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Perinatal Postmortems: What Is Important to Parents and How Do They Decide?

Authors

  • Andrew C. G. Breeze MB, MRCOG,

    1. Andrew C. G. Breeze is a Subspecialty Trainee in Fetal & Maternal Medicine; Gerald A. Hackett is a Consultant Obstetrician and Gynaecologist; Christoph C. Lees is a Consultant in Obstetrics and Fetal-Maternal Medicine in the Division of Fetal-Maternal Medicine; Flora A. Jessop is a Consultant Paediatric Histopathologist in the Department of Histopathology, Addenbrooke’s Hospital; and Helen Statham is a Senior Research Associate in the Centre for Family Research, University of Cambridge, Cambridge, United Kingdom.
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  • Helen Statham BSc,

    1. Andrew C. G. Breeze is a Subspecialty Trainee in Fetal & Maternal Medicine; Gerald A. Hackett is a Consultant Obstetrician and Gynaecologist; Christoph C. Lees is a Consultant in Obstetrics and Fetal-Maternal Medicine in the Division of Fetal-Maternal Medicine; Flora A. Jessop is a Consultant Paediatric Histopathologist in the Department of Histopathology, Addenbrooke’s Hospital; and Helen Statham is a Senior Research Associate in the Centre for Family Research, University of Cambridge, Cambridge, United Kingdom.
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  • Gerald A. Hackett MD, FRCOG,

    1. Andrew C. G. Breeze is a Subspecialty Trainee in Fetal & Maternal Medicine; Gerald A. Hackett is a Consultant Obstetrician and Gynaecologist; Christoph C. Lees is a Consultant in Obstetrics and Fetal-Maternal Medicine in the Division of Fetal-Maternal Medicine; Flora A. Jessop is a Consultant Paediatric Histopathologist in the Department of Histopathology, Addenbrooke’s Hospital; and Helen Statham is a Senior Research Associate in the Centre for Family Research, University of Cambridge, Cambridge, United Kingdom.
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  • Flora A. Jessop BSc, MBChB, FRCPath,

    1. Andrew C. G. Breeze is a Subspecialty Trainee in Fetal & Maternal Medicine; Gerald A. Hackett is a Consultant Obstetrician and Gynaecologist; Christoph C. Lees is a Consultant in Obstetrics and Fetal-Maternal Medicine in the Division of Fetal-Maternal Medicine; Flora A. Jessop is a Consultant Paediatric Histopathologist in the Department of Histopathology, Addenbrooke’s Hospital; and Helen Statham is a Senior Research Associate in the Centre for Family Research, University of Cambridge, Cambridge, United Kingdom.
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  • Christoph C. Lees MD, MRCOG

    1. Andrew C. G. Breeze is a Subspecialty Trainee in Fetal & Maternal Medicine; Gerald A. Hackett is a Consultant Obstetrician and Gynaecologist; Christoph C. Lees is a Consultant in Obstetrics and Fetal-Maternal Medicine in the Division of Fetal-Maternal Medicine; Flora A. Jessop is a Consultant Paediatric Histopathologist in the Department of Histopathology, Addenbrooke’s Hospital; and Helen Statham is a Senior Research Associate in the Centre for Family Research, University of Cambridge, Cambridge, United Kingdom.
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  • Andrew C. G. Breeze’s salary was funded in part by Cambridge Fetal Care, Cambridge, United Kingdom.

Address correspondence to Helen Statham, BSc, Senior Research Associate, Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RF, UK.

Abstract

Abstract:  Background:  Falling consent rates for postmortems, regardless of age of death, have been widely reported in recent years. The aim of this study was to explore parental attitudes to, and decision-making about, a perinatal postmortem after termination for fetal abnormality, late miscarriage, or stillbirth.

Methods:  A prospective self-completion questionnaire was given to 35 women and their partners. The participants had experienced second or third trimester pregnancy loss in a single fetal medicine and delivery unit in the United Kingdom and were making decisions about having a postmortem. They were asked to complete a questionnaire about their attitudes to, and expectations of, a perinatal postmortem.

Results:  Thirty-one questionnaires were received from parents of 17 babies (49% of those asked; 16 from mothers, 15 from fathers). Parents of nine babies (53%) said they would agree to a full postmortem, of three babies to a limited postmortem, and of four babies to an external examination only; one couple were undecided. The most important issues for the parents in this study that related to their decisions about a postmortem centered on the need for information, both for future planning and about what had happened. Moderately important issues related to altruism, which is, improving medical knowledge and helping other parents experiencing similar bereavement. Among the lowest scoring issues were potential barriers, such as concerns about cultural or religious acceptability of a postmortem, funeral delays, and what would happen to the baby’s body.

Conclusions:  Bereaved parents who participated in this study, where postmortem consent rates were relatively high, thought that their need for knowledge eclipsed assumed barriers when deciding whether or not to have a postmortem for their baby. (BIRTH 39:1 March 2012)

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