Work

National survey of perinatal professionals’ experiences and approaches to conducting prebirth periviable (22+0 to 23+6 weeks) conversations: a mixed-methods study

Year: 2026

Type: article

Abstract: Background Conducting prebirth conversations with parents facing periviable birth (22+0 to 23+6 weeks) presents numerous challenges for perinatal professionals. This mixed-methods survey aimed to gather a holistic assessment of the experiences and issues encountered by UK-based perinatal professionals in relation to periviable birth.Methods A voluntary, anonymous national online survey of perinatal professionals was conducted using QualtricsXM, developed with input from a parental advisory group. The survey was structured into discrete sections exploring different elements of prebirth conversations and incorporated vignette-based scenarios (22+3, 23+3, 24+3 weeks) to explore professionals’ experiences of prebirth periviable discussions, including communication, moral distress and training needs. It was distributed through relevant professional organisations across the UK between March and April 2022. Quantitative data were summarised descriptively and qualitative free-text responses were analysed using reflexive thematic analysis.Results The survey received 387 views with responses across the perinatal multidisciplinary team (MDT). The completed response rate varied from 100 respondents (questions related to training) to 321 (clinical vignette questions).In contrast to national guidance, the survey showed that only two-thirds of paediatric and neonatal consultants and one-third of obstetric consultants would include comfort care within prebirth discussions with parents. Additionally, the survey demonstrated that involvement in these conversations confers a moral distress burden to perinatal professionals across the MDT.Conclusion Variation in management options presented to parents has the potential to limit their ability to be meaningfully involved in decisions relating to their baby. Further research is required to determine how best to train and support perinatal professionals to deliver this challenging area of care.

Source: BMJ Paediatrics Open

DOI: 10.1136/bmjpo-2025-004153

Authors: Jennifer L H Peterson, Kate Delany, Edward D Johnstone, Ajit Mahaveer, Debbie M Smith

Institutions: University of Manchester, Manchester University NHS Foundation Trust

Language: English

Topic: Ethics and Legal Issues in Pediatric Healthcare

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: Central Manchester University Hospitals NHS Foundation Trust