Late stillbirth post mortem examination in New Zealand: Maternal decision-making

Robin S. Cronin, Minglan Li, Michelle Wise, Billie Bradford, Vicki Culling, Jane Zuccollo, John M.D. Thompson, Edwin A. Mitchell, Lesley M.E. McCowan

Research output: Contribution to journalArticleResearchpeer-review

12 Citations (Scopus)

Abstract

Background: For parents who experience stillbirth, knowing the cause of their baby's death is important. A post mortem examination is the gold standard investigation, but little is known about what may influence parents’ decisions to accept or decline. Aim: We aimed to identify factors influencing maternal decision-making about post mortem examination after late stillbirth. Methods: In the New Zealand Multicentre Stillbirth Study, 169 women with singleton pregnancies, no known abnormality at recruitment, and late stillbirth (≥28weeks gestation), from seven health regions were interviewed within six weeks of birth. The purpose of this paper was to explore factors related to post mortem examination decision-making and the reasons for declining. We asked women if they would make the same decision again. Results: Maternal decision to decline a post mortem (70/169, 41.4%) was more common among women of Māori (adjusted odds ratio (aOR) 4.99 95% confidence interval (CI) 1.70–14.64) and Pacific (aOR 3.94 95% CI 1.47–10.54) ethnicity compared to European, and parity two or more (aOR 2.95 95% CI 1.14–7.62) compared to primiparous. The main reason for declining was that women ‘did not want baby to be cut’. Ten percent (7/70) who declined said they would not make this decision again. No woman who consented regretted her decision. Conclusion: Ethnic differences observed in women's post mortem decision-making should be further explored in future studies. Providing information of the effect of post mortem on the baby's body and the possible emotional benefits of a post mortem may assist women faced with this decision in the future.

Original languageEnglish
Pages (from-to)667-673
Number of pages7
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume58
Issue number6
DOIs
Publication statusPublished - Dec 2018
Externally publishedYes

Keywords

  • autopsy
  • decision-making
  • fetal death
  • post mortem
  • stillbirth

Cite this