Accessibility and challenges of perinatal palliative care in Poland

Abstract

Introduction: This article examines the legal status and level of accessibility to perinatal palliative care (PPC) in Poland, with a focus on the number of services provided and the number of parents receiving PPC services. Material and methods: The desk research was based on information obtained from the National Health Fund regarding the number of units that signed a contract for the provision of guaranteed PPC services from 2018 to the first half (January–June) of 2022; the number of parents receiving the service from 2018 to 2022; and the number of services provided by a doctor, a psychologist and by primary care midwives (PCMs). In addition, the Map of Health Needs and National Transformation Plan data were used to prepare the data. Results: In Poland, since 2018, PPC services have been provided with public funds under contracts signed with the National Health Fund. Since 2022, these type of services has been provided by 17 centres. Care was provided to 1,860 pregnant women diagnosed with lethal foetal anomaly and to four fathers. There are still voivodeships in which there is a lack of provision of PPC services that are financed from the state budget. Conclusions: In Poland, there is no full accessibility to publicly funded PPC in every voivodeship. The lack of a sufficient number of PPC centres and the lack of a uniform national standard of practice for this type of care — provided in hospices, hospitals and home settings — prevents women from having continuity of professional perinatal care. There is a need to ensure the quality of the services provided and make progress towards the employment of midwives in PPC facilities by service providers to ensure that women receive obstetric care from the moment of an adverse diagnosis, professional preparation for childbirth and the postnatal period.