A qualitative exploration of psychological adaptation and posttraumatic growth after termination of pregnancy for fetal anomalies in subsequent pregnancy and childbirth

The termination of pregnancy for fetal anomalies (TOPFA) is a profoundly traumatic reproductive event. Although previous studies have documented grief, psychological adaptation, and posttraumatic growth following pregnancy loss, limited understanding exists regarding how women with a history of TOPFA retrospectively make sense of this experience and integrate distress, coping, and growth during subsequent pregnancy and childbirth. This study aimed to explore long-term psychological adaptation and posttraumatic growth in women who underwent termination for fetal anomalies, with a particular focus on the experiences of subsequent pregnancy and childbirth. We adopted a descriptive qualitative design and conducted face-to-face interviews with 16 women with a history of TOPFA who had subsequently experienced pregnancy and childbirth between May to September 2025. The data were analysed using Braun and Clarke’s reflexive thematic analysis approach. The study identified a central theme, “A Journey of Hope Beneath the Shadow’s Veil,” reflecting women’s retrospective experiences of psychological adaptation and growth. Three phases emerged: (1) Dwelling in the Darkness, characterised by emotional collapse, helplessness, isolation, and why me; (2) Tracing the Light, involving the construction of meaning through social support and inner resilience; and (3) Becoming Through the Broken, which includes self-redefinition, cautious emotional adjustment during subsequent pregnancies, and symbolic healing through the birth of a new child. Women with prior TOPFA experience a nonlinear and evolving process in which grief, vulnerability, meaning-making, and psychological growth coexist. These findings highlight the need for culturally sensitive and trauma-informed care throughout women’s reproductive experiences.