Family-Centered Antenatal Care With a Life-Limiting Fetal Condition: A Developmental Theory-Guided Approach

Abstract

Trisomy 18 (T18) is the second-most common autosomal trisomy and includes multiple anomalies, growth restriction, and a severely shortened life span, often lasting only hours or days. Côté-Arsenault and Denney-Koelsch extended Reva Rubin's work, describing the psychosocial stages of pregnancy by describing the stages and developmental tasks for a pregnancy altered by a life-limiting fetal condition such as T18. When a diagnosis of T18 is made prenatally, the pregnancy changes dramatically, although it remains a psychosocial developmental process. The extended stages of pregnancy with T18 or another life-limiting fetal condition are: Pre-Diagnosis, Learning the Diagnosis, Living With the Diagnosis, Birth and Death, and Post Death. As they navigate these stages, parents must also address 7 developmental tasks of pregnancy, which are (1) Navigating Relationships, (2) Comprehending Implications of the Condition, (3) Revising Goals of Pregnancy, (4) Making the Most of Time With Baby, (5) Preparing for Birth and Inevitable Death, (6) Advocating for Baby With Integrity, and (7) Adjusting to Life in Absence of Baby. Knowledgeable health care providers can do much more than support parents through grief and facilitate discussions about birth planning. This case report highlights the importance of a knowledgeable provider who can help parents navigate the stages and tasks of pregnancy, empowering them to make choices consistent with their values so they have no regrets.