412 - Awareness of unmarried fathers’ legal standing in treatment decision making for their newborn
Friday, April 28, 2023
5:15 PM – 7:15 PM ET
Poster Number: 412 Publication Number: 412.106
Siobhan McDonnell, Medical College of Wisconsin, Wauwatosa, WI, United States; Kathryn E. Flynn, Medical College of Wisconsin, Milwaukee, WI, United States; Jennifer J. McIntosh, Medical College of Wisconsin, Milwaukee, WI, United States; Ruta Brazauskas, Medical College of Wisconsin, Milwaukee, WI, United States; Una Olivia Kim, Northshore University HealthSystems, Crystal Lake, IL, United States; Michael B. Pitt, University of Minnesota, Minneapolis, MN, United States; Kris Barnekow, Act Early Ambassador to WI, Eagle River, WI, United States; Abbey Kruper, Medical College of Wisconsin, Milwaukee, WI, United States; Mir Basir, Medical College of Wisconsin, Wauwatosa, WI, United States
Clinical Research Assistant Medical College of Wisconsin Wauwatosa, Wisconsin, United States
Background: Births to unmarried parents are increasing. In Wisconsin and many other states, if parents are not married it can take several months after birth to legalize paternity. In such cases, the mother is the only parent who can legally make neonatal treatment decisions. If the mother becomes incapacitated (e.g. due to pregnancy complication), often the unmarried father cannot immediately assume this role. Information on this legality is one of the topics in our smartphone Preemie Prep for Parents (P3) program. Objective: Examine the effect of P3 program on parents’ knowledge of unmarried fathers’ legal standing in treatment decision making for their newborn. Design/Methods: The P3 program is a set of 51 animated videos sent to participants’ smartphones via text-link. One of the videos provides information on unmarried fathers’ legal standing in making neonatal treatment decisions. At 18-21 weeks gestational age (GA), we randomized mothers to receive either the P3 program or links to American College of Obstetricians and Gynecologists webpages (NCT04093492). Fathers who agreed to participate were assigned the same study arm as the mother. If pregnancy continued, knowledge was assessed at 25, 30, and 34 weeks GA. P3 software tracked video usage. Results: Between February 2021 and August 2022, 120 mothers and 52 fathers participated. At 25, 30 and 34 weeks GA, mothers in the P3 arm were more likely than mothers in the control arm to know the legal standing of unmarried fathers to make neonatal treatment decisions (Ps < 0.001; Figure 1). At 25 and 34 weeks GA, fathers in the P3 arm were more likely than those in the control arm to know unmarried fathers’ legal-standing in treatment decisions (Figure 2). Overall, 42 (35%) mothers and 11 (21%) fathers were not married. Despite its relevance for them, unmarried parents were no more likely than married parents to know unmarried fathers’ legal standing in treatment decision making (61% vs. 59%, p=0.85). In the P3 arm, 68% of mothers and 66% of fathers watched the relevant video. P3 parents who watched the relevant video were more likely to know unmarried fathers’ legal standing in neonatal treatment decision making (Figure 3).
Conclusion(s): Despite increasing prevalence of unmarried parents, there is lack of awareness about legalities surrounding neonatal treatment decision-making. The P3 program may offer a platform to provide relevant education to prepare unmarried parents about this situation.
