When a Wanted Pregnancy Ends: TFMR, Grief and Pregnancy After Loss, with Sabrina Fletcher
By Alexia Leachman, founder of Fear Free Childbirth.
Alexia cleared her own tokophobia and developed a method that has helped women clear theirs for more than 10 years.
This post is about termination for medical reasons (TFMR) and the loss of a wanted baby.
Sabrina Fletcher was still on the scan table, her belly exposed and cold from the gel, when the doctor told her she had to choose now.
She was 12 or 13 weeks pregnant with a very wanted baby. The doctor was kind. He showed her what her baby’s scan should look like, then what it did look like, and answered every question about words she’d never heard before. Her baby was very ill. If she continued the pregnancy, he wanted to see her every week, because he was worried her baby’s heart could stop at any time. And if she chose to end it, the decision had to be made now.
“I didn’t understand that,” Sabrina told me. “Like, that part of, like, you have to choose now.”
In this article:
An impossible choice
Sabrina lives in Mexico, where, as in the United States, the rules could change from one state to the next. In the state where she lived, ending the pregnancy would have meant taking her case to the hospital’s ethics committee. She had what she calls a full-body no. She wasn’t going to let people who weren’t even her doctors decide for her.
So she and her husband had about a week. They spent two or three nights not sleeping, reading everything they could, including medical journals. She says her academic background helped, and she wonders what women without it are meant to do. They learned that her baby’s condition could cause swelling in her own body too, so the longer the pregnancy went on, the higher the risk to her. In the end they travelled to Mexico City, where her husband’s family made soup, held their hands, and cried and prayed with them. Sabrina is clear that this was luck. Not everyone has family in the right place.
She describes the moment the decision first came to her, in the scan room, as an intuitive knowing that she was going to have to end the pregnancy. Then all the other thoughts rushed in to cover it up. This was a wanted pregnancy. She needed more information. Among parents who’ve been through it, she says, they call it an impossible choice, or, as she puts it, “the choice, no choice”.
Where is the place for us?
After the procedure, Sabrina went looking for support and found an online group called Ending a Wanted Pregnancy. That’s where she found the term she now uses: termination for medical reasons (TFMR). She likes it because it doesn’t pretend this isn’t an abortion (the word “termination” is right there), and because it says why.
What she found was that women in her situation don’t fit anywhere. In her experience, abortion services often focus on the woman’s goals and her empowerment, which wasn’t what she needed. Her goal was to have a baby. And some baby loss and miscarriage groups won’t let you use the word “abortion”. She’s heard of women sharing their whole story in an in-person group and being told it wasn’t the place for them. “Which, what, where is the place for us?”
That’s why she became a doula. A doula is a birth companion, she says, but really a transition companion, and this is a transition – a postnatal period nobody sees, when the nursery might be ready and you’re picking out an urn. Above anything else, the women who come to her want to connect with other mothers who’ve been through it.
No pathway for a grieving mother
At the clinic, one nurse handed Sabrina tissues and turned her back without a word. Another took her into a small room and asked whether someone was making her do this, because she was crying. When she asked about cremation, she was told it was a lot of paperwork, so she probably shouldn’t.
Sabrina is careful to say this isn’t about individual doctors and nurses, who she thinks mostly have a calling to help. It’s the system. And the moments people in her community remember are the human ones: the doctor whose eyes glistened, the nurse who said she was sorry about their baby. As she points out, those words take the same amount of time as handing over the tissues in silence.
The grief, and what helped
Sabrina describes her grief as acute for a long time, affecting every part of her body and every relationship. “Feels like 10,000 years of rain,” she said. “And a tsunami. Every two minutes.”
What helped was reading other women’s stories. She’d find someone posting about her fifth anniversary, then go back through every post that woman had ever written, to see that she could get there too. She looked after her body as it recovered, did a writing course on grief, and found a trauma therapist who used eye movement desensitisation and reprocessing (EMDR). The therapist told her they’d work on the trauma so she could go through the natural process of grief, and didn’t treat the grief itself as a problem. Sabrina says community is the foundation that lets everything else work: “You can’t grieve a child on your own.”
Sabrina and I have been in touch for years, and I’ve sent women from my work to her community. I’m thinking of one woman who had worked through her fear of birth, only to then face a TFMR. I was so glad to be able to pass her on, knowing she’d be looked after there too.
Pregnancy after loss
Sabrina wanted another baby, and her doctor suggested giving herself six months to heal emotionally first. She says being pregnant again was in some ways harder than the TFMR. She knew all the ways things could go wrong. People talk about “when the baby’s born”, and after a loss it becomes “if we bring this baby home”.
