Perinatal palliative care and the quality of life of newborns with life-limiting conditions – a clinical and decision-making perspective

Perinatal palliative care (PPC) is a relatively new and developing field of medicine aimed at providing continuous, multidisciplinary care for pregnant women facing an adverse prenatal diagnosis, improving the quality of life of newborns diagnosed with life-limiting conditions, and offering support and guidance to bereaved parents after the loss of their child.

This publication focuses primarily on the postnatal period and presents the current state of knowledge on this subject in Poland and other countries around the world, with particular emphasis on organizational, ethical, and clinical aspects. Among the topics discussed are the role of parents in decision-making regarding the care of a terminally ill newborn, methods for recognizing and managing pain and other symptoms in neonates, as well as practical aspects of care in terminal conditions, such as medication dosing, humane extubation, withdrawal of fluid administration, and the process of dying.

Based on an analysis of the available literature, it is concluded that developing clear and uniform standards for neonatal palliative care is particularly challenging due to the need for an indivi­dualized approach to both the patient and their parents. Factors such as personal value systems, religious beliefs, and cultural backgrounds significantly influence expectations, decisions, and perceptions of actions taken within the framework of perinatal palliative care, which further complicates the standardization of procedures.

This paper aims to present this complex issue and encourages further exploration and deepening of knowledge in the field of perinatal palliative care.