Psychological and ethical problems arising for physicians and parents from the prenatal diagnosis of malformations

Early diagnosis of a malformation has positive effects for the parents. Transitory agitation is followed by acception of the fact and stabilization. Obstetrical departments use a scheme of steps, which starts with talking to the mother and relating the problems in stages and continues with presentation of the case at a staff conference with obstetrician, pediatrician, and pediatric surgeon, and ends with psychotherapeutic consultation if necessary. The emotional situation of pregnancy with a malformed child and confrontation triggering a sequence of emotional reactions including wide individual variations are described. The use of new prenatal diagnostic techniques requires care in recognizing the psychological aspects and needs originating from unfavorable diagnoses.