Various experiences and preferences of Dutch parents in prenatal counseling in extreme prematurity

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

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Web of Science)

Abstract

Objective: To investigate experienced and preferred prenatal counseling among parents of extremely premature babies.

Methods: A Dutch nationwide, multicenter, cross-sectional study using an online survey. Surveys were sent to all parents of extremely premature babies born between 2010 and 2013 at 24(+0/7)-24(+)(6/7) weeks of gestation.

Results: Sixty-one out of 229 surveys were returned. A minority (14%) had no counseling conversation. Conversations were done more often by neonatologists (90%) than by obstetricians (39%) and in 37% by both these experts. Supportive material was rarely used (19%). Mortality (92%) and short-term morbidity (88%) were discussed the most, and more frequently than long-term morbidity (65%), practical items (63%) and delivery mode (52%). Most decisions on active care or palliative comfort care were perceived as decisions by doctor and parents together (61%). 80% felt they were involved in decision-making. The preferred way of involvement in decision-making varied among parents.

Conclusion: The vast majority of parents were counseled: mostly by neonatologists, and mainly about mortality and short-term morbidity. Parents wanted to be involved in the decision-making process but differed on the preferred extent of involvement.

Practice implications Understanding of shared decision-making may contribute to meet the various preferences of parents. (C) 2018 Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)2179-2185
Number of pages7
JournalPatient Education and Counseling
Volume101
Issue number12
DOIs
Publication statusPublished - Dec 2018

Keywords

  • Prenatal counseling
  • Parents
  • Decision-making
  • Ethics
  • Extreme prematurity
  • Viability
  • SHARED DECISION-MAKING
  • PERIVIABLE DELIVERY
  • INTENSIVE-CARE
  • PRETERM BIRTH
  • HIGH-RISK
  • VIABILITY
  • INFANTS
  • RESUSCITATION
  • THRESHOLD
  • AMERICAN

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