Maternal and Child Health Journal

, Volume 18, Issue 4, pp 920–929 | Cite as

Characterization of Health Care Provider Attitudes Toward Parental Involvement in Neonatal Resuscitation-Related Decision Making in Mongolia

  • Ryan M. McAdams
  • Ronald J. McPherson
  • Maneesh Batra
  • Zagd Gerelmaa


The aim of this study was to characterize attitudes and practices among health care providers (HCPs) in Mongolia regarding parental involvement in neonatal resuscitation (NR)-related decisions. A voluntary, anonymous questionnaire was administered to 210 HCPs across 19 of 21 Mongolia provinces. Eligible HCPs included midwives, neonatologists, pediatricians, and obstetricians involved in neonatal-perinatal care in both rural and urban hospitals. A total of 210 pediatric HCPs were surveyed and 100 % completed all questions (response rate 100 %). Despite the absence of nation-wide guidelines, NR is uniformly performed at 32-weeks gestation across HCP professions and across rural/urban settings. Most HCPs (67 %) indicate that parents should be counseled about resuscitation, but only 9 % ask the parents if they want their extremely premature child resuscitated and only 17 % counsel the parents prior to birth of an at-risk infant. Most HCPs (72 %) prefer to unilaterally decide when to withdraw NR, and only 28 % indicated that both parents should be involved in the decision. Following a newborn’s death, 75 % of all HCPs reported that they do explain the death to parents, although only 28 % reported receiving any training in parental grief counseling. For HCPs in Mongolia, a discrepancy exists between the perceived value of parental involvement and the actual practice of NR-related counseling. This report is a necessary first step toward understanding the factors that influence NR-related practices in Mongolia, and may serve as model for collecting these types of data in other low and middle income countries.


Neonatal resuscitation High-risk pregnancy Neonatal intensive care Prematurity Global health 



Health care providers


Neonatal resuscitation


Low and middle income countries


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ryan M. McAdams
    • 1
  • Ronald J. McPherson
    • 1
  • Maneesh Batra
    • 1
  • Zagd Gerelmaa
    • 2
  1. 1.Division of Neonatology, Department of PediatricsUniversity of WashingtonSeattleUSA
  2. 2.Health Sciences University of MongoliaUlaanbaatarMongolia

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