A qualitative study of predelivery counselling for extreme prematurity

E Young, E Tsai, A O'Riordan. A qualitative study of predelivery counselling for extreme prematurity. Paediatr Child Health 2012;17(8):432-436. OBJECTIVE: To ascertain from parents of neonates born before 27 weeks' gestational age how to improve predelivery counselling for delivery room resuscitation. METHODS: Qualitative ethnographic study using semistructured, face-to-face interviews of 10 families. Data were analyzed using a constant comparative method. RESULTS: Parents had no previous knowledge about prematurity. They would have preferred prioritized information during predelivery counselling focused on the immediate risks to their child. Resuscitation wishes were inconsistently sought. Opportunities for repeat discussions involving both parents were often missed. Parents agreed that the opportunity to explicitly state resuscitation wishes should be offered. Additional materials, such as pamphlets or videos, would improve counselling. CONCLUSIONS: Information about prematurity should be offered when the pregnancy is deemed high risk, with repeat counselling opportunities for both parents to discuss options. Once the decision is made to resuscitate, parents want the neonatal team to convey a message of hope and compassion.