This care pathway provides guidance to the labor, delivery, and postpartum teams caring for newborns anticipated to receive palliative care at the University of Utah Hospital. The pathway was updated in 2022 and takes into consideration any care plans developed in concert with a palliative care team (e.g., Rainbow Kids, Angel Watch) during the pregnancy. Page 1 of the Pathway is an algorithm for newborn palliative care. Page 2 has considerations for talking with families about resuscitation and care, which includes introducing the topic, confirming the care plan, presenting options, and talking about follow-up for families with or without a defined plan. Clicking on the pathway image downloads a larger PDF.

• The family may opt to change the care plan at any time.
• The palliative plan is overseen by the Well Baby Nursery (WBN) team for babies with a gestational age of ≥34 weeks and the Neonatal Intensive Care Unit (NICU) team for babies <34 weeks.
• Anticipated palliative care deliveries with a gestational age of ≥34 weeks may be physically cared for in the labor and delivery suite, the WBN, or the NICU, depending on anticipated viability and care plan.
• The palliative care pathway enables pre-ordering of comfort measures, including medications. There is an order set in Epic.
• The pathway includes guidance for what to do for in-hospital palliative deaths and infants discharging home with palliative care.
• The guideline includes pointers on how to have serious conversations with expectant families about resuscitation and care plans.