What Are Special Considerations for Perinatal Palliative Care?

Perinatal palliative care and perinatal hospice work is a unique element of the maternal-fetal dyad and of brand-new families. These parents have rarely had relevant life experiences to prepare them for the possibility that their infant may die before or after birth. Providing seamless care to families during these transitions requires intentional collaboration with clinicians who typically do not work in the pediatric space—obstetricians, adult emergency department clinicians, and adult anesthesiologists. This requires perinatal palliative care providers to participate in creating systems of care that can overcome these barriers and allow people who are pregnant and their partners to rely on longitudinal palliative supports across multiple environments—outpatient prenatal care, inpatient labor and delivery, neonatal intensive care unit, and home hospice. Perinatal providers also need to be aware of local hospice resources specific to infant care, since these can be limited. While advances in fetal and neonatal care are improving outcomes from conditions such as complex congenital heart disease and prematurity, advances are also shifting a group of previously lethal neonatal diseases into chronic conditions. The demand for robust perinatal palliative care supports is only going to grow. As such, research, education, and advocacy in this area must continue.