Search PubMed⌕ Search

Biomedical subjects

H Statham

Publications and source records attributed to H Statham.

15 recordsLinked to original sources
PubMed2006

Late termination of pregnancy: law, policy and decision making in four English fetal medicine units:.

OBJECTIVE: UK abortion law allows terminations for fetal abnormality without gestational limit. This study aimed to understand the decision-making experiences of fetal medicine professionals working within this legal framework. DESIGN: Qualitative study using semistructured interviews. SETTING: Four English fetal medicine units. SAMPLE: Fifteen doctors and midwives working in fetal medicine units and the Director of a related voluntary sector group. METHODS: Thematic analysis of transcribed interviews. MAIN OUTCOME MEASURES: Attitudes to abortion legislation; how decisions are made about the offer of late abortion and feticide. RESULTS: Fetal medicine specialists acknowledged the difficulties of ensuring that they worked within the law and within their own ethical frameworks when making decisions about offering terminations after viability. Practice regarding which abnormalities meet the legal criteria appeared to be governed largely by consensus between colleagues within their own and other units and in discussion with other specialists. Study participants reported individual differences about abnormalities where they personally would not wish to be involved in a termination, and also noted a shift in general attitudes over time as to conditions that meet the legal criteria. A proscribed list was believed to be both unworkable, given the variability in diagnoses and unhelpful, leading to reduced patient care. CONCLUSIONS: Research is needed to monitor attitudes to, and interpretation of, UK abortion legislation, which permits termination after a late diagnosis of fetal abnormality without gestational limit. If attitudes are changing, it is important to understand why, and what the consequences will be for parents and for health professionals.

Abortion, Legal↗
PubMed2000

Prenatal diagnosis of fetal abnormality: psychological effects on women in low-risk pregnancies.

When given an adverse prenatal diagnosis, parents are deeply shocked and experience acute grief. This review considers the psychological outcomes for parents whether they opt to terminate the pregnancy or continue, either through choice or because termination is not an option. It covers the full spectrum of malformation from treatable, through those carrying a risk of significant handicap, to lethal. It draws on two types of studies: those that are retrospective and qualitative, describing feelings and aspects of care, and those that are prospective and assess psychological state with standardized measures of grief, anxiety and depression. The relationship between psychological outcome and possible associated variables, such as individual characteristics, nature of the abnormality and obstetric factors is described and evaluated. In addition, the authors draw on both scientific and support group literature to summarize good practice for the care of parents receiving an unexpected diagnosis of fetal abnormality.

Abortion, Eugenic↗
PubMed1997

Women's need for information before attending genetic counselling for familial breast or ovarian cancer: a questionnaire, interview, and observational study.

OBJECTIVES: To describe women's information needs prior to genetic counselling for familial breast or ovarian cancer. DESIGN: Prospective study including semistructured telephone interviews before genetic counselling, observations of consultations, completion of postal questionnaires, and face-to face interviews within two months of counselling. SUBJECTS: 46 women attending genetic counselling for familial breast or ovarian cancer. MAIN OUTCOME MEASURES: Subjects' understanding of process and content of genetic counselling before attending and attitudes about their preparation for the counselling session. RESULTS: Although all women interviewed before the clinic expected to discuss their risk of developing cancer and risk management options, there was evidence of a lack of knowledge about the process and content of genetic counselling, 17 (37%) women said they did not know what else would happen. Most women interviewed after counselling viewed it positively, but 26 (65%) felt they had been inadequately prepared and 11 (28%) felt that their lack of preparation meant that they could not be given an accurate estimation of their risk of cancer. CONCLUSIONS: Some women felt that they did not obtain optimum benefit from genetic counselling because they were inadequately prepared for it. We suggest that cancer family history clinics should provide women with written information about the process and content of genetic counselling before their clinic attendance.

Adult↗
PubMed1997

Who worries that something might be wrong with the baby? A prospective study of 1072 pregnant women.

