Multidisciplinary joint counselling by fetal medicine specialist, neonatologist and midwife counsellor (further specialists as indicated—eg, clinical geneticist) | | Agree diagnosis and prognosis; clear and consistent communication; efficient use of time for both clinicians and patients—avoiding multiple appointments and travel |
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Clearly documented plan for delivery and perinatal period in maternal and prebirth notes and copy for parents and referring centre | | Ensures all staff have access to key information at all times, avoiding repeated discussions with parents; parents carry documentation in case of unplanned delivery elsewhere |
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Liaison with community services supporting palliative care (GP, hospice, community paediatrics) | | Ensures community child heath team has advance plan if death after discharge home is a possibility |
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Liaison with hospital chaplaincy or representatives for other faith and religions | | Parents’ wishes for ceremonies at the time of baby’s death may be discussed and arranged |
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Discussion of case at multidisciplinary meetings, ongoing discussion and liaison with referring centres | | Provides forum for ongoing discussion of case; support for staff |
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Offer parents contact information for ARC and SANDS and if requested, further specialist second opinions | | Ensures that parents have full information from sources independent of immediate healthcare team |
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Senior neonatologist attends delivery | | Avoid inappropriate resuscitation decisions by junior staff; reassurance for parents and obstetric staff for senior neonatalogists to confirm diagnosis and outlook |
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Interval postnatal follow-up with key obstetric, midwifery and neonatal staff | | Gives parents a valuable chance for debriefing remote from the events, and feedback of postmortem examination and other investigations |