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Am J Perinatol 2023; 40(08): 874-882
DOI: 10.1055/s-0041-1731651
Original Article

Bereaved Parents: Insights for the Antenatal Consultation

Marlyse F. Haward
1   Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
,
John M. Lorenz
2   Department of Pediatrics, Morgan Stanley Children Hospital of New York, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York
,
Annie Janvier
3   Department of Pediatrics, Bureau de l'Éthique Clinique, Université de Montréal, Montréal, Canada
4   Division of Neonatology, Research Center, Clinical Ethics Unit, Palliative Care Unit, Unité de recherche en éthique clinique et partenariat famille, CHU Sainte-Justine, Montréal, Canada
,
Baruch Fischhoff
5   Department of Engineering and Public Policy and Institute for Politics and Strategy, Carnegie Mellon University, Pittsburgh, Pennsylvania
› Author Affiliations Funding This study received financial support from Marron-Manginello Endowment of the Valley Hospital Foundation.
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Abstract

Objective The study aimed to explore experiences of extremely preterm infant loss in the delivery room and perspectives about antenatal consultation.

Study Design Bereaved participants were interviewed, following a semi-structured protocol. Personal narratives were analyzed with a mixed-methods approach.

Results In total, 13 participants, reflecting on 17 pregnancies, shared positive, healing and negative, harmful interactions with clinicians and institutions: feeling cared for or abandoned, doubted or believed, being treated rigidly or flexibly, and feeling that infant's life was valued or not. Participants stressed their need for personalized information, individualized approaches, and affective support. Their decision processes varied; some wanted different things for themselves than what they recommended for others. These interactions shaped their immediate experiences, long-term well-being, healing, and regrets. All had successful subsequent pregnancies; few returned to institutions where they felt poorly treated.

Conclusion Antenatal consultations can be strengthened by personalizing them, within a strong caregiver relationship and supportive institutional practices.

Key Points

  • Personalized antenatal consultations should strive to balance cognitive and affective needs.

  • Including perspectives from bereaved parents can strengthen antenatal consultations.

  • Trusting provider-parent partnerships are pivotal for risk communication.

Keywords

decision-making - antenatal consultation - extreme prematurity - parents - bereavement


Publication History

Received: 30 October 2020

Accepted: 25 May 2021

Article published online:
12 July 2021

© 2021. Thieme. All rights reserved.

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