Journey Mapping of Chinese Women Undergoing Termination Due to Fetal Abnormalities: A Thematic Content Analysis Based on Social Media Diaries

Int J Womens Health. 2025 Jun 17:17:1789-1805. doi: 10.2147/IJWH.S509259. eCollection 2025.

Abstract

Purpose: The psychological consequences of pregnancy termination due to fetal abnormalities demonstrate stage-specific characteristics among affected women. With the development of the Internet, social media has increasingly become a significant channel for documenting and sharing health-related experiences. Utilizing journey mapping, this study systematically analyzes self-documented online diaries to explore the experiences of women undergoing induced abortions due to fetal abnormalities across different phases.

Patients and methods: We manually searched three mainstream Chinese text-based social media platforms-Douban, Zhihu, and Jianshu-to collect abortion diaries from user homepages. An interpretative phenomenological thematic content analysis was used to develop journey maps.

Results: A total of 278 diaries from 35 users were analyzed, focusing on the experiences of women undergoing pregnancy termination due to fetal abnormalities, which were divided into four phases: diagnostic, inpatient abortion, puerperium, and post-puerperium. Three main themes emerged in each phase: psychological experiences, coping strategies, and post-traumatic transformation. Ten subthemes were identified: grief, emotional responses, self-blame and guilt, cognitive adjustment, seeking social support, recovery, growth, avoidance behaviors, emotional regulation, and shifting attention. Avoidance behaviors occurred in all phases except the puerperium, emotional regulation was present only during inpatient abortion, and shifting attention appeared solely in the puerperium. The remaining subthemes were present across all phases, with varying frequency.

Conclusion: Women's psychological experiences, coping strategies, and post-traumatic transformations vary across stages, highlighting the need for personalized and adaptive nursing care.

Keywords: experiences; fetal abnormalities; induced abortion; journey map; social media; women’s health.