How can we support the birth of very premature babies, those born before 25 weeks of gestation? Stillborn infant, born alive but who dies very quickly, viable infant or not? What clinical and ethical management would be optimal? There are no national consensus or protocol on this subject. It is clear that these cares depend on local medical teams (sensitivity, availability). Midwives, sometimes alone when facing with these situations, are then placed in a delicate position, they are not allowed to prescribe treatments for such infant. In order to answer these many questions, the Regional Pediatric Palliative Care Resource Team (ERRSPP) then set up a multiprofessional working group in 2017. Thirteen meetings were planned. During these meetings, the various aspects were discussed: medical, legal and ethical. The discussions raised many questions, particularly in the face of legal limits and ethical decisions, but allowed everyone's point of view to change and converge. The working group developed new local tools (detailed written procedures and action flowcharts) for each of the two groups of premature children that were considered: newborn infant born strictly before 24 weeks of gestation on the one hand and newborn infant born between 24 weeks and 24 weeks + 6 days on the other. These new tools reflect a desire for improvement, harmonization of practices and support for caregivers, each situation obviously remaining unique. These procedures, which are still to be perfected, have opened the way to new reflections on support. (C) 2020 Elsevier Masson SAS. All rights reserved.