Struggling with elective terminations of pregnancy

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I have finally have gotten a position in L&D. I had worked towards this position for many years now and somehow during my interview a question was raised and I was blindsided. I was asked if I would have a problem participating in late term terminations.... up to 26wks. How had I not realized this was a very real part of L&D? I worked with OB patients for 5yrs (MD office) and had also done my senior preceptorship in L&D, but somehow this never entered my mind. The interviewer proceeded to go into graphic detail about the procedure and needless to say the obvious reason why we could not comply if the patient requested footprints.

Wow... it's been a few months since and I'm still struggling with this.

I feel compassion for the mother who has to make the heart breaking decision to terminate because of medical/genetic/congenital reasons ect.

I struggle with the elective late termination because I just can not wrap my head around it. In one room I have a mother destroyed at the thought of losing her 25 weeker and in the other another patient as she stated is just "Getting rid of it".

Where is the line between our nursing duties and ethics.

Thanks so much for any response. I know this is a very touchy subject. :confused:

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Specializes in ICU/Critical Care.

To be honest, there are patients who do things that we do not agree with. But try not to be judgmental. It is not your place to tell the patient what they are doing is morally wrong. You may or may not know the reason behind the patient's actions. If you are uncomfortable taking care of a patient that is terminating their pregnancy, then refuse that assiignment.

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I don't know what to say. I had this sort of position for about three months back in the mid 1990's. My oldest daughter was really sick at the time and I just could not stay at the job. The stress in my life then was hard to deal with. I felt really torn. Although I wouldn't have an ab due to an anomaly, I didn't have much trouble caring for that type of pt. They are really grieving and doing what they feel is right. I got upset by people who were having 2nd trimester ab #2 or 3 due to lack of birth control, broke up w/ Mr. Wonderful (again!), hyperemesis (didn't think it would happen again w/ a different dad), and basically just being irresponsible because this was a way out. Some people are really disturbed by their ab's. Others are not. That is the truth from my experience. It was a real eye opener for me. Many people talk in hypothetical terms re. right for choice and psych issues related to having an ab. Truthfully, until you see it and work with it, you cannot fully appreciate the full scope of what is is to deal w/ the pts. and dead/dying fetuses.Every woman is different. I find that both the pro-life and pro-choice sides do a lot of lying and misleading. My experience didn't put me on the pro-choice side, but it did give me a window into another point of view. I will say that a lot of the choosing in these situations is very much not the woman's, but the husband or boyfriend's preference. Many men want to play, but do not want to pay. THere are of course, many good guys out there too, but there are also a lot of men w/ their hand in the equation too. Only you can decide what you can tolerate. I love L/D, but would not work in that type of setting again. You also have to decide if you can be supportive to all of the pts. The whole process of a late term ab, is quite an unpleasant and painful ordeal (which is why I never got why a pt. wouldn't do everything possible to prevent subsequent unwanted pregnancies). I wish you the best, you are in a difficult position.

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Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

I couldn't do a job like that. I have very strong feelings about abortion and just couldn't participate regardless of the reason for the termination. :crying2: In my opinion abortion is the termination of a baby. I don't understand how that procedure has any place on any OB unit. In one room a baby is being born, in another a baby is being terminated.

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Thank you all so much. To be clear, I am not judging anyone. Life experience has taught me that it is never my place to judge another human being, at work or in my personal life. I am mentally trying to cope and process the concept of doing everything to save one and literally terminating another. If anyone has any thoughts about what they do to cope that would be greatly appreciated.

PS The posts and threads I have read so far on this site are amazing and incredibly helpful.... I'm hooked

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Specializes in ICU/Critical Care.

PS The posts and threads I have read so far on this site are amazing and incredibly helpful.... I'm hooked

I'm addicted too.

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I had a baby with trisomy 13. The baby had no chance, due to the numerous defects. If I would've known before giving birth that this was the case, I definately would've aborted. The baby suffered, and I suffered with pre-eclampsia. Well, the baby only lived 13 days and that was with life support. Don't judge women that have made the decision. Believe me, it's a LOT harder dealing with giving birth to a baby and watching it die!

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Specializes in psych. rehab nursing, float pool.

I really have no experience with facing this other than when I was a student. Then I went to my instructor, explained why I felt I could not take care of the patient. 3rd terminated pregnancy for none medical reasons. I saw it as her means of birthcontrol.

Wish I could say she understood, but she did find me a different patient to take care of.

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Specializes in Neonatal ICU (Cardiothoracic).

Most hospitals allow you to sign a statement outlining which procedures you cannot ethically be involved in as a nurse before starting work. Then it is up to management to make sure you are not assigned any such patient.

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Specializes in Critical Care,Recovery, ED.

These are essentially individual decisions by both the patient and the care giver. When working in this area one has to expect that you have to make this choice. End of life decisions are part of most nursing specialties and one must give thought to these questions prior to being confronted with them.

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I believe it is important to have compassion for women when they are deciding to terminate a pregnancy. It is a hard decision-whether they realize it at the time or later in life.

I would assist with early term abortions, but I would really struggle as the pregnancy progressed. The more viable the fetus became, the more difficult I would find it.

Just curious, (hypothetical question for all from an unenlightened man) if you found yourself in an unwanted pregnancy, why would you wait 24 weeks to have an abortion?

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I know that this thread is not an abortion debate, but I agree, I could not participate in late term abortions regardless of the reason.

I firmly believe in a woman's right to choose, but with limitations...my reasoning is not so much a moral one but an ethical one as an advocate for the fetus...I feel that a fetus at around 3 months gestation, can begin to detect pain...so it's for that reason, not the fact of the termination itself, is why I am against the procedure and could never participate in one.

Even for genetic disorders, even for rape or incest, because at the end of the day, in late-term abortions, you still have the same thing...a fetus that can detect pain and would go through God knows what type of suffering.

I just couldn't.

I am sure that people have seen the story on TLC regarding Julie, the baby born with the worst case of Treacher Collins syndrome known to medical history...that baby is the perfect example of why heroic efforts to "save" the baby need to be seriously reconsidered by some parents. That child has known nothing but surgery and pain in her lifetime...she can't even cry...and has to take very heavy doses of pain medications because of the tolerance she has developed to anesthetics in her young life.

If you look her up on YouTube...you will see the video shortly after her birth that they don't dare put on television.

Without heroic efforts after her birth, she would have died on her own, and if you have ever seen the video, you would quickly understand why it probably would have been best for all involved. Losing a child, I can just imagine, would be horrific...but what they have to see that baby go through every day, to me, would be worse than any death.

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