Pre-natal counselling—helping couples make decisions following the diagnosis of severe heart disease

The prenatal diagnosis of a major cardiac abnormality tends to precipitate a crisis for the affected parents. In a setting of grief and emotional distress, there is the challenge to provide meaningful information of the abnormality, its need for intervention and likely outcome, so as to enable the parents, if allowed the option, to come to a fully informed decision as to whether to continue with the pregnancy. This discussion paper reviews the difficulties encountered in counselling affected parents being mindful of the psychological constraints prevalent at the time. While an accurate and detailed diagnosis is important for the professionals, the information required by the parents needs to be simple and focussed on the questions raised by them as they relate to quality of life issues to be experienced by their yet unborn infant/child growing into an adult.