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I'm Sabrina Fletcher,
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I went through a TFMR myself in 2018, with my planned and wanted second baby.
We named her Clara. You can read more about my story here.
The short version is that community, my mindfulness practices, and ritual saved me in my grief... and now I combine all this magic into my programs and private support so you can learn to cope with grief and honor your baby and live from a place of love and peace, bringing their memory with you.
What is TFMR*?
*TFMR = Termination For Medical Reasons
IS what I went through a TFMR? (Expand to see answer)
*TFMR = Termination For Medical Reasons
Typically a TFMR (Termination For Medical Reasons, or a medically indicated abortion) starts with a dire or life-limiting medical diagnosis during a wanted (either planned or surprise-turned-desired) pregnancy. The poor diagnosis can be for either your baby in utero or to your own health where continuing the pregnancy would be harmful or even lead to death. Some people continue, now knowing the risks.
If you have to make a decision to interrupt and end the pregnancy while the baby's heart is still beating, you may consider your loss TFMR.
If you choose to terminate, there are a few different procedures that fall under that category. You may only legally be allowed to access one or the other, depending on the clinic, hospital, health system or even monetary resources. Or an emergency health situation may mean that the doctors highly recommend one procedure or birth over another.
A D&C or a D&E may be how the baby is born (usually with the pregnant person under anesthesia), or you may labor and deliver the baby through the birth canal. The baby's heart may be stopped with an injection before either D&E or delivery. Or in the case of a multiples pregnancy, it may be best for the health of all to reduce the pregnancy and stop one (or more) of the baby's/babies' hearts. Their bodies will remain inside until the other baby/babies are far enough along to be born.
If any of these situations sounds like what you went through, you may have had a TFMR.
And finally, it is important to consider whether YOU feel like you went through a TFMR. If you had to make a medical choice, while your baby's heart (or babies' hearts) was/were still beating, this would legally fall under a termination. Make sure to consider how YOU view what you went through.
Typically a TFMR (Termination For Medical Reasons, or a medically indicated abortion) starts with a dire or life-limiting medical diagnosis during a wanted (either planned or surprise-turned-desired) pregnancy. The poor diagnosis can be for either your baby in utero or to your own health where continuing the pregnancy would be harmful or even lead to death. Some people continue, now knowing the risks.
If you have to make a decision to interrupt and end the pregnancy while the baby's heart is still beating, you may consider your loss TFMR.
If you choose to terminate, there are a few different procedures that fall under that category. You may only legally be allowed to access one or the other, depending on the clinic, hospital, health system or even monetary resources. Or an emergency health situation may mean that the doctors highly recommend one procedure or birth over another.
A D&C or a D&E may be how the baby is born (usually with the pregnant person under anesthesia), or you may labor and deliver the baby through the birth canal. The baby's heart may be stopped with an injection before either D&E or delivery. Or in the case of a multiples pregnancy, it may be best for the health of all to reduce the pregnancy and stop one (or more) of the baby's/babies' hearts. Their bodies will remain inside until the other baby/babies are far enough along to be born.
If any of these situations sounds like what you went through, you may have had a TFMR.
And finally, it is important to consider whether YOU feel like you went through a TFMR. If you had to make a medical choice, while your baby's heart (or babies' hearts) was/were still beating, this would legally fall under a termination. Make sure to consider how YOU view what you went through.
What are the types of TFMR? (Expand to see answer)
If you need to terminate a pregnancy for health reasons, there are a few different procedures that fall under that category.
You may only legally be allowed to access one or the other, depending on the clinic, hospital, health system or even monetary resources. Or an emergency health situation may mean that the doctors highly recommend one procedure or birth over another.
A D&C or a D&E may be how the baby is born (usually with the pregnant person under anesthesia), or you may labor and deliver the baby through the birth canal. The baby's heart may be stopped with an injection before either D&E or delivery.
Or in the case of a multiples pregnancy, it may be best for the health of all to reduce the pregnancy and stop one (or more) of the baby/ies's hearts (also called "selective reduction"). Their bodies will remain inside until the other baby/babies are far enough along to be born.
Some people also experience TFMR through a surrogate needing to end the pregnancy for a variety of reasons.
In some rarer maternal/pregnant person's health reasons, the pregnancy may even be early enough along that taking the abortion pill (chemical management) is available. Sometimes a later induced pregnancy loss may even need to be an emergency cesarean section.
If any of these situations sounds like what you went through, you may have had a TFMR.
You may only legally be allowed to access one or the other, depending on the clinic, hospital, health system or even monetary resources. Or an emergency health situation may mean that the doctors highly recommend one procedure or birth over another.
A D&C or a D&E may be how the baby is born (usually with the pregnant person under anesthesia), or you may labor and deliver the baby through the birth canal. The baby's heart may be stopped with an injection before either D&E or delivery.
