Should Parents Bury Miscarriage Remains?

N E W   Y O R K, Oct. 26, 2000 -- Two years ago, Cecelia McGregor had a miscarriage. She was 10 weeks into her pregnancy.

But today the 29-year-old nurse and mother of two from Minooka, Ill., a suburb of Chicago, says she is still fighting to obtain what’s left of the remains of the baby she named Angelica Rose from the hospital where she had a procedure to remove the dead tissue that remained in her womb after she miscarried.

She says she has been struggling with Provena Saint Joseph Medical Center, in Joliet, Ill., to get what she calls the “products of conception,” some of which she thinks the institution still may possess, so the remains could have a proper burial.The hospital refuses to comment, citing patient confidentiality

McGregor is part of a small but growing movement of parents and healthcare professionals nationwide who are demanding hospitals give parents the option of burying or cremating remains left from a miscarriage. McGregor says she had asked nurses and laboratory technicians about what would happen to the tissue after her procedure, but could not get any information.

States Address Older Fetuses

While most states, like Illinois, only give parents choice in the disposition of the remains after 20 weeks of pregnancy, a few states, such as Massachusetts, require hospitals to tell parents they can control the burial or cremation of remains after any stage of a pregnancy loss. Funeral homes handle the arrangements. Parents in the Bay State also can ask the hospital to handle the remains, which may or may not bury or cremate the remains.

But in the majority of states, contents of the womb prior to 20 weeks of gestation would be handled like medical waste. Hospitals incinerate the material as they would tumors or gallstones.

Experts say some parents are becoming more attached to developing fetuses these days than they were decades ago. There are a number of reasons — technology such as ultrasound and in-vitro fertilization has called unprecedented attention to developing human life, as have the efforts of the anti-abortion rights movement. As a result, parents experiencing miscarriages are experiencing grief from them more acutely, and are seeking rituals to give them comfort. Approximately 500,000 miscarriages occur in the United States each year.

More Attachment To Early Life

Cathi Lammert, executive director of the National Share Office, in St. Charles, Mo., a group that began more than 20 years ago to provide services to those who suffer pregnancy loss, says more people are seeking counsel about commemorating miscarriages. “There may be even more people who feel this way but are fearful of discussing it,” Lammert says. “Those who do, take comfort in putting the remains to rest reverently.”

David Walkinson, a spokesman for the National Funeral Directors Association, of Brookfield, Wisc., says he also is working with an increasing number of parents requesting burial or cremation for miscarriage remains.

“Twenty years ago there would be quiet graveside ceremonies for older stillborns,” Walkinson says. “Now people have grown more attached to their babies earlier. Some people experience an enormous amount of sadness when they lose the pregnancy and want a cemetery service of some kind.” Many funeral homes offer their services to such families without charge, he says.

It is unknown how many hospitals across the country provide counseling and the option of burial or cremation after miscarriage. Anecdotally, experts say not enough hospitals do.

“Most hospitals don’t do the right thing,” says Sherokee Ilse, a Minneapolis, Minn.-based author who since 1982 has been counseling women who experience pregnancy loss. “A few [facilities] do. It’s not just a gallstone — it should be treated differently.”

New Abortion Rights Battleground?

But the prospect of legislation about miscarried remains sets up a potential new battleground between those who support abortion and those who do not. Some anti-abortion rights proponents believe the products of a miscarriage should be accorded the same rights as a person and be allowed a burial or a cremation. This anti-abortion rights position, however, says personhood extends to tissue from elective abortions, and would make it mandatory for women having abortions to be responsible for disposing of the remains.

“Every possible step should be taken to make sure that these miscarriage remains are treated like the remains from any other person and that parents are given the right to deal with it, not hospitals,” says Judy Brown, the president of the anti-abortion rights American Life League. Brown feels the same way about tissue from abortions.

Those who favor abortion rights also support giving parents the option of disposing of the remains of a miscarriage. They believe women who experience a miscarriage be offered a choice when dealing with remains since not all would want a burial or a cremation. But abortion rights supporters would oppose any compulsory legislation with respect to abortions: If women who had abortions were forced to deal with the disposal of the tissues, they might be less likely to have such a procedure.

Nuance is key to understanding this issue, say abortion rights advocates.“This miscarriage issue should be discussed publicly and not distorted by polemic,” says Janet Gallagher, a Brooklyn, N.Y.,-based attorney specializing in reproductive law. “Women can experience real grief from a miscarriage. We need to honor individual’s emotional needs.”

But Gallagher says some pro-abortion rights advocates are reluctant to acknowledge that women experience dramatic grief from miscarriage, because it would provide weight to abortion rights opponents about the value of early fetal life. But, says Gallagher, “abortion has a different emotional meaning than a miscarriage, and both should be treated differently.”

Dr. Michael Greene, former chairman of the OB/GYN practice committee of American College of Obstetricians and Gynecologists (ACOG), says parents should be given the choice, but in his experience as director of maternal and fetal medicine at Massachusetts General Hospital, in Boston, Mass., most parents elect to have the hospital handle the remains.

How Early Is Too Early?

Greene says dealing with remains could be a burden for most parents, adding that at some point the process is “silly” to most reasonable people. “If a women missed a period for two weeks and then menstruates because of a miscarriage, should she save the pads for burial since many miscarriages occur like this?” Green asks.

Planned Parenthood spokeswoman Adina Quijada says her organization, which provides pre- and postnatal reproductive care, says her organization abides by the rules of each state and provides counseling when it is appropriate for miscarriages as well as induced abortions.

To help other parents like herself, McGregor is now lobbying legislators in Illinois to change its law governing the disposal of tissue from pregnancy losses before 20 weeks of gestational age so it would be similar to Massachusetts law.

McGregor held a memorial service for her baby at her church soon after her loss. Last month she says, a hospital official gave her a microscope slide of cells from her lost infant, which she recently buried at a cemetery with a service.

Dispute Ongoing For McGregor

Whether McGregor had any fetal tissue left when the procedure was performed is part of the dispute between the hospital and the woman. McGregor might have lost the fetal tissue at home, leaving only membranous tissue needing to be evacuated during the hospital procedure.

Provena spokeswoman Lisa Lagger says it cannot discuss details of the case because of patient confidentiality issues, but adds the facility abided by state law and Roman Catholic canon when dealing with the remains. Catholic rules give fetal tissue status, Lagger says, but do not give the same accord to surrounding membranes, which could be discarded as medical waste.

Regardless, McGregor still thinks all of the remains should have been given to her. Before she buried the slide she said she saw a baby’s face in the pattern of the cells, and it gave her some solace. “It was some kind of miracle,” McGregor says. “Some kind of sign that a baby existed.”