Birth Plan as a Tool for Humanized Care in the Management of Fetal Conditions with Lethal Prognosis

• Grant number: 25/20559-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2025
• End date: November 30, 2026
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Marcos Masaru Okido
• Grantee: Vitoria Makiyama Frare
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

Advances in prenatal diagnostic methods have enabled the early identification of severe fetal malformations incompatible with life, placing families and healthcare teams before emotional, ethical, and clinical challenges. In such contexts, perinatal palliative care emerges as an approach that prioritizes dignity, comfort, and support, involving not only the newborn but also the parents and healthcare professionals. A strategy still underexplored in Brazil, but with transformative potential, is the use of the birth plan-a tool that records the pregnant woman's wishes regarding childbirth, delivery, and newborn care, even in the face of incurability.This project aims primarily to investigate the impact of the birth plan on the understanding and acceptance of perinatal palliative care, considering its role in supporting loss, helping parents and families cope with grief, and aligning care practices among healthcare teams. The study will be conducted at a fetal medicine outpatient clinic of a public university hospital, through a descriptive design, predominantly quantitative but with qualitative elements.Participants will include pregnant women or family members who prepare a birth plan during prenatal care, as well as professionals directly involved in childbirth and delivery care. Data collection will take place in two phases: (1) preparation of the birth plan, as part of the care process; (2) administration of a questionnaire after birth to assess the experience of using the plan. Professionals will complete a structured form on their perception of the tool's impact.The expected results are to support the implementation of this practice in Brazilian public healthcare services, strengthening the humanization of care in situations of inevitable fetal loss and enhancing maternal protagonism even in end-of-life scenarios.