The life and death dilemma

On what is needed by Parents who make a decision about the fate of their unborn, terminally ill baby.

When the diagnosis of a severe and irreversible fetal defect or incurable illness that threatens the fetus's life has been made, Parents learn that in accordance with the legislation of Poland they can take a decision about the termination of pregnancy. Usually, it is the only solution that is suggested, often without presenting the full picture of the abortion procedure and its consequences. Abortion is often a solution more or less directly forced on Parents and supported by a medical authority.

However, in these difficult circumstances Parents still have some freedom, in which there is room for seeing other solutions and making an autonomous choice. In order to make an informed and independent decision based on reliable information about either solution, several things are needed.

The first one is time. The adverse diagnosis is most often made or confirmed at around 20-22 weeks of pregnancy and Parents learn how little time is left to make a decision (according to the Act, performing an abortion is allowed until the end of the 24 th week of pregnancy). Strong emotions and a sense of having no time to think are hardly conducive to a profound reflection on life and death, whereas Parents need time to go through the first stage, which is usually a sense of shock after hearing the diagnosis of the baby's health. It takes time to understand what the baby's condition is really like and come to terms with it. At first, and often for a longer while, very strong defence mechanisms are in operation, which protect Parents from seeing and accepting the complete picture of the situation.

Finally, it takes time to gather reliable information and carefully consider what the alternatives are and what risks and benefits are entailed by either possible solution. This is time for talking to the people they trust and for expert consultations, to which Parents have the right.

Another consideration which is important for Parents at this time is professional and continuous support. Parents who learn that they unborn baby will die soon experience extreme suffering and deep grief. These hurtful feelings can be accompanied by fear of being forlorn and isolated from the world and other people because of their unusual circumstances. Parents may fear that no one will be able to accompany them in their suffering and grief.

The experience of fear of being left alone in their predicament results in a situation when it may be very hard for Parents to think of remaining in this state for much longer. The fear may be a decisive factor in taking a seemingly easier decision about the termination of pregnancy.

It is precisely at this moment that Parents need continuous support and certainty that there is someone who will stand by their Family through this time. It is crucial to convince Parents that if they decide to continue the pregnancy, they will receive professional medical support combining both professional and very humane approach. They need to feel sure that both themselves and the baby will receive the most suitable possible care.

The awareness that such support is available is crucial from the very beginning, immediately after the diagnosis, at the time when Parents are wondering what decision to take.

Only full information about what either of the possible solutions looks like: abortion, with the exhaustive description of the procedure, as well as continuing the pregnancy, with detailed explanation of the role of the professional supporting team and the huge influence of Parents themselves at the respective stages of pregnancy, childbirth and saying goodbye to the baby can result in an independent and informed Parents' decision.

Experience shows that a profound, unhurried reflection based on exhaustive knowledge accompanied by supportive and comprehensive care very often results in Parents' fully conscious decision about continuing the pregnancy. It is a moment which opens up before them a very fruitful, though uneasy path, as evidenced by those Parents who, remaining under the care of perinatal hospice, have gone this way. It is hard to find among them someone who would regret their decision.

Monika B.