Evidence map›Paper›PMID 42002751›Full record

ArticleBMC pregnancy and childbirth2026

Communicating unexpected news in the fetal medicine setting: experiences of pregnant women with mental health conditions (The UNDERSTAND study).

Ioannis Karapanos, Elena Greco, Jane Fisher, Iona Hindes, Sarah Fisher, Yesmin Begum, Maddalena Miele, Jemima Dooley, Nikolina Jovanović, Stamatina Iliodromiti

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Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ioannis Karapanos *Women's Health Research Unit, Centre for Public Health and Policy, Wolfson Institute of population Health, Queen Mary University London, London, UK. Ioannis.karapanos@nhs.net.
Elena Greco *Women's Health Research Unit, Centre for Public Health and Policy, Wolfson Institute of population Health, Queen Mary University London, London, UK.
Jane FisherAntenatal Results and Choices, Registered Charity No 1148663, London, UK.
Iona HindesWomen's Health Research Unit, Centre for Public Health and Policy, Wolfson Institute of population Health, Queen Mary University London, London, UK.
Sarah FisherWomen's Health Research Unit, Centre for Public Health and Policy, Wolfson Institute of population Health, Queen Mary University London, London, UK.
Yesmin BegumWomen's Health Research Unit, Centre for Public Health and Policy, Wolfson Institute of population Health, Queen Mary University London, London, UK.
Maddalena MieleImperial College London, London, UK.
Jemima DooleySir Henry Wellcome Centre for Mood disorders Research, Exeter University, Exeter, UK.
Nikolina JovanovićCentre for Psychiatry, Wolfson Institute of Population Health, Queen Mary University London, London, UK.
Stamatina IliodromitiWomen's Health Research Unit, Centre for Public Health and Policy, Wolfson Institute of population Health, Queen Mary University London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReceiving unexpected news in pregnancy is highly distressing, and how it is communicated strongly influences psychological outcomes. While clear communication can support understanding and decision-making, poor communication may intensify trauma and isolation. Communication training in fetal medicine remains limited, often excluding lived experience and focusing only on the moment of diagnosis. One in five pregnant women have a mental health condition (MHC), yet no studies have explored how unexpected news is communicated to this group, leaving a critical gap. This study explores the experiences of pregnant women with MHCs upon receiving such news, identifying barriers, facilitators, and opportunities for improvement in communication.

methodsThis co-produced qualitative study involved 22 virtual semi-structured interviews with women with MHCs (anxiety, depression, PTSD, and psychosis) who had received unexpected fetal medicine diagnoses in a past pregnancy. A novel approach to thematic analysis was used, with themes identified in collaboration with members of the public with lived experience.

resultsParticipants reported significant emotional distress, compounded by poor communication practices, lack of empathy, and feelings of being rushed or unsupported. Key themes included (1) the Unknown; (2) the Information; (3) Trust in Healthcare; (4) the Human Element; (5) the Concept of Time; (6) and Ongoing Mental Health Support.

conclusionsThe study underscores the urgent need to improve communication in fetal medicine by ensuring healthcare professionals deliver unexpected news with empathy, allow time for processing, and offer appropriate mental health support. Continuity of care and proactive follow-up can help reduce distress and improve experiences. Training should be informed by the perspectives of those receiving care and emphasise compassionate communication, shared decision-making, and awareness of mental health challenges. Integrating mental health support systematically into fetal medicine pathways is essential for comprehensive care.

Indexed as

CommunicationMental DisordersPregnancy ComplicationsPregnant PeopleTruth DisclosureAdultEmpathyFemaleHumansPhysician-Patient RelationsPregnancyQualitative ResearchTrustYoung AdultAntenatal ultrasoundFetal medicineMental healthMental wellbeingPregnancy complicationsUnexpected news

Identifiers

PMID42002751
PMCPMC13224652

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.