Sensitive Disposal Arrangements and Histopathology Examination of Pregnancy Remains

This leaflet explains what your options are for what happens to your pregnancy remains.

Histopathology

After any surgical procedure to remove pregnancy remains after a miscarriage or ectopic pregnancy, or surgical removal of post-pregnancy retained tissue, we may recommend histological examination of these remains. This means that the remains are examined in the laboratory under a microscope. After histopathology examination, tissue block and slides will be retained in line with Royal College of Pathology guidelines.

Why is histopathology recommended?

This is done to confirm the presence of pregnancy remains and to ensure there are no changes of molar pregnancy. This is particularly important if no foetus is seen on a scan. We will contact you if the histopathology examination shows molar pregnancy. Molar pregnancy is a rare condition where there is an abnormal growth of the cells which should become the placenta. It affects around 1 in 600 pregnancies and needs follow up and sometimes treatment to ensure that it resolves and does not develop into a more serious condition.

Sensitive Disposal

After the histopathology examination is complete, the pregnancy remains will be sensitively disposed of. The Trust can organise disposal by communal cremation or alternatively you can make private arrangements.

What are the options?

The hospital can arrange for your pregnancy remains to be cremated.

If you would like to know the details of the cremation service please contact the Mortuary (Chelsea and Westminster 020 3315 8225 / West Middlesex 020 8321 5876). Please note that this is a combined cremation with other pregnancy remains. The cremations usually take place once a month. Unfortunately, it is not possible to change the time or date of the service. It usually takes a few weeks (but can be up to several months) for the mortuary at Chelsea and Westminster to receive pregnancy remains back from histopathology or cytogenetic testing, so there can be some delay before the cremation occurs.

You may wish to make your own arrangements for a private burial or cremation.

The crematorium or burial grounds will need a certificate confirming that the pregnancy ended before 24 weeks, which we can provide for you at the time of your procedure. If you are undecided and then decide later on to make your own private arrangements please contact Elizabeth Suite at Chelsea and Westminster or Early Pregnancy Unit at West Middlesex University Hospital for the certificate.

You may wish to consider taking your pregnancy remains home to bury yourself, outside of a cemetery.

There are no legal requirements for the burial of pregnancy remains if the loss occurs before 24 weeks. However, there are still some important factors that should be considered in accordance with national guidance:

It must not cause any danger to others
It must not interfere with any rights other people may have on the land
There must be no danger to water supplies or watercourses
There must be no chance of bodily fluids leaking into or onto adjoining land
The foetal tissue should be buried at a depth of at least 24 inches (60cm)
Permission must be obtained from the landowner if the parents do not own the land

Careful thought must be given when considering burial in a garden, taking into account what would happen if the parents moved house or the land is used for new purpose in the future. We suggest you use a plant container that you can move to another house if necessary. If this is your choice the Institute of Cemetery and Crematorium Management (ICCM) can provide you with additional information on this choice.

If you wish to make your own arrangements, pregnancy remains will need to be collected from the Mortuary. Please make sure we have your up-to-date contact details. If the Mortuary is unable to contact you within one month of the date that you signed the SD1 form, a hospital-arranged cremation will take place.

Pregnancy Loss in the Second Trimester

If you experience a pregnancy loss during the second trimester, your healthcare team may offer further medical investigations to help understand why it happened. A clinician will discuss this with you, if it is appropriate in your situation.

When considering funeral arrangements, the options are similar. Some prefer to make their own plans, while others choose to have the hospital proceed with cremation. If you choose for the hospital to arrange this, you can be informed of the date of the service, and there may be ashes available to collect if you wish. However, you can also choose not to receive any details—this is your decision, and your choices will be respected.

What if I cannot make a decision concerning the disposal of my pregnancy remains?

If you are undecided then we will keep your pregnancy remains in the Mortuary. Please contact the Mortuary (Chelsea and Westminster 020 3315 8225; West Middlesex 020 8321 5876) when you have made a decision. If we have not heard from you within one month of you signing the relevant form then the pregnancy remains will be cremated.

Patient Advice and Liaison Service (PALS)

If you require information, support or advice about our services, you can contact the PALS office on the Ground Floor of the hospital just behind the main reception. Alternatively you can feedback your comments/suggestions on one of our comment cards, available at the PALS office, or on a feedback form on our website www.chelwest.nhs.uk/pals. We value your opinion and invite you to provide us with feedback.

Care at Chelsea and Westminster

T: 020 3315 6727

E: chelwest.cwpals@nhs.net

Care at West Middlesex University Hospital

T: 0208 321 6261

E: chelwest.wmpals@nhs.net

Support

If you feel you require any further support or have any queries please do not hesitate to contact the Elizabeth Suite/ Early pregnancy team. A chaplain is also available for pastoral support.

Useful Contacts

Care at Chelsea and Westminster Hospital

Care at West Middlesex University Hospital

Early Pregnancy Clinical Nurse Specialist

T: 020 3315 5070

Early Pregnancy Clinical Nurse Specialist

T: 0208 321 6070 /6506

Mortuary

T: 020 3315 8225

E: chelwest.cwmortuary@nhs.net

Mortuary

T: 020 8321 5876