TFMR Support: Grief After Ending a Wanted Pregnancy
You made the hardest decision of your life — out of love for your baby. You ended a pregnancy you desperately wanted because continuing would have meant your child would suffer, or would not survive. And now you are living with a grief that most people around you do not know how to name.
TFMR — termination for medical reasons — is one of the most misunderstood and isolating forms of pregnancy loss. This article is written for you, and for the partner sitting beside you who is grieving just as deeply, but perhaps more quietly.
"You did not choose this loss. You chose your baby's wellbeing over your own longing to keep them. That is love in one of its most devastating forms."
What Is TFMR?
Termination for medical reasons (TFMR) — also called termination for fetal anomaly (TOPFA) or ending a wanted pregnancy — refers to ending a pregnancy after a serious or life-limiting diagnosis. These diagnoses are typically discovered through amniocentesis, NIPT testing, or anomaly scans, and may include:
- Trisomy 18 or Trisomy 13 — conditions incompatible with life
- Severe cardiac or chromosomal anomalies
- Neural tube defects
- Conditions that would result in significant suffering after birth
For most parents, TFMR happens in the second trimester — after they have passed the "safe zone." They have seen their baby on multiple scans, felt movement, perhaps chosen a name. A diagnosis delivered in a clinical room changes everything, in minutes.
Vernessa's Own Experience of Loss
From Vernessa · Personal Story
"I have been through my own TFMR. There was very little local support that wasn't clinical. No space that held both the body and the heart."
I have walked this path myself. I have experienced my own losses — three pregnancies, including my daughter Violet who we need to let go. I know what it is to sit in a room where the world tilts. Where a scan that was meant to be routine becomes the moment everything changes.
After my own losses, I realised how lonely pregnancy and infant loss can feel — not because people don't care, but because many simply don't know how to be with grief. I remember the things people said: "Don't think too much." "You're still young." "You can have another baby." Words meant to comfort that made the silence feel heavier.
There was very little local support that wasn't clinical. No space that held both the body and the heart. No place where my baby could be spoken about. No room for the emotions that came with it — the sadness, the anger, the guilt, the confusion — to exist without being managed or explained away.
So many parents carry this quietly. They return to work. They show up for family gatherings. They smile when people ask when the next baby is coming. And inside, they are still standing in that scan room.
This is what I bring to the work: not just professional training, but the knowledge that grief doesn't need fixing. It needs witnessing. When you sit with me, you do not need to explain yourself. I already understand something of what you are carrying.
How Men and Women Grieve TFMR Differently
One of the most painful patterns I see in couples after TFMR is that each partner is grieving deeply — and yet grief is making them feel further apart, not closer together. This is not a failure of love. It is a reflection of how profoundly different grief can look between two people.
Outward, relational grief
- Need to talk about the loss or express their thoughts and feelings
- Seek connection, validation, and to be heard
- May want to say the baby's name, mark anniversaries
- Feel the grief physically — in the body that carried the pregnancy
- May feel alone if partner appears to "move on" quickly
- Grief tends to be visible and more socially acknowledged
Private, delayed grief
- Process grief internally, away from others
- Channel emotion into action: fixing, working, keeping busy
- Suppress or minimise their own grief to "be strong"
- Receive far less social acknowledgement as a bereaved parent
- Grief often arrives delayed — weeks, months, or years later
- May appear to have recovered when the grief has simply gone underground
The particular weight of delayed grief
Delayed grief in men is not rare — it is the norm. A man who appears composed in the weeks after a TFMR may find his grief erupting months later in ways he does not immediately recognise as grief: persistent irritability, difficulty sleeping, pulling back from intimacy, losing interest in things he once cared about. By the time the grief surfaces, the world has moved on. He has no language for what is happening, and often no support.
This is one of the reasons I work with both partners after TFMR — because the grief belongs to both, even if it arrives at different times and speaks in different languages.
"Grief does not follow a schedule. And it does not disappear because it is not expressed. It waits."
Anger as Grief — And What Lies Beneath It
Understanding Secondary Emotions
Anger is a common and sometimes more accessible emotion for some people, especially men — but it is rarely the deepest one.
After TFMR, anger can feel like a common visitor to your life. Anger at the diagnosis. Anger at the healthcare system. Anger at friends who complain about healthy pregnancies. Anger at a partner for grieving differently. Anger at yourself — for the decision, for not being "over it," for feeling hopeful again and then guilty about the hope.
For many people — and particularly for men socialised to suppress vulnerability — anger is more accessible than sadness. It feels active rather than helpless. It gives grief somewhere to go. In many cultures, expressing anger is seen as strength, while expressing grief is seen as weakness.
But anger is a secondary emotion. Beneath it, almost always, are the feelings that feel too raw to name:
- Helplessness — "I could not save my baby. I could not change this."
- Loneliness — "No one truly understands what we went through."
- Shame — "People will judge us. We cannot tell the full story."
