Antenatal and neonatal support

For most families, being pregnant is an exciting time and the birth of a child will be a happy, uncomplicated event. Sadly, some babies are diagnosed in utero or born with a life-limiting condition. Martin House provides support for these families, offering one to one, family-led care at home, in hospital and at our hospice.

Our team can support neonatal professionals to explore options when balancing curative care with palliative care. Not all babies will have a diagnosis but if the prognosis of a life-limiting condition is made, either in utero or after birth, professionals can make a referral for support. We also offer parallel planning for babies where it is difficult to predict the prognosis.

If a baby is no longer responding to active treatment, we can  arrange reorientation of care at home or at the hospice.  We are experienced in meeting complex needs, including:
  • compassionate extubation
  • discontinuing life-sustaining infusions, such as Prostin
  • multi-organ failures
  • necrotising enterocolitis
  • hypoxic-ischemic encephalopathy
Regardless of the baby’s underlying condition, our emphasis is always on ensuring effective symptom management and enabling the family to spend quality time with their baby.

The British Association of Perinatal Medicine (BAPN) has identified five categories of perinatal palliative care referral criteria for babies. These are:

Category 1
An antenatal or postnatal diagnosis of a condition which is not compatible with long term survival e.g. anencephaly or bilateral renal agenesis.

Category 2
An antenatal or postnatal diagnosis of a condition that carries a high risk of significant morbidity or death e.g. severe bilateral hydronephrosis and impaired renal function.

Category 3
Babies born at the margins of viability, where intensive care has been deemed inappropriate.

Category 4
Postnatal clinical conditions with a high risk of severe impairment of quality of life and when the baby is receiving life support or may at some point require life support e.g. severe ischemic encephalopathy.

Category 5
Postnatal conditions which result in the baby experiencing “unbearable suffering in the course of their illness or treatment” e.g. severe necrotising enterocolitis, where palliative care is in the baby’s best interests.