Abstract

This book chapter explores the complexities–spiritual, emotional and ethical–faced by parents when they receive a diagnosis of a life-limiting condition for their baby during pregnancy. The diagnosis of a fetal anomaly presents clinicians and parents with complex challenges touching in the very essence of life and death. This chapter brings to conversation this topic which is so often experienced as a silent grief and under-acknowledged in social discourse. One of the most challenging realities  for parents and for those who care for them and their baby when faced with a life-limiting diagnosis is whether to continue with the pregnancy or to make a difficult decision to terminate a much wanted pregnancy when a baby is unlikely to survive. These are complex ethical choices and are not ‘choices’ in the popular understanding of the term. The role of perinatal palliative care is proposed as an approach to care which should be offered to all parents and their babies regardless of the choices made. Each baby and family deserves the highest level of comprehensive compassionate care, symptom control and bereavement support al being cognisant of the recognised physical, emotional, social and spiritual elements of the palliative approach.