[Trouble within compassion: psychological guidance during prenatal diagnosis, from indication to decision]

This paper outlines the importance of psychological guidance throughout the process of prenatal diagnosis, according to the author's everyday experience in a multidisciplinary fetal medicine department. Consequences of the indication of a fetal disease are described for both sides (doctor and patient). The psychological mechanisms involved lead to the discomfort in the obstetrician's compassion and explain the intensity of the mother-to-be's reaction in the devastating situation. Being guided from the indication of a fetal malformation to her final decision aims to allow the mother to think through her first often impulsive and spontaneous decision and to consider different possibilities concerning the outcome of her pregnancy. A protocol is proposed. Guidance throughout the process of medical termination of pregnancy is developed. The psychiatrist's role should complement and follow through the psychological medical guidance. Its aim is to back up the technical and medical teams, to work on the psychoanalytic understanding of what the mother and the couple go through and have experienced, and also the consequences and the significance for the family. This is a preventive approach which deals with the feeling of guilt.