Related Experiment Video
Updated: Aug 16, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Parental decision-making after ultrasound diagnosis of a serious foetal abnormality
Hilmar H Bijma1, Hajo I J Wildschut, Agnes van der Heide
1Department of Public Health, Erasmus MC University Hospital Rotterdam, Rotterdam, The Netherlands. h.hbijma@freeler.nl
Insights
Parental decisions after fetal abnormality diagnosis are influenced by emotions, not just rational risk assessment. Understanding these cognitive and emotional factors is crucial for supporting parents through this difficult process.
Area of Science:
- Fetal Medicine
- Psychology
- Decision-Making Theory
Background:
- Parental decision-making after ultrasound diagnosis of fetal abnormalities is complex.
- Existing literature on parental decision-making in genetic counseling and general decision-making theories provides relevant insights.
- Limited data specifically addresses parental choices following ultrasound detection of serious fetal anomalies.
Purpose of the Study:
- To offer a comprehensive overview of theories guiding parental decision-making post-ultrasound diagnosis of fetal abnormalities.
- To inform clinicians in fetal medicine about relevant decision-making frameworks.
Main Methods:
- Literature review encompassing parental decision-making in genetic counseling and general decision-making theories.
- Synthesis of findings to apply to the specific context of fetal abnormality diagnosis.
Main Results:
- Parents often perceive risk in a binary manner (affected vs. unaffected), with less emphasis on probabilistic gradations.
- Focus shifts towards the potential impact on future family life rather than statistical risk.
- Emotional mechanisms, influenced by framing and stress, play a significant and potentially beneficial role, complementing rational processes.
Conclusions:
- Cognitive processes influenced by emotions are vital and beneficial in parental decision-making after fetal abnormality diagnosis.
- Assessment of parental decision-making should consider emotional outcomes alongside rationality.
- Clinicians should acknowledge the interplay of cognitive and emotional factors in supporting parental choices.
Objective:
The purpose of this article is to provide clinicians who are involved in the field of foetal medicine with a comprehensive overview of theories that are relevant for the parental decision-making process after ultrasound diagnosis of a serious foetal abnormality.
Methods:
Since little data are available of parental decision-making after ultrasound diagnosis of foetal abnormality, we reviewed the literature on parental decision-making in genetic counselling of couples at increased genetic risk together with the literature on general decision-making theories. The findings were linked to the specific situation of parental decision-making after an ultrasound diagnosis of foetal abnormality.
Results:
Based on genetic counselling studies, several cognitive mechanisms play a role in parental decision-making regarding future pregnancies. Parents often have a binary perception of risk. Probabilistic information is translated into two options: the child will or will not be affected. The graduality of chance seems to be of little importance in this process. Instead, the focus shifts to the possible consequences for future family life. General decision-making theories often focus on rationality and coherence of the decision-making process. However, studies of both the influence of framing and the influence of stress indicate that emotional mechanisms can have an important and beneficial function in the decision-making process.
Conclusion:
Cognitive mechanisms that are elicited by emotions and that are not necessarily rational can have an important and beneficial function in parental decision-making after ultrasound diagnosis of a foetal abnormality. Consequently, the process of parental decision-making should not solely be assessed on the basis of its rationality, but also on the basis of the parental emotional outcome.
