[Psychological sequelae of abortion based on fetal indications]

Prenatal diagnosis is based on the concept of selective abortion. The termination of a pregnancy for genetic reasons means a great emotional loss followed by grief and mourning. The case reports of two women are presented, who chose to abort after the prenatal diagnosis of trisomy X. One of them showed psychological and psychosomatic symptoms as a sign of a pathological grief reaction. The depth of her grief is also shown by the published empirical investigations. Four analogous situations are discussed: abortion for psychosocial reasons, miscarriage, stillbirth and the death of premature or newborn babies. In comparison, the specific aspects of abortion for genetic reasons are: the intensive relationship to the child at the time of termination; the strains and anxiety engendered during pregnancy by medical investigations; the conflict situation without a simple solution; the personal decision and responsibility for the abortion; the compounded task of grieving and dealing with feelings of guilt. A routine follow-up for the affected women would be desirable.