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Multidisciplinary palliative care in unborn and newborn babies

BMJ 2011; 342 doi: (Published 11 April 2011) Cite this as: BMJ 2011;342:d1808
  1. Mark D Kilby, Hilda Lloyd professor of fetal medicine1,
  2. Samantha J Pretlove, consultant in maternal and fetal medicine2,
  3. Alison R Bedford Russell, consultant in neonatology2
  1. 1School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
  2. 2Birmingham Women’s Foundation Trust, Birmingham, UK
  1. m.d.kilby{at}

Coordinated clinical care and psychological, spiritual, and social support must be provided throughout the process

Visuals Unlimited/SPL

In September 2010 the BMJ published an article about palliative care and achieving a good death in the 21st century.1 However, the article did not comment on palliative care in the fetus and the newborn. Perinatal palliative care is the holistic provision of supportive care and end of life care. The eligibility of the fetus or neonate for such care should first be established using a multidisciplinary model that is centred on the family.2

Spontaneous and induced pregnancy losses are common. Evidence shows that parents undergo a grief reaction and require support and counselling in the long term.3 The management of such situations has an enduring effect on the psychological and emotional wellbeing of parents and the wider family. Family centred care has become a crucial part of care of neonates.4

If the overall prognosis for the baby is in doubt, palliative care is considered and discussed with parents in the prenatal or early neonatal period. Examples include neonates who are born at the limits of viability or with a serious and potentially lethal congenital malformation, neonates …

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