1. In the section on "The Ethics of Decision-making in the Delivery Room" authors have made a generic discussion around the principles of ethics rather than some practical ethical dilemmas faced by a clinician in a delivery room.

2. At the outset, it may have been good to define a ‘live birth’, What are ‘signs of life’, what constitutes providing either ‘full life support’ or ‘comfort care’ etc. While the Neonatal Resuscitation Program (NRP) guidelines mention first examination of ‘Heart Rate’ after the end of initial steps, do we really examine heart first when dealing with difficult situations of periviability to assess signs of life?

3. Authors have majorly (and infact theoretically rightly so) used gestational age (GA) cut-offs as the main guiding criteria that dictate decisions and actions in tricky situations around periviability. But surely such utopian situations are not invariable. GA is often not known. Hence, a broad framework based on weight cut-offs (which is reliably obtained in all cases at birth) may be more useful and desirable for guiding decisions initiating resuscitation or continuing life support. Another not so uncommon situation is an unbooked pregnant woman who comes and delivers a periviable extreme preterm who needs immediate resuscitation before an informed consent can be obtained.

4. Translating available literature [2] to operational guidelines in our Indian context, we propose the following algorithm:

5. In Table I in 3rd row, 2nd column; i.e. "provide treatment unless provider declines to do so" is probably not justified as ethical principles do not allow the provider to decline treatment particularly when parents prefer to accept treatment.