Maternal fetal medicine, obstetric, and neonatology perspectives on joint prenatal counseling at periviable gestational ages.

Abstract

Objective: To explore perspectives of maternal fetal medicine specialists (MFMs), obstetricians (OBs), and neonatologists (Neos) about antenatal counseling at periviable gestational ages and examine how those perceptions impact multidisciplinary counseling.

Study design: Semi-structured interviews were conducted and thematic analysis performed until thematic saturation.

Results: Interviews of 7 Neos and 8 OB/MFMs identified three themes: (1) roles in periviability counseling; (2) training and lifelong learning to develop/enhance communication skills; and (3) managing interdisciplinary dynamics. Participants agreed on consult content and the appropriate subspecialist to discuss specific topics but differed in their approaches. Subspecialty perspectives differed on resuscitation, survival, and developmental outcomes. Formal communication skills training was identified as a means to scaffold conversations into a uniform approach.

Conclusion: Despite near universal agreement that joint perviability counseling would be beneficial, logistical barriers and lack of a shared framework may hinder its implementation. Formal communication skills training may support organized joint counseling.