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Negotiating acceptable termination of pregnancy for non-lethal fetal anomaly: a qualitative study of professional perspectives
  1. Lisa Crowe1,
  2. Ruth H Graham2,
  3. Stephen C Robson3,
  4. Judith Rankin1
  1. 1 Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
  2. 2 Sociology and Politics, School of Geography, Newcastle University, Newcastle upon Tyne, UK
  3. 3 Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr Lisa Crowe; Lisa.Crowe{at}


Objective This study aims to explore the perspectives of professionals around the issue of termination of pregnancy for non-lethal fetal anomaly (TOPFA).

Methods Semi-structured interviews were undertaken with medical professionals (14 consultants in fetal medicine, obstetrics, neonatology and paediatrics) and social care professionals (nine individuals with roles supporting people living with impairment) from the Northeast of England. Analysis adopted an inductive thematic approach facilitated by NVivo.

Results The overarching theme to emerge from the interview data was of professionals, medical and social care, wanting to present an acceptable self-image of their views on TOPFA. Professionals’ values on ‘fixing’, pain and ‘normality’ influenced what aspects of moral acceptability they gave priority to in terms of their standpoint and, in turn, their conceptualisations of acceptable TOPFA. Thus, if a termination could be defended morally, including negotiation of several key issues (including ‘fixing’, perceptions of pain and normality), then participants conceptualised TOPFA as an acceptable pregnancy outcome.

Conclusion Despite different professional experiences, these professional groups were able to negotiate their way through difficult terrain to conceptualise TOPFA as a morally acceptable principle. While professionals have different moral thresholds, no one argued for a restriction of the current legislation. The data suggest that social care professionals also look at the wider social context of a person with an impairment when discussing their views regarding TOPFA. Medical professionals focus more on the individual impairment when discussing their views on TOPFA.

  • UK
  • Termination of pregnancy
  • fetal anomaly
  • professionals
  • qualitative

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  • Contributors LC conceived and designed the research study, with RHG, SCR and JR. LC was responsible for the acquisition of data. LC coded and analysed all transcripts with RHG who coded a random sample. All authors were involved in the interpretation of the data. LC wrote the first draft of the manuscript and all authors were involved in subsequent revision. All authors approve the final manuscript.

  • Funding This research was funded by a medical research council/economic and social research council integrated studentship, G0800128-3/1.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval A favourable ethical opinion was received from the Newcastle and North Tyneside 2 Research Ethics Committee (10/H0907/50).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement This research is a result of a PhD by LC. This PhD is available via the Newcastle University depository.

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