BACKGROUND: Little is known about the normal range and pattern of pregnant women's worry about something being wrong with the baby, or how this relates to other factors. The objective of this study was to examine the extent to which women are worried about the possibility of something being wrong with the baby relative to other worries they may have, and to determine whether demographic, experiential, attitudinal, and personality characteristics are associated with this worry. METHODS: Longitudinal data were collected from 1072 pregnant women who completed postal questionnaires at 16, 22, and 35 weeks of pregnancy. Multivariate statistical techniques were used to determine which variables were independently related to worry about the baby. RESULTS: Worry that something might be wrong with the baby was one of the most prevalent worries at 16 weeks, although not as widespread a source of extreme worry as miscarriage or giving birth. Worry dropped in midpregnancy but rose again at 35 weeks. The most important factors related to this worry were perceived likelihood that something might be wrong with the baby and trait anxiety, although negative mood, previous pregnancy outcomes, and initial reactions to the current pregnancy all demonstrated significant, independent effects. CONCLUSIONS: Women who answered "Don't know" to "Have you any reason to think that your baby might be more likely than any other to have some sort of a problem?" had consistently high anxiety throughout pregnancy. We suggest that this question be asked routinely in early pregnancy to identify these potential worries and, it is to be hoped, reassure them at an early stage.

Adolescent↗
PubMed1993

Serum screening for Down's syndrome: some women's experiences.

OBJECTIVES: To describe the experiences of a small group of women who had positive results after serum screening for Down's syndrome. DESIGN: Semistructured telephone interviews and correspondence with women after a positive screening result (four women) negative amniocentesis results (eight), or termination of a pregnancy with a confirmed abnormality (eight). SUBJECTS: 20 women who contacted Support After Termination For Abnormality about their experiences of serum screening for Down's syndrome. MAIN OUTCOME MEASURES: Women's knowledge and understanding of the test; staff misconceptions; communication of results; how women coped with the diagnostic process; attitudes to the test and to termination of abnormal fetuses. RESULTS: All women were made anxious by their positive screening test, no matter how they were told. The women's experiences suggested that medical staff were unclear about the implications of screening tests and how to interpret risk. Even after receipt of negative amniocentesis results some women remained anxious. Staff did not always recognise women's concerns while awaiting amniocentesis results. CONCLUSIONS: The way in which serum screening is being implemented does not always meet the needs of women with positive results. Some of the problems were not specific to screening for Down's syndrome. When screening tests are introduced policies should be adopted to ensure appropriate support for participants.

Adaptation, Psychological↗
PubMed1993

Testing for fetal abnormality in routine antenatal care.

The detection of fetal abnormality is a major component of routine antenatal care. A variety of techniques are now in use, although these are constantly being modified in the pursuit of more accurate and earlier detection. In this paper we draw attention to the distinction between screening and diagnostic tests, and describe the techniques which have been most commonly used in the UK: serum-screening for neural tube defects; screening for Down's syndrome; ultrasound scanning; amniocentesis and chorionic villus sampling.

Chromosome Aberrations↗
PubMed1993

Psychosocial issues raised by a familial ovarian cancer register.

A Familial Ovarian Cancer Register has been established which has recruited primarily through media publicity. In depth semi-structured interviews were carried out with 20 women who had volunteered in order to explore (1) knowledge about the disease, (2) motivations for contacting the Register, and (3) expectations. We found that interviewees were generally well informed about the symptoms of the disease as a result of their relatives' experiences. There was, nevertheless, a need for information which the Register was seen as potentially fulfilling, although most subjects gave altruistic reasons for volunteering. Only one interviewee said that the publicity about the Register had made her more anxious. Most said that their anxieties had not been affected either way by the Register. Subjects did not have a clear idea of what being on the Register would mean, although there was an expectation of screening for early signs of the disease. Many interviewees had models of familial disease which did not follow mendelian genetics. This has implications for the targetting of education and screening programmes. Other psychosocial issues raised by a register of this kind are discussed, many of which require continuing monitoring to ensure that the psychological costs do not outweight the benefits.

Adult↗
PubMed1991

EPDS by post.

Explore the source record for details and available documents.

Adult↗