Or in the case of a multiples pregnancy, it may be best for the health of all to reduce the pregnancy and stop one (or more) of the baby/ies's hearts (also called "selective reduction"). Their bodies will remain inside until the other baby/babies are far enough along to be born.
Some people also experience TFMR through a surrogate needing to end the pregnancy for a variety of reasons.
In some rarer maternal/pregnant person's health reasons, the pregnancy may even be early enough along that taking the abortion pill (chemical management) is available. Sometimes a later induced pregnancy loss may even need to be an emergency cesarean section.
If any of these situations sounds like what you went through, you may have had a TFMR.
Ask yourself: DO I feel like it was a TFMR? (expand to see answer)
It is important to consider whether YOU feel like you went through a TFMR. If you had to make a medical choice, while your baby's heart (or babies' hearts) was/were still beating or while the tiny baby/fetus was still developing, this would legally fall under a termination. Make sure to consider how YOU view what you went through.
Some people who have had an ectopic pregnancy or molar/partial molar pregnancy consider their loss a TFMR as well.
If you feel that your baby's death was due to TFMR and are looking for grief support, we recommend applying to join our Facebook group and/or getting support by joining our email list (form at the very bottom of this page).
If you have in an upcoming TFMR,
induced or surgical pregnancy loss:
Group and private support available:
Wondering what support would be best for you? Get on an enrollment call with me here and you can ask me anything
If you do consider your pregnancy loss to be a TFMR, come and join our screened (and free) support group:
The TFMR Support Circle (Facebook Group) is a safe place to feel supported by other bereaved TFMR parents who have been through it too.
In this free Facebook group you will:
- Find the support and connection you need in a confidential space (closed group, all members go through a screening process)
- Have your questions answered about grief and all the emotions and layers that come with TFMR (ending a wanted pregnancy for medical reasons, for your health or your baby's)
- Connect with other TFMR parents who are dealing with and feeling the same thing so you can feel less alone
Grief support after TFMR on the blog:
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...and another TFMR support resource for you:
Nothing can take away the grief,
but here are a few ideas to soothe you in your pain:
(These are some self-care practices that I used after my TFMR and that I've seen work for other bereaved parents too)
Not another guide about bubble baths, but how to REALLY care for yourself and cope with the pain and grief of terminating a wanted pregnancy
The TFMR Doula Decree
1. TFMR, termination for medical reasons, is is IS pregnancy loss and no one will convince us otherwise.
2. With everyone saying this or that about "abortion," it’s even more important than ever to embrace our TFMR grief journey as OUR OWN.
3. Around here, our grief refuses to be CONFINED into 5 neat, organized "stages": we know in our bones that after our baby dies in such a tragic way we learn to grow AROUND grief, also bringing the joy and love we have for this baby along.
4. We're done just dreaming about it, it’s time to live in a world where we receive healing grief support, from diagnosis, to gut-wrenching decision, through the heartbreaking death of our babies, and beyond.
5. Bereaved TFMR parents aren’t just an add-on to "miscarriage and stillbirth"… no, we BELONG and we're an essential part of the wider pregnancy loss community. AND we deserve TFMR-safe spaces, tailored to our unique pain.
6. Here we know that making an excruciating end-of-life decision for our babies and bodies is an act of deep love as a GOOD parents and GOOD people. For our selves, our families, for our collective well-being. We never asked for our love to look like this, and yet love spelled any other way is STILL LOVE.
UNNUMBERED AND IMPERATIVE:
Most importantly, legal reform so the best possible medical and grief care are possible WORLDWIDE, in every hospital, in every clinic, in every place birthing people are seen. Free, accessible and COMPASSIONATE care for pregnant people and their families in their darkest hour.
2. With everyone saying this or that about "abortion," it’s even more important than ever to embrace our TFMR grief journey as OUR OWN.
3. Around here, our grief refuses to be CONFINED into 5 neat, organized "stages": we know in our bones that after our baby dies in such a tragic way we learn to grow AROUND grief, also bringing the joy and love we have for this baby along.
4. We're done just dreaming about it, it’s time to live in a world where we receive healing grief support, from diagnosis, to gut-wrenching decision, through the heartbreaking death of our babies, and beyond.
5. Bereaved TFMR parents aren’t just an add-on to "miscarriage and stillbirth"… no, we BELONG and we're an essential part of the wider pregnancy loss community. AND we deserve TFMR-safe spaces, tailored to our unique pain.
6. Here we know that making an excruciating end-of-life decision for our babies and bodies is an act of deep love as a GOOD parents and GOOD people. For our selves, our families, for our collective well-being. We never asked for our love to look like this, and yet love spelled any other way is STILL LOVE.
UNNUMBERED AND IMPERATIVE:
Most importantly, legal reform so the best possible medical and grief care are possible WORLDWIDE, in every hospital, in every clinic, in every place birthing people are seen. Free, accessible and COMPASSIONATE care for pregnant people and their families in their darkest hour.
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TFMR Awareness Day Member
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Find The TFMR Doula on social media:
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Get support directly to your email: