Emotional response and mental health of women undergoing medical termination of pregnancy for fetal anomalies in second trimester: A prospective observational study - 01/04/26

Doi : 10.1016/j.jogoh.2026.103172

Zeba Afreen ¹ , Vatsla Dadhwal ^2,^⁎ , Sujata Satapathy ³ , Vidushi Kulshrestha ⁴ , K Aparna Sharma ⁴ , Anubhuti Rana ⁵ , Richa Vatsa ⁵ , Juhi Bharti ⁵

¹ Junior Resident, Department of Obstetrics and Gynaecology, AIIMS New Delhi, India

² Ex-professor, Department of Obstetrics and Gynaecology, AIIMS New Delhi, India. Professor MFM, Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine

³ Professor, Clinical Psychology, Dept. of Psychiatry, AIIMS New Delhi, India

⁴ Professor, Department of Obstetrics and Gynaecology, AIIMS New Delhi, India

⁵ Associate Professor, Department of Obstetrics and Gynaecology, AIIMS New Delhi, India

^⁎ Corresponding author: Vatsla Dadhwal, Address: Vatsla Dadhwal, Room 217C, Department of Obstetrics and Gynecology, University of Illinois at Chicago, College of Medicine, 820 S.Wood Street, Chicago, Illinois 60612 Room 217C, Department of Obstetrics and Gynecology University of Illinois at Chicago College of Medicine 820 S.Wood Street Chicago Illinois 60612

Sous presse. Manuscrit accepté. Disponible en ligne depuis le Wednesday 01 April 2026

Abstract

Objective

To assess the emotional response and mental health of women undergoing second-trimester medical termination of pregnancy (MTP) for fetal anomalies.

Methods

This prospective observational study included 120 women undergoing MTP between 14–24 weeks gestation for fetal anomalies Emotional response and mental health were evaluated using the Impact of Event Scale–Revised (IES-R), Kessler Psychological Distress Scale (K10), Hospital Anxiety and Depression Scale (HADS), and Perinatal Grief Scale (PGS), administered before MTP and at 1 month post-procedure. Demographic, obstetric, and MTP-related data were collected using structured questionnaires and case records.

Results

At MTP, 50.8% of women reported acute stress reactions (IES-R), with 44.2% intrusion, 42.5% avoidance, and 41.7% hyperarousal. Psychological distress was observed in 55.8%, symptoms of anxiety in 65.8%, and depression in 59.2%, and grief response in 41.7% (active grief 58%, difficulty coping 40%, despair 38.3%). At 1 month, symptoms persisted in a subset: acute stress in 13.1%, psychological distress in 8.9%, symptoms of anxiety 30.4%, depression 35.2%, and grief in 84% women

Conclusions

Second-trimester MTP exerts a substantial psychological impact, with persistent emotional difficulties in many women. The findings emphasize the need for systematic psychological support, ideally extending to couples.

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Keywords : Second trimester, Medical Termination Of Pregnancy, Anxiety, Depression, Psychological Distress, Grief