feeling of caregivers after a palliative management of extreme premature babies in delivery room.

Conditions: Caregiver Feeling

Summary: introduction : the birth of a child is usually a happy event that caregivers working in delivery rooms share with families. unfortunately, newborns sometimes need palliative care as soon as birth occurs. in france, neonates who were liveborn under 24+0 weeks amenorrhea (date of last mentrual period) or weighing less than 500 grams) usually have non resuscitation in delivery room \[ancel 2020\]. some of them are considered as viable (referring to world health organisation definition : either term ≥ 22 + 0 amenorrhea week or birth weight ≥ 500 grams), others as nonviable (term \< 22 aw and birth weight ≤500 grams). in france, legislative development over last two decades have allowed the emergence of palliative care in delivery room. in a french survey in 2016, 83% of maternities were confronted at least once a year with this situation.

in france as in other countries, published studies concerning palliative care for extremely premature babies focused on the " grey zon " period, but not on the nonviable preterm infants (also called late miscarriage) who have signs of life at birth. only a fairly recent french book of 735 pages exclusively dedicated to the palliative approach in perinatal medicine, reports in a single chapter the existence of palliative care in extremely non-viable premature newborns. there is a paucity of articles about the actual experience of caregivers confronted to palliative care of extremely preterm babies, viable or non viable, primarily studies in the so-called "gray" literature. thus, a midwifery graduation thesis describes the experience of midwives in a french university hospital following the care of babies born alive between 18 and 24 weeks old . two recent reviews explore the notion of resilience of caregivers who have been involved in perinatal palliative care . a nursing graduation dissertation explores the emotions of caregivers faced with perinatal bereavement . primary objective: the primary objective of this both qualitative and quantitative monocentric study is to explore the feelings of caregivers (doctors, midwifes, nurse's aids, pediatric nurses) within 2 months of a palliative situation for an extremely preterm baby in a delivery room, viable or not, and not eligible for resuscitation. secondary objective: the secondary objective of the study is to quantify the impact of this stressful event: * within the first month (acute stress). * 2 months after the event (post-traumatic stress). expected impact of the study: * these care situations are not described in the scientific literature and little described in the so-called grey literature: this study aims to make them readable. * the caregiver's feelings and the mechanisms that underlie them may differ, depending on the type of profession and links within a team: this study aims to better characterize and understand them. * as a result, the investigators hope this study will identify avenues for work and action to better support caregivers and prevent work-related burnout.

Eligibility criteria:
inclusion criteria: * any caregiver working at the universitary hospital of reims (france) (pediatrician, obstetrician, midwife, midwife, nurse's aide, pediatric nurse, midwife student, peidatrician student). * who cared for an extremely preterm newborn in a delivery room, with a palliative approach, * and gave his/her consent. * the baby must have shown at least minimal signs of vitality (that is : heartbeats, cry, respiratory movements, painful facies, gasps). * the caregiver must has been physically present with either the newbor, or the mother, or both. exclusion criteria : none

Keywords: caregiver feeling palliative care delivery room extremely preterm birth