Termination for Medical Reasons (TFMR) Therapy & Support
Your loss and your grief matter
Termination for medical reasons, often shortened to TFMR, is ending a pregnancy because of a serious fetal diagnosis, a risk to the pregnant person’s health, or other significant medical circumstances. Often it involves a deeply wanted pregnancy.
TFMR can be both a medical decision and a profound loss. Termination for medical reasons therapy offers a place to bring all of it, whether you are processing a new diagnosis, navigating a decision, or grieving months or years later.
Ending a wanted pregnancy for medical reasons can be an incredibly painful and isolating experience. Whether you are facing a difficult diagnosis, navigating a complex decision, or grieving after a termination for medical reasons, you deserve compassionate support without judgment. Your experience and your grief matter.
I’m Ashley Luongo, LMHC, PMH-C, a licensed mental health counselor who has worked in mental health since 2011. My practice focuses on infertility, pregnancy loss, pregnancy after loss, and perinatal mental health. I offer TFMR counseling for adults in Massachusetts and Rhode Island.
Understanding Termination for Medical Reasons
Pregnancy termination for medical reasons may happen when:
- A serious fetal condition or diagnosis is identified
- Continuing the pregnancy would pose significant risks to the pregnant person’s health
- A family is facing other complex medical circumstances affecting the pregnancy
Every situation is different. People come to TFMR through different diagnoses, timelines, values, and beliefs, and they feel many different ways about it afterward. In therapy, there’s no expectation that you explain or justify your experience.
The Emotional Impact of TFMR
Emotional responses to TFMR vary widely, and no particular response is required. You may experience some of the following, none of these, or feelings that change from day to day:
- Grief and sadness
- Guilt or self-blame
- Anger
- Anxiety
- Depression
- Trauma related to the diagnosis, procedures, or hospital stay
- Isolation or grief that others don’t recognize
- Difficulty talking with friends or family
- Strain in your relationship
- Fear about future pregnancies
Grieving After Termination for Medical Reasons
Grief after termination for medical reasons is often complicated by stigma and silence. You may have told very few people what happened. You might feel unsure whether you belong in pregnancy loss support spaces, or worry about how others will react.
Some people feel grief and relief together. Others feel mostly numb, or something else entirely. These responses can shift over time, and there is no timeline for grief. Therapy after TFMR offers somewhere your experience can be acknowledged without needing to be explained or defended.
Therapy Before and After TFMR
TFMR grief counseling can be helpful at any stage, including:
- Processing an unexpected prenatal diagnosis
- Navigating uncertainty and difficult emotions
- Exploring your values and concerns without pressure
- Preparing emotionally for medical procedures
- Processing the experience afterward
- Managing grief and trauma responses
- Navigating relationships and communication
- Considering future family-building decisions
- Managing anxiety during a future pregnancy
Therapy provides emotional support. It does not replace guidance from your medical team, and I will never steer you toward a particular reproductive decision.
EMDR Therapy for Trauma Related to TFMR
Some people experience ongoing traumatic stress connected to receiving a devastating diagnosis, medical appointments and procedures, hospital experiences, specific memories, or a later pregnancy.
When clinically appropriate, EMDR therapy may be an option for processing distressing memories and trauma-related symptoms. I am EMDR-trained through an EMDRIA-approved program. EMDR is not meant to erase grief, and it isn’t the right fit for everyone. We would decide together whether it could help.
Pregnancy After TFMR
Considering or experiencing another pregnancy after termination for medical reasons can bring up anxiety about prenatal testing, fear of another diagnosis, and difficulty feeling hopeful. You may feel grief alongside excitement, find appointments triggering, or struggle to trust your body or your medical care.
Another pregnancy is not required for healing, and it doesn’t replace the pregnancy you lost. If you do become pregnant again, pregnancy after loss therapy can offer support throughout, and postpartum support after loss is available once your baby arrives.
Compassionate TFMR Counseling in Massachusetts and Rhode Island
I am a Licensed Mental Health Counselor (LMHC) with about 15 years of experience in the mental health field. My background includes:
- Perinatal Mental Health Certification (PMH-C)
- EMDR foundational training through an EMDRIA-approved program
- Postgraduate education in infertility counseling
- Experience supporting pregnancy loss, infertility, and pregnancy after loss
I offer in-person therapy in Franklin, Massachusetts and telehealth throughout Massachusetts and Rhode Island. My practice is inclusive and nonjudgmental, and I welcome individuals, couples, and families of all genders and backgrounds.
Frequently Asked Questions About TFMR Therapy
What does TFMR mean?
TFMR stands for termination for medical reasons. It refers to ending a pregnancy because of a serious fetal diagnosis, a risk to the pregnant person’s health, or other significant medical circumstances. It often involves a wanted pregnancy, and many people experience it as a profound loss.
Is termination for medical reasons considered pregnancy loss?
Many people experience TFMR as a pregnancy loss, and it can bring the same grief as other losses, along with its own complexities. How you understand your experience is personal. In therapy, you can describe it in whatever way feels true for you.
Can therapy help with grief after TFMR?
Therapy can provide a supportive, nonjudgmental place to process grief, guilt, anger, relief, or any other feelings after TFMR. It can also help with trauma responses, relationship strain, and isolation. Healing looks different for everyone, and therapy moves at your pace.
Can I begin therapy before making a TFMR decision?
Yes. Some people seek support after a prenatal diagnosis while they are still gathering information. Therapy can help you sort through emotions, values, and concerns. I don’t give medical advice or steer anyone toward a decision; your medical team is the right source for medical information.
Is EMDR helpful after a traumatic pregnancy experience?
EMDR may help some people process distressing memories related to a diagnosis, procedure, or hospital experience so those memories feel less intense. It isn’t right for everyone, and it doesn’t erase grief. We would assess together whether EMDR fits your needs.
Can I seek support months or years after TFMR?
Absolutely. Grief and trauma don’t follow a schedule. Feelings can resurface around due dates, anniversaries, a new pregnancy, or seemingly unrelated events. It is never too late to seek support.
Do you offer virtual TFMR counseling in Massachusetts and Rhode Island?
Yes. I offer telehealth for adults located in Massachusetts and Rhode Island, and in-person sessions at my office in Franklin, Massachusetts.
Can therapy help with anxiety during pregnancy after TFMR?
Yes. Pregnancy after TFMR can bring fear about testing and appointments, along with grief that resurfaces. Therapy can help you manage anxiety and make room for both hope and grief throughout the pregnancy.
Related Support
- Pregnancy loss therapy – for miscarriage, stillbirth, and other loss
- Pregnancy after loss therapy – support in a later pregnancy
- EMDR therapy – for traumatic stress after medical experiences
- Infertility counseling – if you are navigating fertility treatment
You Deserve Support
Whether you are facing a difficult diagnosis, navigating a decision, or grieving a pregnancy that ended for medical reasons, you do not have to navigate these experiences without support. Therapy can offer a space to process your emotions, honor your experience, and move forward at your own pace.