Hope pluralism in antenatal palliative care

When parents face the distressing news during pregnancy that their baby is affected by a serious medical condition that will likely lead to the baby’s death before or soon after birth, they experience a range of complex emotions. Perhaps paradoxically, one common response is that of hope. Navigating such hope in antenatal interactions with parents can be difficult for health care professionals. That can stem from a desire to accurately communicate prognostic information and a fear of conveying ‘false hope’ to families. In this paper we examine the role that hope plays when parents and health care professionals are grappling with a confirmed antenatal diagnosis of a life-limiting condition. We assess what it means to hope in this context and consider the different types of hopes held by both parents and health care professionals as well as why hopeful thinking might be helpful and not harmful. We propose “hope pluralism” as a concept that might allow healthcare professionals to accommodate a multitude of parental and professional hopes, even where these conflict. Finally, we offer some practical suggestions for how professionals should evaluate and respond to hope in situations that might (from the outside) appear hopeless.