She’d find women in her group who were further along and read how they’d felt at each week of their pregnancy. Then she started posting her own. She had a doula, midwife care, hypnobirthing and an altar in the room for the baby she’d lost, Clara. After 10 days of on-and-off contractions, her daughter was born in the water about an hour after Sabrina had wondered whether she was making the whole thing up.
The months afterwards were hard. She describes checking and rechecking her daughter’s head size and ears, and the thoughts going round and round. Looking back, she’d have asked her doula to come and talk to her once a week, someone who’d tell her that of course she was focusing on this, after what she’d been through. At the time of recording, her daughter was seven. “She’s fine and I’m fine.”
If you’re frightened of being pregnant again
You’re not alone in that. The free Tokophobia Test takes about five minutes and gives you a picture of what you’re dealing with, whether or not you’re pregnant.
Take the free Tokophobia Test › (Provided by our approved partner Fearless Birthing, founded, like Fear Free Childbirth, by Alexia Leachman.)
The care she’d design
I asked Sabrina what she’d build if she could start with a blank sheet. She’d give women a choice of pathway, so a woman grieving a wanted baby could choose a bereavement route. She’d like every hospital to have a bereavement suite away from the maternity ward, so you don’t hear other babies crying through the curtain. If clinics stay, she’d want a private room, where partners, doulas and family can be with her. She’d want staff to say TFMR, as easily as we say miscarriage or stillbirth, and to point women towards grief support. And she’d take the pictures of chubby babies and the empowerment posters off the walls.
“This is a family,” she said. “This is a death in the family. Treat it as such.”
Questions I get asked about this
What is TFMR?
TFMR stands for termination for medical reasons. It’s when a wanted pregnancy is ended because of a serious diagnosis in the baby, or a risk to the mother’s own health. Sabrina uses the term because it names both the termination and the reason for it.
Is it normal to grieve after a TFMR?
Yes. Sabrina describes her grief as acute and long-lasting, and many women in her community grieve their baby as a bereavement. A TFMR can also bring trauma, which some women get help with alongside grief support.
Where can I find support after a TFMR?
In the UK, Antenatal Results and Choices (ARC) supports parents through screening, diagnosis and TFMR. Sabrina runs online groups for anyone who has been through a TFMR, including a free Facebook group. Your GP or midwife can also help you find support near you.
What helps in a pregnancy after loss?
For Sabrina it was community, reading how other women had felt at each stage, midwife and doula care, and knowing where she’d find support if something went wrong. She says she’d have asked for more support in the months after the birth too.
Where to go from here
Sabrina’s free Facebook group, The Sanctuary membership and small groups are at thetfmrdoula.com, and her podcast, Our TFMR Stories, has more women’s stories. In the UK, ARC supports parents through TFMR.
If you’re frightened of being pregnant again, the free Tokophobia Test takes about five minutes. For support with fear in pregnancy, the Tokophobia Support Circle is a small monthly membership with a live group call each month, and the Tokophobia Support Programme offers focused one-to-one help. Both are run by our approved partner Fearless Birthing (founded, like Fear Free Childbirth, by Alexia Leachman).
And if you’d like to help us understand more about pregnancy, birth, fertility and loss, the anonymous Birth & Babies Survey takes about 10 minutes.
If this has brought something up for you, talk to your GP, midwife or health visitor, or call NHS 111. Samaritans are there 24 hours a day on 116 123, for free. Outside the UK, contact your local emergency services.
About Sabrina Fletcher: Sabrina Fletcher is a TFMR doula who lives in Mexico. After her own termination for medical reasons in 2018, she began bringing together parents who have been through TFMR. She runs a free Facebook group, The Sanctuary monthly membership and small groups that meet for three months, and hosts the podcast Our TFMR Stories. thetfmrdoula.com ›
About the author: Alexia Leachman has specialised in tokophobia and reproductive anxiety since 2015, and has personal experience of tokophobia. She is the founder of Fear Free Childbirth and hosts its podcast. She developed the Head Trash Clearance Method, which she uses in her work with women and teaches to perinatal professionals. She is the author of Fearless Birthing and Betrayed By Your Biology and a contributor to Childbirth, Midwifery and the Media. Alexia has hosted the Fear Free Childbirth podcast since 2015. More about Alexia ›
Read next:
- Coping with a Miscarriage, with Susie Gower
- Fertility treatment trauma and responding to loss with compassion
Fear Free Childbirth is a publication and is not a substitute for medical or mental-health care. If you’re struggling to cope or in crisis, please contact your GP, midwife or a qualified professional.
- When a Wanted Pregnancy Ends: TFMR, Grief and Pregnancy After Loss, with Sabrina Fletcher - 6th November 2026
- Birth Imprints: Why You Might Fear a Birth You’ve Never Had, with Nicole Moore - 6th November 2026
- A Healthy Baby Doesn’t Mean the Birth Wasn’t Traumatic: What New Research Shows - 23rd October 2026
