Chinese couples’ lived experiences and decision-making on pregnancy continuation following prenatal anomaly detection: phenomenological and theory of planned behaviour insights

OBJECTIVES: Prenatal detection of fetal anomalies creates significant emotional and decision-making challenges for expectant parents. International research has described shock, uncertainty, and distress following diagnosis, yet little is known about how such experiences unfold within Chinese cultural and family contexts. Family authority, lineage expectations, and concerns about stigma may shape how parents interpret the diagnosis and negotiate reproductive choices. Evidence remains limited regarding how Chinese couples experience emotional disruption, navigate family involvement, and make sense of the diagnosis during a period marked by uncertainty and moral pressure. This study sought to address this gap by exploring the lived experiences of Chinese couples following detection of a suspected or confirmed fetal anomaly. METHOD: The qualitative phenomenological study employed Moustakas' transcendental phenomenology(TP) and Ajzen's Theory of Planned Behavior(TPB). Conducted in Suzhou City, situated in the Yangtze River Delta region of Eastern China, the research spanned from November 21, 2024, to February 15, 2025. The participants were 30 couples who had experienced prenatal anomaly detection in the past 12 months. RESULTS: Analysis identified five themes that described how couples experienced emotional rupture, cultural pressure, and relational strain after receiving a prenatal anomaly diagnosis. Parents reported an abrupt loss of their anticipated future, marked by shock, temporal disruption, and efforts to regain a sense of control. Decision-making occurred within a landscape shaped by moral tension, clinical uncertainty, and unequal options. Cultural expectations related to filial piety, lineage, and family reputation influenced how parents interpreted the diagnosis and negotiated reproductive choices. Family and clinical support played complex roles by offering stability for some and creating additional pressure for others. The diagnosis also reshaped couple relationships, strengthening some bonds while exposing significant strain in others. CONCLUSIONS: Chinese couples experiencing potential fetal congenital anomalies undergo intense emotions and employ various coping strategies. Their decisions are influenced by medical advice, cultural influences, and the availability of resources. By integrating the TP and TPB, this study examines their experiences and decision-making processes, emphasizing the need for culturally tailored support and counseling that respects their emotional and cultural contexts.