The Edge of Perinatal Viability:Understanding the Dutch Position

Contains fulltext : 231104.pdf (publisher's version ) (Open Access

On the limits of viability: toward an individualized prognosis-based approach

Contains fulltext : 229908.pdf (Publisher’s version ) (Closed access

Leven met het einde in zicht: de waarde van een brede benadering.

Dit adviesrapport gaat over het belang van passende zorg en ondersteuning voor mensen voor wie de dood door ziekte of toenemende kwetsbaarheid in zicht komt, zonder dat duidelijk is wanneer deze zal volgen. Mensen in deze situaties bevinden zich als het ware in een ‘tussenland’: een periode waarin het zoeken is naar hoe vorm te geven aan het leven met een beperkter of onzeker perspectief en naar een nieuw evenwicht tussen draagkracht en draaglast. Een periode waarin het bevorderen van de kwaliteit van leven in welke vorm dan ook van groot belang is, gegeven de onzekerheid van het al dan niet slagen van medische behandelingen en het daarmee samenhangende verdere perspectief

Complexity and interplay of faced adversities and perceived health and well-being in highly vulnerable pregnant women—the Mothers of Rotterdam program

Abstract Background Living in socially disadvantaged circumstances has a widespread impact on one’s physical and mental health. That is why individuals living in this situation are often considered vulnerable. When pregnant, not only the woman’s health is affected, but also that of her (unborn) child. It is well accepted that vulnerable populations experience worse (perinatal) health, however, little is known about the lived adversities and health of these vulnerable individuals. Objectives With this article, insights into this group of highly vulnerable pregnant women are provided by describing the adversities these women face and their experienced well-being. Methods Highly vulnerable women were recruited when referred to tailored social care during pregnancy. Being highly vulnerable was defined as facing at least three different adversities divided over two or more life-domains. The heat map method was used to assess the interplay between adversities from the different life domains. Demographics and results from the baseline questionnaires on self-sufficiency and perceived health and well-being were presented. Results Nine hundred nineteen pregnant women were referred to social care (2016–2020). Overall, women had a median of six adversities, distributed over four life-domains. The heat map revealed a large variety in lived adversities, which originated from two parental clusters, one dominated by financial adversities and the other by a the combination of a broad range of adversities. The perceived health was moderate, and 25–34% experienced moderate to severe levels of depression, anxiety or stress. This did not differ between the two parental clusters. Conclusions This study shows that highly vulnerable pregnant women deal with multiple adversities affecting not only their social and economic position but also their health and well-being

Complexity and interplay of faced adversities and perceived health and well-being in highly vulnerable pregnant women—the Mothers of Rotterdam program

Abstract Background Living in socially disadvantaged circumstances has a widespread impact on one’s physical and mental health. That is why individuals living in this situation are often considered vulnerable. When pregnant, not only the woman’s health is affected, but also that of her (unborn) child. It is well accepted that vulnerable populations experience worse (perinatal) health, however, little is known about the lived adversities and health of these vulnerable individuals. Objectives With this article, insights into this group of highly vulnerable pregnant women are provided by describing the adversities these women face and their experienced well-being. Methods Highly vulnerable women were recruited when referred to tailored social care during pregnancy. Being highly vulnerable was defined as facing at least three different adversities divided over two or more life-domains. The heat map method was used to assess the interplay between adversities from the different life domains. Demographics and results from the baseline questionnaires on self-sufficiency and perceived health and well-being were presented. Results Nine hundred nineteen pregnant women were referred to social care (2016–2020). Overall, women had a median of six adversities, distributed over four life-domains. The heat map revealed a large variety in lived adversities, which originated from two parental clusters, one dominated by financial adversities and the other by a the combination of a broad range of adversities. The perceived health was moderate, and 25–34% experienced moderate to severe levels of depression, anxiety or stress. This did not differ between the two parental clusters. Conclusions This study shows that highly vulnerable pregnant women deal with multiple adversities affecting not only their social and economic position but also their health and well-being