Hope after TFMR (Termination for Medical Reasons) – What to Know
When we think of pregnancy loss, we usually think about a miscarriage that occurs very early in pregnancy. Pregnancy loss, however, can also refer to the decision to terminate for medical reasons (TFMR). Terminating a wanted pregnancy for medical reasons can be a heartbreaking decision, and often women and couples feel like they are suffering alone. As a therapist in the Washington DC and Bethesda area, I have supported clients as they navigate these difficult times and have helped them work through the pain and loss that can be part of the journey to becoming a parent.
Women often, understandably, believe that once they enter the second trimester, that they are in the clear. The reality is, however, that genetic and/or chromosomal defects are often not detected until well into the second trimester. When a mother or couple has to make the heartbreaking decision to end a wanted pregnancy for the health of the mother or the fetus, it can not only feel very lonely, but can also feel taboo and shameful to talk about. As a maternal mental health specialist, it is my hope that with increased education and awareness about pregnancy loss, we can take some of the shame away from the decision to terminate a wanted pregnancy for medical reasons.
The experience of termination can feel traumatizing for both the woman and the couple. Depending on state laws, people may have to travel to safely terminate, or women may have to go to a clinic where there are protestors outside. There can also be the trauma of having to tell friends, family, co-workers, and even the parking lot attendant at your work, what happened. Pregnancy late in the second or even third trimester is noticeable. So when you suddenly don’t look pregnant, that can be a traumatic experience in and of itself.
Therapy can help women and couples process the trauma of what they have experienced. It can help unwrap the shame that can come in the aftermath of making such a decision. Therapy can help the woman or couple grieve the deep loss of the baby they had hoped and wished for. It can help them decide when they are emotionally ready to try for another baby. And then, it can help to process the anxiety around subsequent pregnancies – will this happen again? Can I ever feel safe in another pregnancy? These are common questions women and couples struggle with, and therapy can help to normalize, honor and address all of these questions as well as to process the underlying feelings of grief and loss.
Making the decision to end a wanted pregnancy for medical reasons can feel taboo and shameful, and the loss can be incredibly difficult and traumatic. It is important for women and couples to know that they are not alone; there is help, and there is hope. Please reach out for more information.