8. Limited and Complete examinations

You can choose to have a complete or a limited post-mortem examination on your baby. Your placenta can be part of the post-mortem. Each option will give different amounts and kinds of information.

A complete post-mortem measures, weighs and examines all the internal organs in detail to find out why the baby died. The baby’s face, arms, legs, hands and feet are not usually affected. After the examination, your baby’s body is carefully restored, as following an operation.

If you do not want a complete post-mortem, you can choose to have a limited examination of certain organs, skin samples, or an external examination of your baby.

You can have an examination of your placenta. This can provide extremely valuable information. During this examination, samples are taken for study under a microscope. Hospitals do not have to ask for consent to examine your placenta but should inform you if they intend to do this.

The senior health professional who talks with you about consenting for post-mortem can explain fully the differences in the types of examination, and will give you written information to take away to help you think about your choices.

7. Future pregnancies

A post-mortem examination may discover if there was a problem that could affect any future pregnancies. Whether a post-mortem examination confirms an earlier diagnosis or finds new information, it can help the doctors understand your baby’s condition or cause of death and can assess the chances of the same problems happening in a future pregnancy.

6. Ending a pregnancy for medical reasons

A post-mortem examination may be helpful if you have had to end a pregnancy for medical reasons, even if there were detailed scans and tests done during pregnancy. Whether or not a post-mortem is possible will depend on the stage of pregnancy and the method used to end the pregnancy. It is best to discuss this with the hospital staff as they can advise you on your options.

5. What might a post-mortem examination tell you?

A post-mortem examination of your baby and of the placenta may help to find out why your baby has died. Although it does not always find a definite cause of death, it may still answer some question. Here are a few examples of why a post-mortem might be useful:

  • It can confirm or change a diagnosis.
  • It may find conditions that have not been diagnosed before.
  • It can exclude some common causes of death, such as medical
  • problems with your baby, infections or growth restrictions.
  • It can help assess the chances of problems happening again in a
  • future pregnancy.
  • It can help provide information about a genetic condition.
  • It may tell you the gender of your baby.

Even if your medical team already suspect the cause of your baby’s death, a post-mortem might confirm this.

The post-mortem showed that there was something wrong with my placenta and it had stopped working. This means the amniotic fluid wasn’t being produced and the baby wasn’t gaining weight. – Sophie

4. When should a post-mortem take place?

A post-mortem will usually provide the most information if it is carried out within a few days of a baby’s death. If you need to hold the funeral within 24 or 48 hours, tell the staff at the hospital as they may be able to arrange a post-mortem within this time. Sometimes, babies need to be transported to specialist centres in other hospitals where post-mortems can take place.

Once you have consented to have a post-mortem examination, you can change your mind and withdraw consent. It is best to ask the hospital how much time you have to do this.

3. What is a post-mortem?

A post-mortem is a medical examination of your baby’s body. The examination is carried out a specialist doctor called a perinatal pathologist who will try to find out the reason for your baby’s death.

Usually, a senior health professional will talk with you about having a post-mortem examination. A post-mortem examination cannot be done without your consent 1. You can choose to have a full or a limited post-mortem (see below). An examination of your placenta (the part of a woman’s womb that nurtures the baby during pregnancy) can also provide important information about the cause of death.

The choice about having a post-mortem is very personal. Only you can decide what to do.

In some limited circumstances, a post-mortem can be ordered without parental consent, by a coroner (England, Wales and Northern Ireland) or procurator fiscal (Scotland).

If you consent to a post-mortem, you will still be able to see your baby in hospital until the time of the post-mortem. You will sometimes be able to take your baby home following the birth before the post mortem, but it is important to check if this is possible with the team looking after you.

When the time comes for the post-mortem examination, hospital staff will take your baby to a mortuary. Keepsakes such as soft toys and blankets can stay with your baby, and your baby will be well looked after and treated with respect. You will be able to see your baby again, if you wish, after the examination has been completed. Some parents choose to say goodbye to their baby before the post mortem. Ask staff any questions you have and they will be able to help.

