Introduction One of the 3 major neural tube defects, anencephaly is incompatible with life. Women with affected fetuses are offered termination of the pregnancy. However, about a quarter of the population served in East Lancashire is Muslim and termination of pregnancy is not an acceptable option for a significant proportion of them.

Case Presentation We describe the cases of four women diagnosed with anencephaly in our unit from 2010 to 2013.

Two women opted to have terminations on diagnosis of anencephaly. Of the two who opted to continue the pregnancy, one delivered a stillborn in the third trimester. This pregnancy was complicated by polyhydramnios requiring amnioreduction. The other woman delivered a live anencephalic fetus that survived the stay in hospital and passed soon after being discharged from hospital with the parents.

Discussion Detailed action plans were developed with the multidisciplinary team when women opted to continue with the pregnancy to support the decision to the fullest. This included arranging for the delivery to be conducted in a specialised room with a team trained in bereavement support and communication between the Neonatology Team and the Coroner’s office with regards to prompt issuing of the death certificate.

Healthcare professionals must be prepared for the possibility that women may choose not to have a termination on diagnosis of anencephaly. Early referral and prompt communication within the multidisciplinary team is paramount in ensuring that these women obtain the best care and support possible.