Testing/Autopsy
This is YOUR baby, not the hospital’s baby. You should be asked whether you wish to have your baby’s body, the placenta, and the cord tested to help you learn more about what might have happened, unless they are already 100% sure they know the cause.
If you are not asked, bring it up and make your wishes clear. You may find the idea of having your baby cut during an autopsy to be difficult to agree to, which is completely understandable). Keep in mind though, that an autopsy is much like surgery and the wounds can be sewn up. If you can get over this idea, you may be grateful later that you did agree to some testing. Most bereaved parents do begin to ask questions about what happened to their baby at some point during their greiving and healing process. If you did not agree to an autopsy or testing of any kind at the time of your loss, it is too late to go back and have it done...once your baby's body is gone.
It is highly recommended to do some testing. You only get one chance to do this and may wish later on that you had some information. There are many things that can be done that might shed light on what did or didn't happen:
- Ask to be interviewed thoroughly about what happened in the days prior to your baby's death. Some people call this a verbal autopsy,
- Have the placenta examined. It appears that the placenta actually gives quite a bit of history of the pregnancy and can be quite effective in learning about possible causes Some suggest that more information can be learned from a placenta than the actual baby, unless there are structural/physical problems with the baby. There are placental pathologists who want parents to authorize a placenta ‘block’ (piece of placenta) to be sent to them to examine. Both Dr. Harvey Kliman (Yale University) and Dr. Mana Parast (University of San Diego) do research on placentas and are searching for potential ‘causes’ that may be very important when it comes to identifying high risk mothers/babies and offering prevention information. A small portion of the placenta can be sent to Dr. Kliman for examination; he will give back any information he can on what he learned about possible problems. This service is free. Pass this on to your doctor/hospital pathologist who can easily send the placental block, if you request it. Check out Dr. Kliman's website to learn more,
- Have the cord measured, examined, and even examination of the ultrasound pictures to see what was going on with the cord.
- Ask for blood tests of mom and baby's cord blood,
- Genetic studies from a small skin sample (this may be expensive if not covered by insurance, so do check out the cost).
- Check for infection in mom and baby.
Keep in mind, that even if you don’t get an answer as to what caused your baby’s death, you may get answers as to what DID NOT cause it. You might learn you did not have an infection, the cord was not crimped, twisted, knotted or cutting off oxygen, the placenta did not stop working, etc.
Cost may be an issue, so ask your doctor or a social worker at the hospital to help you determine if your insurance covers it or if the hospital does, and what the actual costs might be if you are expected to pay for it. Give this serious thought which may help you in subsequent pregnancies and to ease your mind down the road. In the end, whether a miscarriage, stillbirth, or early neonatal death...you should be asked to decide what testing you wish.
When a baby dies suddenly at home, at a daycare, or somewhere besides the hospital, an autopsy may be required and you may not get a say. This can feel like an invasion of your privacy, but laws take over. While it may be hard to understand or support, you may not have a choice. Learn what you need to by asking questions and what are your rights.