Table 1 Recommendations about prenatal counseling in policy statements

AAP Recommendation [3]

Discussion should be appropriate to family’s level of understanding

Counseling should be sensitive to family’s religious, social, cultural, and ethnic diversity

Provide the most accurate prognostic morbidity and mortality data available (local or national data)

Discuss that despite intensive care, many extremely premature infants die in the first few days

Parents have the option to withdraw treatment later even if resuscitation is successful

Discuss all options for care including comfort care if appropriate

Provide time for parents to ask questions

Ideally OB and Neonatology will discuss resuscitation together so that consistent approach is presented to parents

ACOG Recommendations [11]

Counseling regarding short-term and long-term outcomes should take into consideration anticipated gestational age at delivery as well as other variables

Counseling should be provided by a multidisciplinary team

A pre-delivery plan should be made with parents but may be modified based on evolution of the clinical situation

NICHD Recommendations [2]

Counseling should be bi-directional, collaborative, and ongoing process

Discussion of the alternative to and rationale for or against active maternal and neonatal intervention are appropriate

Institutional, regional, or national data regarding outcomes should be provided as available

Consider the use of decision aids or other materials

Provide information regarding the possibility of survival and disabilities separately

Offer information regarding anticipated NICU care and NICU complications

Information given to families should include what some children cannot do because of disabilities and what may can do

Discuss options for comfort care and circumstances that might result in reconsideration of life-sustaining interventions