Fetal Therapy Choices: Uncertain and Emotional Decisions and the Doctor’s Role in Parental Decision-Making

Making good decisions prospectively is difficult, especially when there is the perception that the stakes are high. There is often uncertainty regarding prognosis and emotions prevail both between a couple and in the interactions with their healthcare professional team. This is the case when parents have to decide about fetal therapy for congenital malformations and the health of their unborn child. Parents are usually unprepared for the often rare disease the fetus is found to have. Still in a state of shock, they receive a lot of detailed and difficult information, and need to decide whether to choose fetal therapy (which often carries risks of perinatal death or preterm birth as complications), expectant management, or sometimes the very difficult option of termination of pregnancy. The obstetrician or fetal medicine specialist aims to provide the parents with all the relevant factual information and to support them in their decision process.