Prise de décision quant au devenir d’une grossesse compliquée par une anomalie fœtale sévère : facteurs impliqués, impacts et considérations éthiques
In case of life-threatening fetal anomaly, women are confronted with the decision to terminate or to continue the pregnancy and have their child affected by a disease that could impact on his quality of life or life expectancy.  The purpose of this thesis is to have a better understanding of their decision-making process and offer tools so that clinicians can offer an appropriate decisional support.    In a qualitative study using grounded theory, ten interviews were conducted with women whose pregnancy was complicated be life-threatening fetal anomaly.  Results shows that women are at different states of their maternity process (posture) at the time of decision-making: assumed maternity and maternity project.  The decision in itself is not determined by the posture, but the posture will influence the reasons why the woman would choose to continue or terminate her pregnancy.  Different levels of clinician’s implication in the decision-making process are expected by women.  All women express the importance of receiving complete medical information, but only some women expect a clinician's active implication in their decision-making process.   Decision-making process for pregnancies complicated by life-threatening fetal anomaly is a complex phenomenon influenced by many non-medical factors.  The establishment of a therapeutic relationship consistent with the woman’s expectations might help her to take a decision in accordance with her wills and values.
Recherche qualitative Fetal anomaly Pregnancy termination Quality of life Decision-making process Therapeutic relationship Shared decision-making process Qualitative research Grounded theory