Prospective parents' perspectives on antenatal decision making for the anticipated birth of a periviable infant

The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
Brownsyne Tucker EdmondsKaren Kavanaugh

Abstract

To examine prospective parents' perceptions of management options and outcomes in the context of threatened periviable delivery, and the values they apply in making antenatal decisions during this period. Qualitative analysis of 46 antenatal interviews conducted at three tertiary-care hospitals with 54 prospective parents (40 pregnant women, 14 partners) who had received counseling for threatened periviable delivery (40 cases). Participants most often recalled being involved in resuscitation, cerclage, and delivery mode decisions. Over half (63.0%) desired a shared decision-making role. Most (85.2%) recalled hearing about morbidity and mortality, with many reiterating terms like "brain damage", "disability", and "handicap". The potential for disability influenced decision making to variable degrees. In describing what mattered most, participant spoke of giving their child a "fighting chance"; others voiced concerns about "best interest", a "healthy baby", "pain and suffering", and religious faith. Our findings underscore the importance of presenting clear information on disability and eliciting the factors that parents deem most important in making decisions about periviable birth.

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Citations

Jan 9, 2019·Maternal and Child Health Journal·Tara A LynchPaul Burcher
Feb 13, 2019·International Journal of Technology Assessment in Health Care·Michal Stanak
Mar 14, 2020·Obstetrics and Gynecology·Nansi S BoghossianJeffrey D Horbar
Apr 26, 2020·The Journal of Perinatal & Neonatal Nursing·Rebecca L Cypher, Lisa M Foglia
Oct 23, 2019·Paediatric and Perinatal Epidemiology·Brownsyne Tucker EdmondsKaren Kavanaugh
Sep 14, 2019·JMIR Pediatrics and Parenting·Adriane F HaraganKatherine P Himes
May 28, 2020·Obstetrics and Gynecology·Sierra A HajduEmily A DeFranco
Nov 10, 2020·Patient Education and Counseling·Brownsyne Tucker EdmondsMiriam Kuppermann
Aug 21, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Katherine WoodDominic Wilkinson

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