- Guilt — "We made the decision. We signed the consent form."
- Profound love — a love that has nowhere to go because the baby is gone.
Grief work that only addresses anger — without going beneath it — does not complete the grief. It manages it. True healing requires making contact with what the anger is protecting.
The Body Keeps Score — Why Mind Alone Is Not Enough
Mind · Body · Emotions — An Integrated Approach
The mind can be reprogrammed. The body remembers everything.
After TFMR, it is tempting to try to think your way through the grief. To rationalise — "we made the right decision." To reframe — "we gave our baby a peaceful ending." To reason — "I should be grateful for what I have."
The mind is powerful. And these statements may all be true. But grief after TFMR is not a cognitive problem. It is an embodied experience that took place inside a body that carried the pregnancy, felt the movement, and then went through the delivery or procedure. That body has its own memory — and the nervous system holds what the mind would like to file away.
Bessel van der Kolk's research — and decades of clinical work in trauma — confirms what many bereaved parents know intuitively: the body keeps score. Unprocessed grief does not disappear because you decide to move forward. It is stored — in the musculature, in the nervous system's threat responses, in the way the body braces or freezes in situations that recall the loss, even unconsciously.
This is why my approach to TFMR grief is integrative — working simultaneously with the body (through TRE®), the mind (through the evidence-based Grief Recovery Method), and the emotions and identity (through ontological coaching). Not because one is more important than the others, but because grief after TFMR needs to be met in all three places at once.
How Unresolved TFMR Grief Shows Up
Unresolved grief after TFMR does not stay still. It moves through time and finds expression in unexpected places — sometimes months later, sometimes years. Many parents do not connect what they are experiencing to the TFMR at all.
Unresolved grief can show up as:
These are not signs of weakness or abnormality. They are the nervous system and the heart still trying to process something that was never fully held. They are the body and the emotions asking to be witnessed.
Many of my clients come to me two or three years after a TFMR — finally ready to do the grief work they did not have the resources to do at the time. There is no expiry date on grief work. It is never "too late" to complete what was left unfinished.
Finding the Right TFMR Support
TFMR support is scarce in Singapore and across Southeast Asia. General counselling may not have specific experience with this loss. General pregnancy loss support may not fully address the particular complexity of a decision that TFMR involves — the guilt, the disenfranchised grief, the invisibility.
The most effective support for TFMR grief:
- Holds space for both the grief and the decision, without judgment
- Understands that TFMR is a distinct loss — not a variation on other pregnancy loss
- Addresses the body as well as the mind — because the grief lives in both
- Is available for couples as well as individuals, honouring different grieving rhythms
- Understands the cultural complexity of grief in Asian families
Online sessions available across the region
Offers space for partners to grieve differently, at their own pace Understands the cultural complexity of grief in Asian families Malaysia · Indonesia · Philippines · Hong Kong · Australia · globally"You do not need to explain yourself here. Whatever you decided, whatever you are carrying — there is a space for it."
— Vernessa
Frequently Asked Questions
Is TFMR grief as real as other pregnancy loss?
Completely. Research consistently shows that grief after TFMR is as significant as any other perinatal loss — and frequently more complicated by guilt, shame, and the cultural silence around termination. The fact that a decision was involved does not diminish the grief. If anything, it adds layers that require more careful, specialist support.
Why is my partner not grieving the way I am?
Men and women tend to process grief differently. Men more often grieve internally and privately, and frequently experience delayed grief — the full weight arriving weeks or months after the loss. What looks like "not grieving" is often grief that has gone underground. Both responses are real. Both deserve support.
It's been two years since our TFMR. Is it too late to seek support?
Never. Unresolved grief does not have an expiry date. Many parents come to grief work years after a TFMR — when the grief resurfaces through a trigger, a subsequent pregnancy, or simply an accumulation of what has been carried in silence. The work is still meaningful, still possible, and often more needed than they realised.
Why do I feel angry rather than sad?
Anger is often a more common and accessible emotion for some people after TFMR — it feels active and is more socially acceptable than open grief. But anger is a secondary emotion. Beneath it are usually helplessness, loneliness, guilt, and profound love for a baby who is gone. Grief work that only addresses the anger does not complete the grief. It needs to go deeper.
Can coaching help even if I've already seen a therapist or counsellor?
Yes. Coaching and therapy serve different purposes and often complement each other. Coaching is forward-focused — working with where you are now and what you want to move through. If you have done previous work and still feel something is unresolved, somatic and grief-integrated coaching can reach what cognitive approaches sometimes miss.
You Don't Have to Carry This Alone
I am Vernessa Chuah — Singapore's first ICF-certified pregnancy and infant loss coach. I have walked my own path of pregnancy loss, and I have supported bereaved parents navigating TFMR grief since 2021. I bring both professional training and lived understanding to this work.
A free discovery call is always the right place to start. No pressure, no agenda — just a warm, honest conversation.