235 - On the Record - Parental Reflections on Antenatal Counseling

Publication Number: 235.5638

Mikki-Ann Martin, University of Michigan Medical School, Ann Arbor, MI, United States; Marin Arnolds, University of Michigan Medical School, Ann Arbor, MI, United States

Background: Preterm delivery is often an unexpected, untimely, and devastating event for parents. Neonatologists are routinely consulted to meet with such parents during this time. Information shared should strike a careful balance between what the parents consider important and what the neonatologist believes is essential for informed decision-making. Insights from parents who have recently gone through antenatal counseling and a Newborn Intensive Care Unit (NICU) admission are particularly valuable to identify gaps in communication and highlight what was most helpful or lacking during the consult. The experience of bereaved families is less well studied.

Objective: To elicit insights regarding antenatal counseling from current and bereaved NICU parents who have had antenatal counseling, preterm delivery, and a NICU admission.

Design/Methods: Parents of neonates admitted to the NICU, who had received antenatal counseling for an anticipated preterm delivery at < 28 weeks of gestation participated in semi-structured interviews prior to NICU discharge or after neonatal death. Parents were recruited from two institutions. The interviews were audio-recorded, transcribed and coded by two study members. Thematic analysis of the data was performed using NVIVO software.

Results: Twenty parent interviews were conducted around the time of hospital discharge or after neonatal death for twenty-one neonates (Table1). Two major themes (1) The Content of Consult and (2) The Role of the Physician emerged along with novel interrelated subthemes (Figure1). Subthemes and illustrative quotes are displayed in Table 2. Under the major theme Content of Consult, subthemes included: (1a) use of statistics for setting expectations, not for decision making, (1b) parents wanting the honest truth, (1c) the curveball of the circumstance and (1d) following up being helpful. The second major theme, Role of the Physician subthemes were (2a) parents desire to be informed with medical evidence, (2b) parents acknowledging that one can never be fully prepared and (2c) parents wanting for NICU providers to motivate them by using language hope and optimism to encourage them through a difficult NICU experience.

Conclusion(s): Reflections from experienced NICU parents emphasize the vital role of the physician, which is to not only to inform and prepare but also to motivate families to withstand the challenges ahead, ultimately improving outcomes and parent satisfaction. In this way, parents teach physicians how we can be their best advocate during the antenatal counseling process.

Table 1
Demographic data of study participants and neonates.

Figure 1


Table 2


Table 1
Demographic data of study participants and neonates.

Figure 1


Table 2