Bertaud Sophie, Kirven Rachel, Kirven Thomas, Harrop Emily, Crudgington Amanda, Wilkinson Dominic
Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK.
Louis Dundas Centre for Children's Palliative Care, Great Ormond Street Hospital for Children, London, UK.
Palliat Med. 2024 Dec;38(10):1194-1198. doi: 10.1177/02692163241280374. Epub 2024 Sep 27.
Perinatal palliative care can offer compassionate support to families following diagnosis of a life-limiting illness, to enable them to make valued choices and the most of the time that they have with their newborn. However, home birth is usually only offered in low-risk pregnancies.
A couple who received an antenatal diagnosis of hypoplastic left heart syndrome and who had made a plan to provide palliative care to their baby after birth requested the option of a home birth.
Recommend birth at hospital or explore the possibility of a home birth with perinatal palliative care support.
Multidisciplinary discussion and collaboration enabled a plan for home birth to be made which anticipated potential complications.
The baby was born at home and died on day 5 of life receiving outreach nursing, paediatric and palliative care support and buccal and oral opioids for symptom management. We include reflections from the family on the importance of this experience.
We provide a list of potential criteria for considering home birth in the setting of perinatal palliative care.
Facilitating a home birth in the setting of perinatal palliative care is an option that can be hugely valued by families, but this service may be practically difficult to deliver in many contexts. Further research is needed to understand the preferences of women and families receiving perinatal palliative care.
围产期姑息治疗可以在确诊危及生命的疾病后为家庭提供富有同情心的支持，使他们能够做出有价值的选择，并充分利用与新生儿相处的时间。然而，家庭分娩通常只适用于低风险妊娠。
一对夫妇在产前被诊断出患有左心发育不全综合征，并计划在孩子出生后为其提供姑息治疗，他们要求选择家庭分娩。
建议在医院分娩，或探讨在围产期姑息治疗支持下进行家庭分娩的可能性。
多学科讨论与协作促成了一项家庭分娩计划，该计划预计到了潜在并发症。
婴儿在家中出生，在出生后第5天死亡，期间接受了外展护理、儿科和姑息治疗支持，并使用了口腔阿片类药物进行症状管理。我们纳入了家庭对这段经历重要性的反思。
我们提供了一份在围产期姑息治疗背景下考虑家庭分娩的潜在标准清单。
在围产期姑息治疗背景下促成家庭分娩是一种家庭可能极为重视的选择，但在许多情况下，这项服务在实际操作中可能难以提供。需要进一步研究以了解接受围产期姑息治疗的妇女和家庭的偏好。
