Antenatal counseling by a neonatologist – an international survey of practice

Premature delivery presents enormous complexities for all professionals involved with prospective parents. Discussion with the parents on the likelihood of problems after preterm delivery, both short term and long term, is quite challenging. There is a wide variation of practice when it comes to antenatal counselling, in different hospitals in the same country and certainly in different countries. Aims To evaluate variation in practice in antenatal counselling in anticipated preterm deliveries in Europe and Asia. Methods Information was obtained using an electronic survey on factors considered most important for developing guidelines for good practice. The survey was sent to all participants of the neonatal online training project (UK, EU countries and India). Results We received 59 responses for analysis. The discussion with prospective parents was led by the Consultant in 23% and Specialist Registrar (or equivalent) in 39% of neonatal units. 65% of neonatal units did not have any written guidelines for antenatal counselling. 38% do not document any communication. Written material was provided in 43% of neonatal units. Immediate postnatal discussion by a senior member of the neonatal team occurred in majority of the units. 6% of doctors had received some form of formal training in antenatal counselling. Great variation was observed when it involves discussion of long-term neonatal outcome, mortality and on potential events during delivery. Discussion Our survey reveals great variation in daily practice in antenatal counselling. There was no clear guidance for criteria for antenatal discussion including gestation. There needs to be an international guideline or consensus for practising effective parental communication.