Professionals' preferences in prenatal counseling at the limits of viability: a nationwide qualitative Dutch study

Rosa Geurtzen*, Arno van Heijst, Jos Draaisma, Laura Ouwerkerk, Hubertina Scheepers, Mallory Woiski, Rosella Hermens, Marije Hogeveen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

23 Citations (Web of Science)

Abstract

Prenatal counseling practices at the limits of viability do vary, and constructing a counseling framework based on guidelines, professional and parental preferences, might achieve more homogeneity. We aimed to gain insight into professionals' preferences on three domains of counseling, particularly content, organization, and decision making and their influencing factors. A qualitative, nationwide in-depth exploration among Dutch perinatal professionals by semi-structured interviews in focus groups was performed. Regarding content of prenatal counseling, preparing parents on the short-term situation (delivery room care) and revealing their perspectives on "quality of life" were considered important. Parents should be informed on the kind of decision, on the difficulty of individual outcome predictions, on survival and mortality figures, short- and long-term morbidity, and the burden of hospitalization. For organization, the making of and compliance with agreements between professionals may promote joint counseling by neonatologists and obstetricians. Supportive materials were considered useful but only when up-to-date, in addition to the discussion and with opportunity for personalization. Regarding decision making, it is not always clear to parents that a prenatal decision needs to be made and they can participate, influencing factors could be, e.g., unclear language, directive counseling, overload of information, and an immediate delivery. There is limited familiarity with shared decision making although it is the preferred model.

Conclusion: This study gained insight into preferred content, organization, and decision making of prenatal counseling at the limits of viability and their influencing factors from a professionals' perspective.

Original languageEnglish
Pages (from-to)1107-1119
Number of pages13
JournalEuropean Journal of Pediatrics
Volume176
Issue number8
DOIs
Publication statusPublished - Aug 2017

Keywords

  • Prenatal counseling
  • Limits of viability
  • Decision making
  • Extreme prematurity
  • SHARED DECISION-MAKING
  • EXTREMELY PREMATURE-INFANTS
  • EXTREMELY PRETERM BIRTH
  • HEALTH-CARE
  • HIGH-RISK
  • EXTREME PREMATURITY
  • INTENSIVE-CARE
  • PERINATAL-CARE
  • PARENTS
  • DELIVERY

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