SYSTEMATIC REVIEW article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1553040
This article is part of the Research TopicCare of the extremely preterm infantView all 11 articles
A rapid review of periviable (22+0-23+6 weeks) counselling practices and the need for a trauma-informed care approach
Provisionally accepted
- 1Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, England, United Kingdom
- 2Manchester University NHS Foundation Trust (MFT), Manchester, United Kingdom
- 3Alder Hey Children's Hospital, Liverpool, United Kingdom
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Given the risks of mortality and morbidity for infants born in the periviable period, a decision is made between parents and professionals prior to the birth as to whether survival-focused or comfort care is most appropriate at delivery. Medical information should be shared with parents and parental perspectives and priorities in relation to this information should be explored and integrated into the decision-making process. Conducting these conversations is complex and nuanced. This rapid review conducted a systematic search of the available literature relating to the approaches to and content of the pre-birth periviable conversation and identified three core themes: Transparency, Collaboration and Empowerment. In brief, these themes demonstrate that the information provided to parents should consistently outline all available care options relevant to their baby, including compassionately delivered, but honest and descriptive accounts of emotive options, such as comfort care. Information should be individualised to the specific circumstances and risk factors of that individual family. Perinatal professionals should seek to incorporate discussion of topics key to the ‘good parent belief’ to empower parents within their role. Avoiding or omitting discussion of uncertainty and dismissal of hope within these conversations was associated with parental distrust and impaired communication. The themes identified within this rapid review align with the principles of trauma-informed care and provided a structure for further research and service development focused on improving the quality and experience of pre-birth periviable conversations for future parents.
Keywords: neonates, Extreme preterm, Periviable, Resuscitation, counselling, trauma & maternity care
Received: 29 Dec 2024; Accepted: 05 May 2025.
Copyright: © 2025 Peterson, Graham, Johnstone, Mahaveer and Smith. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jennifer Peterson, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, England, United Kingdom
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