When Life Is Expected to Be Brief: A Case-Based Guide to Prenatal Collaborative Care

Author:

Wilson Sharen1,Mehlhaff Krista2

Affiliation:

1. *Department of Neonatology

2. †Department of Maternal-Fetal Medicine, University of Maryland Medical Center, Baltimore, MD

Abstract

Advances in fetal health detection and neonatal care have improved outcome predictions but have outpaced the development of treatments, leaving some families facing the heartbreaking reality of their baby’s short life expectancy. Families with a fetus that has a life-limiting condition must make tough decisions, including the possibility of termination, perinatal palliative care options, and the extent of newborn resuscitation. Access to abortion services is crucial in decision-making, underscoring the significance of palliative care as an option. Perinatal palliative care programs offer vital support, honoring the baby and family throughout pregnancy, birth, and death. They provide compassionate care for pregnant individuals, partners, and newborns, integrating seamlessly into standard pregnancy and birth care. Successful programs prioritize families’ desires, goals, and personal priorities, whether through a dedicated team or an organized system. “Regardless of the length of a baby’s life or duration of illness, it is their lifetime. The infant and family deserve skilled and compassionate attention to their plight; a safety net throughout the experience; a palliative care approach emphasizing living fully those days, hours, and even moments.” (1)

Publisher

American Academy of Pediatrics (AAP)

Reference22 articles.

1. Taking palliative care into pregnancy and perinatal loss: a model for community collaboration;Sumner;National Perinatal Association Bulletin. Autumn,2003

2. Update on overall prevalence of major birth defects--Atlanta, Georgia, 1978–2005;Centers for Disease Control and Prevention (CDC);MMWR Morb Mortal Wkly Rep,2008

3. Review of birth defects in a community hospital over a ten-year period;Vaz;Obstet Gynecol Int J,2016

4. Infant mortality in the United States, 2020: data from the period linked birth/infant death file;Ely;Natl Vital Stat Rep,2022

5. Perinatal Palliative Care: ACOG COMMITTEE OPINION, Number 786;Obstet Gynecol,2019

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