학술논문

Prospective parents’ perspectives on antenatal decision making for the anticipated birth of a periviable infant
Document Type
article
Source
The Journal of Maternal-Fetal & Neonatal Medicine. 32(5)
Subject
Reproductive Medicine
Midwifery
Biomedical and Clinical Sciences
Health Sciences
Clinical Research
Pediatric
Behavioral and Social Science
7.3 Management and decision making
Management of diseases and conditions
Reproductive health and childbirth
Good Health and Well Being
Decision Making
Female
Fetal Viability
Humans
Life Support Care
Male
Parents
Pregnancy
Qualitative Research
Decision making
premature infants
parents
values
antenatal counseling
Paediatrics and Reproductive Medicine
Obstetrics & Reproductive Medicine
Paediatrics
Reproductive medicine
Language
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.