The Disposition of Fetal Remains

This blog is not the usual essay; instead, it presents information about what to do with fetal remains in the case of a miscarriage and a request that Catholics share this information as a way to encourage respect for human life.

With permission, I am copying for you the “Guide for Hospital Miscarriage Care” created by the pro-life organization Secular Pro-Life. https://secularprolife.org/

Background of the Need

If you have had a miscarriage, you likely were never given the opportunity to have a discussion with hospital personnel about your child’s remains. The body just “disappeared,” leaving you to wonder where it went and why no one talked to you about it or asked what you wanted done.

Hospitals don’t want to tell grieving parents that the child’s remains were deposited into their medical waste and taken to an incinerator. Parents have always been left with just the assurance that “we’ll take care of it.”

Some of my pro-life friends. however, have made a point of demanding that the remains be taken to a funeral home for proper burial, including a funeral Mass and a grave in a Catholic cemetery. The lost child is worthy of such respect, just as any older child would be. Its pre-born status, every pro-life person knows, does not make it any less a human, any less your child who is mourned and whose existence deserves acknowledgement. [See: https://www.patheos.com/blogs/musingsfromthepew/2023/02/killing-our-child-was-not-an-option/]

Besides hospital silence on the subject, there has traditionally been a cultural silence about miscarriages. In recent times, however, parents have started to demand that the topic of miscarriage be brought out into the public; that the impact of grief and suffering be recognized for the trauma that it is.

As a result, Secular Pro-Life has created a Guide for Hospital Miscarriage. With input from attorneys, medical professionals, and loss parents, they have developed the following “Fetal Remains Disposition and Patient Support Policy.”

https://secularprolife.org/disposition-protocol/

Suggested Hospital Protocol: Fetal Remains Disposition & Patient Support Policy

Note to readers: Secular Pro-Life provides this protocol as a framework to help healthcare institutions offer compassionate, respectful care following pregnancy loss. All of the following are suggestions and can be adapted as appropriate to each hospital’s resources, patient population, and regulatory environment.

Policy Number: [Insert Number]

Effective Date: [Insert Date]

Department Responsible: Obstetrics & Gynecology / Labor & Delivery / Emergency Department

Review Cycle: Annually

At all times, “fetal remains” can refer to remains of the embryo or fetus at any point in pregnancy.

1. Purpose

To ensure respectful, compassionate, and legally compliant care for patients experiencing miscarriage. This policy outlines disposition options for remains, support services, memory-making opportunities, and standardized communication procedures.

1. Scope

This policy applies to all hospital personnel who provide care to patients undergoing, anticipating, or having completed a miscarriage.

III. Policy Statements

Respectful Disposition Options

The hospital must offer all patients the following options for fetal remains:

• Respectful cremation coordinated by the hospital, clearly distinct from medical waste incineration.
• Release of remains to a licensed funeral home of the patient’s choice.
• Release to another authorized institution, such as a private lab, for permitted handling (e.g., genetic testing, private cremation).

Genetic Testing

Genetic testing may be offered. A small tissue sample is collected, with the remainder of the remains handled according to the patient’s selected disposition method.

Patient Communication

All patients: a) Receiving news that a miscarriage is likely, b) Actively miscarrying, or c) Who have miscarried, must be provided a written explanation detailing their rights and options.

Any patients who inquire about miscarriage options must be given this same information.

Standardized Written Information

Written materials must include:

• Clear explanations of all disposition options
• Definitions distinguishing respectful cremation from medical waste disposal
• Contact list of funeral homes and authorized labs (see Section VI)
• Information about home recovery kits
• A list of available grief counselors and spiritual care advisors
• Memory-making options

Home Recovery Kits

Patients who miscarry at home may request a Home Recovery Kit, including:

• A collection basin
• Disposable gloves
• Small sieve
• Biohazard bag
• Written instructions for use and respectful disposition
• Grief support resources and funeral contact information

Grief and Spiritual Support

All patients experiencing miscarriage must be offered referrals to:

• Licensed grief counselors, with special training in pregnancy loss;
• Hospital-based or affiliated spiritual advisors, including chaplains or clergy from diverse religious backgrounds; and
• Patient advocates of choice, such as doulas, social workers, or similar.

Contact information for these resources must be included in the written packet and documented in the patient’s chart when offered.

