Pastoral care utilization among women electing pregnancy termination for fetal anomalies

Objective: To identify determinants of requesting pastoral care (PC) at the time of pregnancy termination for fetal anomalies. Methods: PC was provided by a hospital-based chaplain. Data were reviewed for 88 women who elected pregnancy termination. Nominal logistic regression and Kruskal-Wallis and Student t tests were used as appropriate. Results: None of 37 women who underwent dilatation and curettage (D and C) or dilatation and evacuation (D and E) requested PC as compared with 40 of 51 patients who underwent prostaglandin induction of labor (p < 0.001). The decision to seek PC was related to gestational age (p < 0.001), but not to maternal age, prior termination of pregnancy, gravidity, parity, racial background, or insurance status. The gestational age was also a significant predictor of the procedure performed (p < 0.001). D and C/D and E were significantly more likely to be performed at earlier gestational ages. Women seeking PC were less likely to have experienced previous pregnancy loss or the death of a child. Among women who sought PC, 20% had experienced previous pregnancy loss or the death of a child, as opposed to 54% of women in the prostaglandin group who did not seek PC (p = 0.03). In the D and C/D and E group, the figure was 46%. Conclusions: Utilization of PC is much more frequent among women undergoing prostaglandin induction of labor than D and C/D and E. Determinants of seeking PC are related to issues congruent with choices of the termination procedure. Patients who experienced a previous pregnancy loss or the death of a child are also less likely to feel the need, or do not want, chaplaincy involvement.