Optimizing Family Counseling for Anticipated Extremely Preterm Delivery
Boston Children's Hospital
Summary
Antenatal family counseling for anticipated extremely preterm deliveries remains ethically and practically challenging for maternal-fetal medicine specialists and neonatologists alike. The overall goal of this project is to improve antenatal counseling and counseling outcomes for families facing anticipated extremely preterm delivery through innovative, interdisciplinary simulation-based education for maternal fetal medicine specialists and neonatologists, using language preferred by families, and focusing on eliciting values and building partnerships through advanced communication and relational skills.
Description
Extremely preterm birth near the limit of viability, defined broadly as birth between 20 and 26 weeks' gestation, accounts for substantial infant morbidity and mortality as well as both parental and provider distress. Prenatal counseling for families anticipating extremely preterm delivery remains ethically and practically challenging for both Maternal Fetal Medicine (MFM) specialists and neonatologists. Physicians must quickly establish a trusting relationship with families and convey complex medical information. They must sensitively elicit family preferences and values regarding life and de…
Eligibility
- Age range
- 18–99 years
- Sex
- All
- Healthy volunteers
- No
1. Pregnant women and their partners Inclusion Criteria: * English-proficient adult pregnant woman admitted between 22 0/7-25 6/7 weeks' estimated gestation for anticipated extremely preterm delivery and her adult partner (if available) for whom an antenatal neonatal intensive care unit (NICU) consultation was requested and performed Exclusion Criteria: * Non-English proficient * Fetal congenital malformation(s) * \<18y old * \<22 0/7 or \> 25 6/7 weeks' estimated gestation * Repeat consultation 2. Counseling MFM and Neonatology providers Inclusion Criteria: * Pract…
Interventions
- BehavioralEducational intervention
Investigators will first determine preferred language and approaches by families, then redefine current training for prenatal counseling at extreme prematurity by developing and implementing two novel, interdisciplinary simulation-based educational programs for MFM and Neonatology (a workshop and an online module), focusing on eliciting values and building partnerships through advanced communication and relational skills, to improve counseling practices and outcomes
Locations (3)
- Boston Children's HosptialBoston, Massachusetts
- Beth Israel Deaconess Medical CenterBoston, Massachusetts
- South Shore HospitalWeymouth, Massachusetts