Perinatal Counseling II

Perinatal Counseling II

COMPARISON OF MOTHERS’ AND COUNSELORS’ PERCEPTIONS OF PREDELIVERY COUNSELING FOR EXTREMELY PREMATURE INFANTS. Keenam, Heather T., et al. PEDIATRICS Vol. 116 No. 1 July 2005, pages 104-111

Objective: To understand mother’s and counselor’s perceptions of their roles in decision making about resuscitation of the extremely premature infant at delivery; and their satisfaction with the counseling and decision making process.

Methods: Mothers who delivered an infant between 22-27 weeks gestation were interviewed using a structured interview format. Mother’s and Counselor’s perception of the content, tone and directiveness of predelivery counseling and their satisfaction with the decision-making process were compared.

Results: Specific mother-counselor pairs showed little correlation in their perceptions of whether a treatment recommendation had been made or choice had been given about resuscitation. Despite a lack of perceived choice, mothers generally believed that they were included in treatment decisions (66.7%) and were satisfied with the amount of influence that they had in the decision-making process.

Conclusion: In general, mothers were satisfied with directive counseling. They felt that this type of counseling made them be joint decision makers even when they were given no explicit choice about their infant’s treatment at birth.

Comments: This kind of counseling is closer to a model of informed assent than informed consent. It is possible that a directive form of counseling that gives information and recommendations but also elicits patient preferences allows mothers to choose their level of participation in the decision-making. It also shows us that while under stress we do not comprehend well.

I often wondered how much of what I am saying is being clearly understood. This study shows that very little is being comprehended and often way over our parents head. But surprisingly, the role they play makes the mothers feel they participated in the decision making. EV.

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