Book Review: The Silence of TFMR: A Compassionate Guide to Terminating a Pregnancy for Medical Reasons By Rosanna Brown
Review By: Afshan Ali – Midwife
Year of publication 2026
Name of publisher Watkins Media Limited
Number of pages 320
Price Print edition £14.99; e book £11.50
Paperback and e book available
ISBN number 978-1836810452
eISBN 978-1836810469
The book will also be available for purchase here.
The Silence of TFMR by Rosanna Brown sensitively explores an often less-spoken-about experience of pregnancy and baby loss. Drawing on her own experience with her son William, alongside the experiences of other parents and healthcare professionals, Brown brings both compassion and understanding to the complexities surrounding TFMR. At the heart of the book is a desire to help families feel less alone, while also encouraging greater understanding and more open conversations amongst those supporting and caring for them.
The book covers the subject comprehensively, following the journey from antenatal screening and diagnosis through decision-making, termination, birth and saying goodbye, before exploring the physical and emotional aftermath, post-mortem examination, relationships, returning to work and subsequent pregnancies. Importantly, it also acknowledges families who choose to continue a pregnancy following a life-limiting diagnosis, avoiding the suggestion that there is a single appropriate response to complex fetal diagnoses.
The book does not seek to be a traditional academic or clinical text, and this is perhaps one of its strengths. By placing lived experience at its heart, alongside case studies and professional perspectives, Brown gives a voice to experiences that clinical guidance and research cannot always fully capture. As a midwife providing specialised bereavement care, I found these personal accounts particularly valuable in understanding how care, communication and decision-making may be experienced by families. The book complements rather than replaces the clinical evidence and guidance that underpin professional practice.
Its relevance to midwifery practice is substantial. TFMR encompasses clinical care, informed decision-making, birth, bereavement and psychological support. Brown’s narrative demonstrates how communication, terminology and seemingly small interactions with healthcare professionals can influence how families experience and remember their care. The book also specifically offers guidance for healthcare professionals on approaching appointments compassionately.
Overall, The Silence of TFMR successfully combines personal narrative, practical information and professional perspectives. Its greatest strength is perhaps not simply explaining what happens during TFMR, but communicating what it can feel like. I would recommend it particularly to midwives, student midwives and maternity professionals. For those providing bereavement care, it offers an important opportunity to reflect critically on our language, assumptions and practice, and ultimately on whether the care we provide truly centres the individual experiences of bereaved parents.