'Ground E'.
- While TFMRs are legal throughout pregnancy, this option may not be available. Most abortion clinics only perform first-trimester abortions, as second- and third-trimester terminations require entirely different methods.
- Want to know more about pregnancy termination regulations? ➡️ Go to Abortion Laws.
What are Foetal Defect Abortion Methods?
Once the screening results are in, the ultrasound is completed, and the baby has undergone further diagnostic tests, the pregnancy is well into the second trimester or beyond. A termination at this point would be considered a late-term abortion. Unless the life of the mother is at stake, TFMRs are elective abortions, since you have the choice to let nature take its course, or terminate the pregnancy.
There are three options for late-term abortions:
- Medical induction: Labor is induced in a hospital setting. If the pregnancy is beyond 22 weeks (point of viability), the foetus is given an injection to prevent a live birth. The procedure takes 1 to 3 days.
- D&E: The cervix is dilated, and the baby is evacuated in pieces. This procedure takes about 30 minutes.
- D&X: The cervix is dilated, and the baby is extracted feet first. The brain is removed to decrease the circumference of the head for easier expulsion. This is an outpatient procedure.
Most TFMRs in the UK are inductions as few trained surgeons are available.
For more information on late-term abortions, click HERE.
Foetal Defect Diagnosis — Where to Go from Here
A red flag during a screening or a diagnosis of chromosomal anomaly would turn your world upside down. The feelings you are having are a kind of grief — for the dreams and plans you had for your child’s future. Life may be different from what you had envisioned. It is normal to react with shock, sadness, anger, anxiety or guilt. Or perhaps you feel completely numb. Any feeling is valid.
💭 In addition to a whole range of emotions, you probably have many questions going through your mind. You might find it helpful to write them down. Here are some questions other women in similar situations have posed:
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Can I be sure that my baby really has a congenital disability and how could I be certain of the severity?
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How will others react?
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No one understands how I feel. Whom can I turn to?
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Will I be able to manage taking care of a special needs child? What kind of support is available?
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Should a special needs child have a right to birth? Does a special needs child want to live? Would foster care or adoption be a feasible option for me?
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Is life only worth living if it is free from suffering? Is that a decision I can make?
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How have other parents dealt with this situation? What were they going through emotionally? Would it be helpful to talk to them?
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Consider talking with someone who has walked this road before you. Perhaps they will allow you a sneak peek into their day-to-day lives. Additionally, you could find out more about support options. This will help you get a better picture of what to expect — without the pressure of choosing a specific route.
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Weighing your options may feel like a marathon — a long-distance race between your hopes and fears, leaving you exhausted. Medical professionals often add to the pressure, giving the impression that an immediate decision needs to be made.
🕰 Take the time to carefully weigh each step:
- What do I really want?
- Who would be a good support person for me?
- What are my personal values?
You owe it to yourself!
Worrying About Birth Defects Without Diagnosis?
According to a recent poll by Parents magazine, you are not alone: 78% of pregnant women share this fear. Perhaps you did not take advantage of antenatal care and are concerned that the baby did not receive proper nutrients. You may have conceived later in life and are aware of the higher risk of birth defects. Perhaps you have had a history of miscarriages and fear that something will go wrong again.
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Maybe you used alcohol, drugs or medication, and now you are wondering whether your consumption could have harmed your baby?
Frequently these suspicions prove to be groundless. Only 3% of babies are born with birth defects, most of which are minor or very treatable. You may find it helpful to speak to your doctor or midwife about these concerns.
Palliative Birth: An Option to Consider?
Some antenatal diagnoses reveal conditions that are life-threatening to the baby. It may not survive birth or only live for a short period of time.
If you would like to find out more about neonatal palliative care, go to:
The Reaction of Others
Unlike most elective terminations, you are considering the abortion of a baby that was desired and anticipated with joy. This turn of events has left you reeling. You and everyone around you expected your pregnancy to progress smoothly.
Many women in this situation feel very alone. The people around them are likely at a loss for words and may respond with little compassion and hurtful remarks — this may even include her partner. He may be overcome by his own sense of powerlessness and may not be able to provide support.
If this describes you, know that you are not alone. We want to be there for you by providing the support you long for. Our digital coaching supplies unbiased counsel, making you feel understood and heard. Our self-evaluation tools were developed with your situation in mind:
- ⚖️ Wondering whether to have a late-term abortion? — Take the Abortion Test and receive an immediate evaluation
- 💡 Your greatest concern — Take the Solution Finder Test
- 💪🏾 Do I have what it takes? — Strengths Finder Test
FAQs
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Theoretically, having a termination for medical reasons (TFMR) is possible until birth. An abortion is commonly considered "late-term" when performed after the first 12 weeks of pregnancy. Here, more complex abortion methods come into play, since early abortion methods can no longer be used. This can be very taxing for the woman. Usually, she is given ample time to weigh her decision and seek support. Our Fetal Defect Abortion Test may prove helpful in this situation.
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Even if your prenatal screening has shown an increased likelihood for Trisomy 21, this may not be confirmed. While you are gaining clarity, seek out families who are raising a child with Down syndrome. This will provide you with a picture of what life could look like. A wide array of support programs is available to special needs children and their parents. Other options include foster care or adoption.
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Consulting parents of special-needs children, as well as specialists, can provide guidance in knowing what to expect, and how to prepare.
A wide variety of state and private support options cater to the child's specific needs. For some, foster care or adoption is a good alternative.
If it becomes apparent that the baby is not expected to live long, a palliative birth can be planned for. Here, both baby and parents are cared for medically and emotionally, so that even a short time together can be filled with love and tenderness.
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Disclaimer:
While profemina aims to provide you with the most up-to-date information possible, we cannot guarantee the accuracy of all content found in this article.