It was upsetting to think someone we didn’t know would operate on our baby, but it felt like we owed it to him to understand what had happened. – Bereaved mother

2. Post-mortem examinations

It can be very hard to think about a post-mortem examination for your baby. Staff at the hospital will talk with you about what is involved and try to answer any questions you have. If you are unsure what to do, you can discuss how you feel with them. You might also like to discuss this with your family and friends, your doctor, or a midwife or nurse. The staff on the Sands Helpline (0808 164 3332, helpline@sands.org.uk) are also available to provide you with support.

1. Finding out why a baby died

When your baby dies, it can feel very important to understand why. Sometimes the cause of death is clearly related to a medical condition in the mother or baby. For many babies the cause is not clear straight away and investigations can help to understand what happened. Sadly, in many cases, even after full investigations the cause of death may remain unclear. This is because there is still a lot that we don’t understand about why many babies die.

Parents of babies who have died may not have answers from medical staff before or immediately after their baby is born. This is because most baby deaths are unexpected and there needs to be an investigation into what was happening in the baby or the mother’s body that caused the baby to die.

Some parents are keen to know why their baby has died. Others may feel unsure or worried about this in case it exposes medical problems that could affect other pregnancies. Not all baby deaths are understood and more research is needed to understand why babies die. There are, however, two possible investigations that might provide some answers. The first is a post-mortem; the second is a review of care.

It can sometimes be clear that a baby died because of direct harm to the baby or its mother, or because of something that happened during pregnancy. Women who are victims of abuse and have become pregnant in this context are more likely to experience injuries that can cause a baby to die. If you are a victim of abuse and need support, please contact www.womensaid.org.uk.

While doctors may not find all the answers about why your baby died, you should be able to discuss what happened and ask any questions you may have once the results of any investigations are shared with you.

6. You may also want to

Visit a Sands Garden

This might be especially important if you cannot find any information about your baby’s burial or ashes. There are several of these around the UK. Phone our Helpline (0808 164 3332) to find out if there is one near you and get the garden contact details.

You could also visit the Sands Garden at The National Memorial Arboretum in Staffordshire which is open every day except Christmas Day. The Sands Garden was established in 2000 and is dedicated to the memory of all babies who have died. It is a tranquil place where families can remember their own baby in peace. The paths within the garden are lined with stones or pebbles on which families have written their baby’s name or a short message. If you would like to visit and add your own stone, use one that is no bigger than 7 cm diameter and write on or decorate it with indelible markers. Stones and indelible markers are stocked the National Trust shop at the Arboretum. You might also want to attend the Sands annual service in June at the Arboretum. Information about the service is posted on our website each year in March.  www.sands.org.uk

Come to a Lights of Love non-denominational service

These are held every year in December in several towns across the UK. During the service, parents and families can light a candle in memory of their baby and write a message to hang on a Christmas tree. The date and venues for each year’s Lights of Love services will be announced on the Sands website each autumn.

Plant a tree

You could explore the possibility of planting or dedicating a tree either in your own or a friend’s garden or local park, the Woodland Trust, or National Trust.

5. Shared burial or cremation

In many cases stillborn babies were buried in a shared grave with other babies. These graves are usually unmarked, though they do have a plot number and can be located on a cemetery plan. In other cases, babies were buried in shared graves with adults.

In many cases several babies were cremated together. This still happens when a hospital arranges funerals for very premature babies. The crematorium should have a record of where the ashes were scattered or buried.

If your search is successful, make an appointment to be shown the exact location of the grave, or the area where the ashes were scattered or buried. Most cemetery and crematoria staff will be very helpful and will give you as much information and help as they can. You may want to take a camera with you to take photographs. There are sometimes restrictions on what can be placed on a grave – especially if it is a shared grave – or a place where ashes from several babies were scattered or buried. The staff will tell you what is allowed.