First-time mothers' experiences of foetal reduction in pregnancy following assisted reproductive technology treatment in Taiwan: a qualitative study.

BACKGROUND: Foetal reduction-removal of one or more foetuses to reduce the number of foetuses in multiple conceptions-is a procedure used for improving pregnancy outcomes following assisted reproductive technology (ART) treatment. While there is a recognition of the importance of understanding the experiences of women who undergo foetal reduction to offer appropriate help and support, studies that provide relevant insights are sparse. Our aim was to gain an in-depth understanding about first-time mothers' experiences of foetal reduction following ART treatment in Taiwan. METHODS: We adopted a qualitative design based on a phenomenological approach for this study. In-depth semi-structured interviews were conducted with seven first-time mothers who underwent foetal reduction following ART treatment at a fertility centre in Taipei, Taiwan. All interviews were recorded, transcribed and analysed using the Colaizzi strategy. RESULTS: The views and experiences relating to foetal reduction reflected five key themes: hesitation, ambivalence and distress; the guilt of knowingly terminating a life; rituals and ceremonies to ease the sense of guilt; persuading oneself to consider the 'big picture'; and wishing for a reunion in next pregnancy. Mothers often regretted that they took clinical advice to implant multiple embryos and then having had to resort to foetal reduction. There was a sense of hesitation, ambivalence and distress reflected in the views from all participants. They believed that they ended the fetuses' lives knowingly and expressed strong feelings of guilt. Mothers often tried to persuade themselves to look at foetal reduction within the 'big picture' of the overall pregnancy outcome. Losing their unborn babies was as an unforgettable incident for most mothers, and they wished for a reunion with the lost baby in the next pregnancy. CONCLUSION: Findings indicate the need for ART providers to undertake a more sensitive approach that involves detailed discussions with women and their families to tailor the embryo transfer processes to suit individual needs. Women who undergo foetal reduction should be provided with tailored interventions towards enhancing their coping strategies before and after foetal reduction taking into account the cultural and religious context.

First-time mothers' experiences of pregnancy and birth following assisted reproductive technology treatment in Taiwan.

BACKGROUND: Assisted reproductive technology (ART) treatment tends to involve significant physical and emotional commitments that can impact maternal, infant, and family health and well-being. An in-depth understanding of experiences is necessary to provide adequate support for women and their families during pregnancy and transition to parenthood following ART treatment. The aim of this study was to explore first-time mothers' experiences of pregnancy and transition to parenthood following successful ART treatment in Taiwan. METHOD: Twelve first-time mothers who conceived and gave live birth using ART treatment were purposively selected from a fertility centre in Taipei, Taiwan. Women's experiences in pregnancy and in their transition to motherhood were explored using semi-structured in-depth interviews. All interviews were recorded, transcribed, and analysed using the Colaizzi strategy. RESULTS: The mothers' accounts reflected three main themes: 'being different from mothers who became pregnant naturally', 'ensuring health and safety of the foetus', and 'welcoming new lives with excitement'. The difference mothers felt about themselves was evident in four subthemes: becoming pregnant after a long wait, feeling vulnerable during pregnancy, relying on family's assistance and support, and worrying about the impact of ART on health. The theme on 'ensuring health and safety of the foetus' encompassed three subthemes: activities to protect the unborn baby, monitoring foetal movement constantly to maintain peace of mind, and receiving foetal reduction for the sake of the pregnancy. Narratives around 'welcoming new lives with excitement' reflected four subthemes: overcoming hardship for worthwhile results, realising one's life and dreams, proving to be fertile enough to give birth, and return to normal life track. CONCLUSION: Findings indicate the need for educational and psychosocial interventions to support women and their families physically and psychologically during ART treatment. The stigma related to infertility and the psychosocial support from family are aspects to consider while planning intervention programmes.

Effects of a prenatal yoga programme on the discomforts of pregnancy and maternal childbirth self-efficacy in Taiwan.

OBJECTIVE: to evaluate a yoga programme provided to primigravidas in the third trimester of pregnancy with the aim of decreasing the discomforts associated with pregnancy and increasing childbirth self-efficacy. DESIGN: non-randomised controlled experimental study. SETTING: a hospital in northern Taiwan. PARTICIPANTS: the target population was primigravidas at 26-28 weeks of gestation (no high-risk pregnancies) who had not engaged in regular exercise or yoga for at least one year. The study included 88 individuals; 43 in the control group and 45 in the experimental group who took part in the prenatal yoga programme. INTERVENTION: the duration of the prenatal yoga programme was 12-14 weeks, with at least three sessions per week. Each workout lasted for 30 minutes. MEASUREMENTS AND FINDINGS: women who took part in the prenatal yoga programme reported significantly fewer pregnancy discomforts than the control group (38.28 vs 43.26, z=-2.58, p=0.01) at 38-40 weeks of gestation. The subjects who participated in the yoga programme exhibited higher outcome and self-efficacy expectancies during the active stage of labour (104.13 vs 83.53, t=3.24, p=0.002; 99.26 vs 77.70, t=3.99, p ≤ 0.001) and the second stage of labour (113.33 vs 88.42, t=3.33, p=0.002; 102.19 vs 79.40, t=3.71, p ≤ 0.001) compared with the control group. KEY CONCLUSIONS: the provision of booklets and videos on yoga during pregnancy may contribute to a reduction in pregnancy discomforts and improved childbirth self-efficacy. IMPLICATIONS FOR PRACTICE: this yoga programme provides health-care professionals with an evidence-based intervention.