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Multifetal pregnancy reduction: psychodynamic implications

M K McKinney1, S B Tuber, J I Downey

  • 1University of Michigan Psychological Clinic, Ann Arbor, USA.

Psychiatry
|January 1, 1996
PubMed
Summary

Multifetal pregnancy reduction is a distressing event for women, causing bereavement and complex emotional responses. However, achieving healthy births often leads to satisfaction with the decision.

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Area of Science:

  • Psychology
  • Reproductive Medicine
  • Psychoanalysis

Background:

  • Advanced reproductive technologies impact maternal psychological experiences.
  • Multifetal pregnancy reduction (MPR) involves selective abortion in multiple pregnancies.
  • The psychological effects of MPR on women require in-depth examination.

Purpose of the Study:

  • To explore the psychodynamic implications of multifetal pregnancy reduction.
  • To analyze women's emotional experiences during and after MPR.
  • To understand the complex psychological responses to selective fetal abortion.

Main Methods:

  • Qualitative analysis of interviews with 44 women who underwent MPR.
  • Psychoanalytically-informed perspectives: drive theory, ego psychology, object relations, self psychology, and developmental psychology.
  • Exploration of emotional experiences, bereavement reactions, and attachment complexities.

Main Results:

  • MPR is a significant source of stress and distress for women.
  • Approximately 25% of women experienced bereavement reactions impacting functioning.
  • Common responses included ambivalence, guilt, and narcissistic injury, complicating maternal-fetal attachment.

Conclusions:

  • Despite distress, achieving healthy births often validates the decision for women.
  • MPR presents complex psychodynamic challenges for maternal well-being.
  • Further research with pre-reduction interviews and long-term follow-up is recommended.

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