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Multicenter Study
. 2019 Mar;32(5):820-825.
doi: 10.1080/14767058.2017.1393066. Epub 2017 Nov 5.

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

Brownsyne Tucker Edmonds  1 , Teresa A Savage  2 , Robert E Kimura  3 , Sarah J Kilpatrick  4 , Miriam Kuppermann  5 , William Grobman  6 , Karen Kavanaugh  7
Affiliations
Multicenter Study

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

Brownsyne Tucker Edmonds et al. J Matern Fetal Neonatal Med. 2019 Mar.

Abstract

Objective: 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.

Study design: 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).

Results: 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.

Conclusions: 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.

Keywords: Decision making; antenatal counseling; parents; premature infants; values.

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Conflict of interest statement

Declaration of Interest Statement:

The authors report no conflict of interest.

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