Table 4 Themes and representative quotes for content analysis of the free text
Theme | Representative quotation |
|---|---|
Every situation is different | The decision should be individualised for every family (Paediatrician) |
The burden of guilt is too much for parents | No parent wants to live with the ‘did I kill my baby’ dilemma (Neonatal nurse) |
Parental choice is paramount | Will the parents be willing to look after a disabled child they didn’t want resuscitated? (Midwife) Parents are influenced by lesser degrees of disability and not only severe disability (Obstetrician) |
Advocating for the baby | At 24 weeks approximately half the survivors will have only mild or no disability. The uncertainty of outcome combined with uncertainty around exact gestation make any definitive advice around outcome imprecise. Resuscitation is not the last opportunity to withhold treatment from a baby … Choosing death is not necessarily a decision to be rushed. The disabled have rights. (Neonatologist) If a healthcare professional believes the chance of survival for an infant is good, full active management should happen regardless of the parental opinion. I believe we have to advocate for the baby when the parents do not have its best interests in mind. (Midwife) |
Following the law | When it comes to the wellbeing of a premature infant, there are legal guidelines regarding viability to protect the unborn child (Nurse) |
Ways to educate pregnant women about prematurity | Perhaps a basic handout of survival and disability statistics of babies born less than 30 weeks gestation should be given to parents at their first booking-in clinic. If the parents have a basic awareness, they may already have made a decision should they be unlucky enough to have an extremely preterm baby … most parents choose trying to save the baby because they have not had time to think what life would be like caring for a moderately or severely disabled child. (Neonatal nurse) If they are healthy this wont be needed. Why upset the mum as she will think something is wrong … the woman at risk could be identified … and then educated (Midwife) |