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Table 1 Recommendations about prenatal counseling in policy statements

From: Parental understanding of crucial medical jargon used in prenatal prematurity counseling

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