Termination for medical reasons around cancer and pregnancy

A cancer diagnosis during pregnancy may in some cases lead to the difficult decision to have a termination for medical reasons (TFMR). This could be necessary to begin urgent cancer treatment without delay. It may also be recommended due to other serious health concerns affecting either the parent or the baby. Making such a decision during an already challenging time can be emotionally complex, and having access to compassionate support is important for navigating the physical and emotional experience that follows.

This page offers information on Termination for Medical Reasons (TFMR) and is informed by the experiences of families we’ve had the privilege to support. Some have chosen to continue their pregnancies, even in the face of uncertain treatment options for their specific cancer. Others have made the incredibly difficult decision to end their pregnancy, with the hope that doing so would offer the best chance of their survival. Each path is deeply personal, and we respect the strength and courage behind every choice.

We also have a page dedicated to the experience of baby loss after a miscarriage or still birth around a cancer diagnosis. We are also working on a page dedicated to the experience of Gestational Trophoblastic Disease (GTD) which will be coming shortly.

What is a termination for medical reasons / TFMR?

A 'Termination for Medical Reasons' is when a pregnancy is ended due to the health of the unborn baby or that of the mother/birthing person ('Termination for Maternal/birthing person's Health' or 'Termination for Maternal/birthing persons Mental Health'). 

from www.tfmrmamas.com 

If you are having to consider whether to have a termination for medical reasons, it is likely to be one of the most difficult decisions that you will ever have to make. The trauma of receiving a cancer diagnosis while pregnant is immense and only increases when you add the burden of making choices around whether to continue with your pregnancy. 

You may question whether it is safe to continue your pregnancy while struggling with strong emotions like guilt and selfishness. The constant uncertainty about making the right choice can linger for a long time. Even if positive news comes after treatment or surgery, you may continue to struggle with grief associated with your loss amid the relief of having no evidence of disease.  

Sometimes this grief is not just about the loss of this specific pregnancy but can include concerns about whether future pregnancies will be possible. You may also feel the need to support others in their grief, including that of other children, grandparents, and wider family who will never meet their sibling/grandchild/family member. All of these feelings that this may bring up are completely normal but can be incredibly complex to navigate. 

TFMR and cancer

As a mum or birthing partner diagnosed with cancer in pregnancy, you may feel quite isolated and alone in your experience of TFMR as it is most often associated with families facing tough decisions regarding the health of their baby.  

Many of the families we support don’t feel their experiences align with those who have made decisions based on foetal health. Their choices may have been determined by the urgent need to prioritise their own health or by the responsibility of caring for existing children and supporting their family. These circumstances can carry a complex emotional weight, and for some, may lead to feelings of guilt or isolation.

As a result, some may feel hesitant to seek peer support from the TFMR support services, worrying that their decisions might be misunderstood or judged. 

At Mummy Star, we always approach discussions around TFMR within the context of pregnancy and cancer, and we will signpost to trusted services that offer compassionate support and an understanding of these complex experiences.

In our Support Library, you can read about the experiences of Sarah, a mum supported by Mummy’s Star, who faced the incredibly difficult decision to end her pregnancy following a cancer diagnosis and who sadly lost her baby, Jacob.

Practical support

Your care team will be able to talk you through the details of what to expect to happen on the day of your TFMR, who to contact if you have any questions and how your recovery can be managed around any potential cancer treatment, including surgery.

Some Mummy’s Star mums have shared that knowing in advance about the possibility of breast tenderness and milk production after the procedure, particularly when the pregnancy was in its later stages,  helped them feel more prepared for what to expect physically in the days that followed.

Emotional Support

No matter how your situation has unfolded, those who have experienced baby loss alongside a cancer diagnosis deserve timely care and support that recognises the complex trauma,  emotions and grief involved in both.

Trying to process the mix of emotions that can come up may at times feel overwhelming and it can be difficult, but not impossible, to find someone who can provide adequate support for both aspects.

The loss of a baby is a profound and life-changing experience. Grief doesn’t follow a set timeline and significant dates and anniversaries may bring up intense or unexpected emotions. Please remember that accepting help is not a sign of weakness and it’s never too late to reach out for support.

Hospital and medical support

Health professionals, either in hospital or community, should be offering you the same bereavement support as would be offered to any parent experiencing the loss of their baby. If this has not been your experience, and you would like some support, we would encourage you to ask of them what is available in your local area.  

Your GP can be a helpful starting point and may also be able to connect you with local bereavement resources.  In addition, we at Mummy’s Star are here to listen and can help signpost you to appropriate, compassionate support services.  

Expert advice

We have been fortunate to collaborate with Lucy Sumner from White Candle Counselling, who specialises in helping those going through miscarriage, baby loss, TFMR and infertility to feel more understood and supported. 

You might like to take a look at the  Ask the Expert session that Lucy recorded with the Mummy Star team which highlights some of the challenges that you might be experiencing since your loss.  In it she acknowledges the complex mix of emotions and grief that may be coming up for you and talks about the importance of seeking counselling and support at a time that is right for you.   

Creating memories and saying goodbye

A ‘memory pack’ is something you can create to retain precious memories of your child, and is sometimes provided by your hospital or you can find advice and resources from support services 4Louis and Simba.

What may be available will depend on the stage of your pregnancy, but your pack might include: locks of hair, hospital name band, handprint, a toy you have purchased for baby in advance, a baby scan photo and more.

Where it is possible, and feels right for you, consider whether you’d like to see or hold your baby after they have been delivered; this might feel difficult but can help to release some feelings of grief. If you do not want to see your baby, photographs can still be taken (which you may want to see in the future) and a memory pack still created.

Parents often choose to name their baby and have a funeral or memorial event to acknowledge their baby’s life. Should you choose not to have a private funeral, the hospital will ensure your baby is laid to rest with dignity.

Support from family and friends

Sometimes family and friends can be unsure how best to support you. This can include not knowing whether to mention your loss at all, not knowing what to say to you or how to phrase things when they talk about your child and your loss. Let them know what words and phrases you want them to use when referring to your baby and your experience.

If you have given your baby a name, share this if you feel comfortable. It can be helpful to hear your baby’s name said and recognised by others around you.

If you don’t feel comfortable talking about your loss, or feel you are having to repeat the conversation many times, you could consider asking a trusted family member or friend to share this on your behalf.

Specific support for those experiencing miscarriage, stillbirth or baby loss

In addition to the support mentioned already, you may find it helpful to explore the websites of the organisation detailed below. Although the information that they provide often focuses on terminations due to concerns about a baby’s development, they have a deep understanding of the emotional impact of ending a pregnancy and are experienced in supporting people through this kind of loss.

Antenatal Results and Choices (ARC) has some very helpful resources on making difficult decisions during pregnancy, including a booklet which has been written specifically for those who are considering a termination of pregnancy. Although this focuses on termination following a diagnosis of an anomaly in a baby, it explores many of the emotional and practical challenges that may also resonate with your experience. They also offer a helpline for individual support.

TFMR Mammas is a support organisation for families who have made the difficult decision to end a pregnancy. They have a website and you can follow them on Instagram. 

White Candle Counselling is a Cheshire based counselling service led by Lucy Sumner. She offers counselling to women experiencing issues around TMFR, baby loss, infertility and miscarriage. Sessions can be face-to-face, by phone or online sessions.

You should also be offered access to all the usual bereavement and loss support provided by your hospital and/or care provider; in the same way you would, had there not been a cancer diagnosis.