Compelling experiences of families whose pregnancies are affected by a life-limiting fetal diagnosis highlight the importance of advance care planning in perinatal palliative care. This chapter presents a case that depicts multiple complexities of multidisciplinary care through various stages: prenatal planning, delivery room logistics, neonatal care, transition to home hospice, and bereavement care. It assesses local resources as part of program development to ensure advance knowledge of what may or may not be available for perinatal palliative care patients. The chapter then provides anticipatory guidance to expectant perinatal parents to facilitate the composition of a birth plan. It identifies specific decisions to consider when formulating a perinatal palliative care plan for care of mother and baby during the antenatal period, at the time of birth, and during the postnatal period. Finally the chapter describes support for staff who are providing perinatal palliative care to patients.