Managing broken expectations after a diagnosis of fetal anomaly

• Published in: SSM. Qualitative research in health 2022-12, Vol.2, p.100188, Article 100188
• Main Authors: Theroux, Rosemary, Hersperger, Cheryl L.
• Format: Article
• Language: English
• Subjects: Antenatal care; Congenital abnormalities; Expectant parents; Maternal behavior; Qualitative research; Theory
• ISSN: 2667-3215; 2667-3215
• DOI: 10.1016/j.ssmqr.2022.100188

The prenatal diagnosis of a fetal anomaly is unexpected, and for many parents it is devastating. It is considered a traumatic perinatal event that presents a crisis for parents. Expectant parents dealing with a lethal anomaly are particularly at increased risk for perinatal depression, anxiety, and traumatic stress. A growing number of qualitative researchers have examined the experience of fetal anomaly. Despite the accumulating knowledge, theory has not been developed. The purpose of this study is to analyze and synthesize evidence drawn from grounded theory research in order to develop a theory that describes and explains the process parents use to manage the diagnosis and predict their needs. A systematic search was conducted in 5 databases. Fourteen grounded theory research articles were chosen and were analyzed with grounded theory methods. Parents' expectations about pregnancy and future parenting were broken with the diagnosis of a fetal anomaly. Parents use a six-stage process of Repositioning to work through the problem and direct their course on the best new pathway for their family. Both personal and situational conditions influenced the decisions and management strategies used by the family. The factors that enhance parents’ repositioning can facilitate the development of interventions to improve the care for these families. •Receiving the unexpected news of a fetal anomaly, is a traumatic perinatal event that represents a crisis for parents.•Their expectations of the path to parenthood were broken, and a new pathway was needed.•A theory is needed that describes, explains, and predicts how parents manage the broken expectations and determine a new pathway.•The process of repositioning is used to manage their broken expectations and facilitate navigation along the pathway. Multiple factors enhance repositioning and affect the decisions and strategies used to manage the crisis.