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

Brownsyne Tucker Edmonds*, Teresa A. Savage, Robert E. Kimura, Sarah J. Kilpatrick, Miriam Kuppermann, William Grobman, Karen Kavanaugh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)820-825
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume32
Issue number5
DOIs
StatePublished - Mar 4 2019

Keywords

  • Decision making
  • antenatal counseling
  • parents
  • premature infants
  • values

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

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