Mental health nursing and the prenatal diagnosis of a congenital anomaly; a narrative of experience
Authors: Shakes Pieta , Cashin Andrew 
Published: May 2020

Accessible Summary

What is known on the subject

Many parents find out that their unborn baby has a difference in their health, development, or genetics.

This news is often unexpected and can be distressing and traumatic, which can lead to anxiety. There is a gap in support for parents.

What the paper adds to existing knowledge

This paper offers a story of the lived experience of the first‐author, a mental health nurse who was told that her baby had a difference late in pregnancy.

The narrative moves through the anxiety and difficulties faced when falling between gaps in the systems.

What are the implications for practice

This paper identifies the need for more support for parents who receive a prenatal diagnosis.

This support is within the mental health nurse scope of practice across a range of settings and services.

People who have been given a psychiatric diagnosis have been excluded from other studies that explore the experience of the unexpected news of a congenital anomaly.

Research in this area is indicated.

Relevance to mental health nursing

Mental health nurses are well‐positioned to address the gap in psychosocial support for parents who have received a prenatal diagnosis.

As clinicians who are recognized to deliver federally funded pregnancy support counselling, psychosocial support is within the mental health nurse scope of practice.

Some parents will require a higher level of support, assessment and intervention when they experience reactive mental illness or pre‐existing mental illness is exacerbated.

Furthermore, people who have received a psychiatric diagnosis have been excluded from studies that explore the experience of receiving a prenatal diagnosis.

This exclusion has resulted in a gap in knowledge.

Introduction

Expectant parents who receive a prenatal diagnosis of a congenital anomaly often experience shock, distress and a heightened risk of mental illness.

Aim

This paper aimed to highlight the gap in psychosocial support for parents who receive a prenatal diagnosis through the personal narrative of a mental health nurse who received a third‐trimester diagnosis.

Method

The first‐author reviewed her medical records and photos to recall moments of the experience and prompt reflection.

Findings

The narrative moved through the shock, guilt and subsequent pathological anxiety that followed a prenatal diagnosis at 32‐week gestation and the option to terminate.

Discussion

The gap in psychosocial supports for parents who receive a prenatal congenital anomaly diagnosis raises the risk to parental mental health and potentially confounds the risk to the baby. Mental health nurses are well‐positioned as service providers to fill this gap.

Implications for Practice

The provision of psychosocial support after a prenatal diagnosis is within the mental health nurse scope of practice. This support may be provided through pregnancy support counselling, innovative nurse‐led perinatal mental health services or as additional support to a parent with the lived experience of mental illness who receives a prenatal diagnosis of a congenital anomaly.