Values Parents Apply to Decision-Making Regarding Delivery Room Resuscitation for High-Risk Newborns

Abstract

The values that parents find most important during decision-making regarding delivery room resuscitation may not be addressed routinely in prenatal counseling. Parents and physicians may have different interpretations of what is discussed and what decisions are made. Future work should investigate whether physicians can be trained to address effectively parents' values during the decision-making process and whether addressing these values may improve physician-parent communication and lead to better postdecision outcomes for parents.

Adolescent mothers in the NICU: how much do they understand?

“…15 Unfortunately, parents who do not ask questions may be incorrectly interpreted by providers as being well informed. 16 Our previous work 3 and that of others 5,10,17 describes some of the difficulties that many parents face in absorbing information about their infant's medical crisis and participating in decisionmaking. Maternal postpartum recovery, intense emotions, grief and disbelief can all diminish parents' ability to absorb and process cognitive information.…”

“…2 This decision-making is challenging for parents and providers alike, as they struggle to integrate complex medical information, prognostic uncertainty, time pressures and intense emotions. [3][4][5][6] Data regarding parent perceptions of communication with providers in the NICU have generally not focused specifically on the experiences of adolescent parents. 5,[7][8][9][10] Adolescent parents may be particularly vulnerable to adverse outcomes related to poor parent-provider communication, as many have appreciable socioeconomic burdens.…”

Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation

“…Instead, religion, spirituality, and hope may be more important factors. 57,58 There are also cultural differences in terms of preferences for resuscitation of extremely preterm newborn infants, although these may reflect differences in institutional practices or resources. 59 Understanding the importance of parental values and experiences is essential to shared decision-making.…”

Teaching antenatal counseling skills to neonatal providers

“…9-11 They also commonly expressed doubts about their ability to rationally process so much information during a time of intense emotional stress. 4,10 Parents commonly expressed a wish that their physician had been able to convey to them a sense of hope and compassion, 7,12,13 and felt abandoned when physicians seemed to be "following protocol" or "acting by the book." 10 Women reported feeling "mistrustful" of physicians who communicated only bad news, and perceived such Table 1 -Representative standardized patient comments following simulated antenatal counseling sessions with neonatology fellows.…”