Women’s experiences of the consenting process for pregnancy remains disposal following early miscarriage

Author:

Kilshaw SusieORCID

Abstract

Background and methodologyUK clinical practices around managing pregnancy remains after pregnancy loss involve a process of documenting consent. Women are typically offered options for disposal, which may include cremation, burial, releasing for private arrangements, releasing to a funeral director and, in some cases, sensitive incineration. A single researcher conducted 20 months of ethnographic fieldwork in one National Health Service (NHS) Trust including observing the consenting process for pregnancy remains disposal (n=28) and interviewing 27 women, including 19 who had experience of the consent process for pregnancy remains disposal, about their understanding, attitudes and experiences of pregnancy remains disposal. Transcripts were analysed for representative themes.ResultsPrior to the discussion and consenting process most participants had not given consideration to disposal methods. Participants expressed surprise about the discussion and disposal pathways with most suggesting it was inappropriate, particularly given the early stage of their pregnancy (<12 weeks’ gestation). In some cases, the consenting process caused distress due to the way the participant framed their pregnancy remains being divergent from implied meaning in discussions about disposal.ConclusionsCurrent practices appear discordant with the views of some women experiencing miscarriage. A person-centred approach to pregnancy remains disposal is recommended to accommodate a diverse range of approaches so as not to challenge a woman’s experience of and agency about her body, pregnancy and pregnancy remains.

Funder

Wellcome Trust

Publisher

BMJ

Reference19 articles.

1. Human Tissue Authority (HTA) . Guidance on the disposal of pregnancy remains following pregnancy loss or termination. 2015. Available: https://www.hta.gov.uk/guidanceprofessionals/guidance-sector/post-mortem/guidance-sensitive-handlingpregnancy-remains

2. Royal College of Nursing (RCN) . 2018. Managing the disposal of pregnancy remains: RCN guidance for nursing and Midwifery practice Available: https://www.rcn.org.uk/Professional-Development/publications/managing-the-disposal-of-pregnancy-remains-uk-pub-009-942

3. National Bereavement Care Pathway . Miscarriage, ectopic pregnancy and molar pregnancy: full guidance document. 2022. Available: https://nbcpathway.org.uk/pathways/miscarriage-bereavement-care-pathway

4. What British women say matters to them about donating an aborted fetus to stem cell research: A focus group study

5. Consent to the use of aborted fetuses in stem cell research and therapies

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