Memory-Making Options

Where remains are visually identifiable, patients must be offered opportunities for memory-making, including:

• Photographs of the child;
• Footprints or handprints, if possible and appropriate; and
• Keepsake containers or memorial certificates (optional).

Staff should be trained to approach these options sensitively and without pressure.

Staff Training

Required annual training must include:

• Compassionate miscarriage communication
• Cultural sensitivity
• Disposition options
• How to sensitively offer memory-making and support services
• Proper use and explanation of home recovery kits

1. Procedure

Miscarriage Notification or Confirmation, presented by the staff at the time of miscarriage, which is a written packet and verbal summary of:

• Disposition options,
• Genetic testing,
• Grief and spiritual support referrals, and
• Memory-making opportunities.

At this time, the patient’s questions are answered and preferences documented.

Genetic Testing Procedure

• Consent is obtained.
• Tissue is sampled, and residual remains preserved pending the patient’s disposition decision.

Release to Funeral Home or Lab

• Hospital coordinates transfer according to institutional policy.
• Chain-of-custody and consent forms are completed.

Support Referrals

• Referrals to counselors or spiritual care documented in the chart.
• Follow-up contact or appointments scheduled, if patient agrees.

1. Documentation

Patient acknowledgment of options and any decisions must be recorded in the [Fetal Remains Disposition Acknowledgment Form].

Use [Miscarriage Support Services Checklist] to document offerings of grief support, memory-making, and written materials.

1. Local Contacts

• Funeral Homes & Authorized Institutions [insert table of Names, Addresses, Phone Numbers, and relevant Notes]
• Grief Counselors [insert table of Names, Addresses, Phone Numbers, and relevant Notes]
• Spiritual Care Advisors [insert table of Names, Addresses, Phone Numbers, and relevant Notes]

VII. References

• AAPLOG or ACOG Practice Bulletin: Early Pregnancy Loss
• State Regulations on Fetal Remains Disposition
• Hospital Ethics and Patient Experience Committee Recommendations

VIII. Review & Approval

Approved by:

☐ Ethics Committee

☐ Patient Experience Committee

☐ OB/GYN Department Head

☐ Legal Counsel

Implementation of the Solution and Possible Pro-Life Results

Advice from Secular Pro-Life: “Please feel encouraged to (1) contact your local hospitals, OB offices, or other relevant medical facilities, (2) ask them if they have a miscarriage disposition protocol and, if they don’t, (3) ask who you can talk to about creating one. Use the example protocol as a launching point. Please also forward this information to people and organizations you think may be interested.”

Secular Pro-Life hopes that promoting this policy will be a simple way to build a society that better respects prenatal life and cares for parents and families. As a Catholic blogger, I ask that Catholics/Catholic organizations take on the establishment of a Fetal Remains Disposal Policy at their local hospitals. I would hope that most hospitals would welcome these guidelines as a way to better serve their patients.

In the process, it might also happen that people will realize that these mourned fetuses are no different from those who died from abortion. “Wait, if there’s a baby to bury, then…” This realization brings up questions about the humanity of the child, about the abortion procedure, and about abortion clinic practices and information. Suddenly, the whole house of cards comes tumbling down to reveal the truth of the humanity of the child and the barbarism of abortion.

Think about that young, post-abortive father who is now making public appearances to tell his story. He begged for his child’s life, but his girlfriend went ahead with a second-trimester abortion. Part of his grief was knowing that his daughter was dumped into the medical waste, and he wasn’t able to give her a funeral or a burial. His demands for his daughter’s dignity have raised a lot of questions about abortion and paternal rights.

While talking to your local hospital, besides the respectful disposition of fetal remains, please also ask whether the hospital has a perinatal hospice program, which goes hand-in-hand with this disposal of fetal remains policy. In fact, you might suggest it first, and the disposal policy will naturally follow. You can read about perinatal hospice in this previous blog: https://www.patheos.com/blogs/musingsfromthepew/2021/09/blogs-musingsfromthepew-p272/

The practice of perinatal hospice and respectful disposal of fetal remains will likely set a tone at the hospital and among its staff that will help to build a culture of life. So much kindness and comfort can be generated by these programs, yet they take little effort or cost to set up. Please consider approaching your local hospital. The impact could be life-changing.