Tests and investigations
After a second trimester loss, most hospitals offer some tests of the baby and possibly blood tests for you and perhaps your partner. We talk below about the different kinds of tests you may be offered for your baby.
Post-mortem
Post-mortem means “after death”. It is used to describe a range of tests that can be carried out to provide information after a death. It is also called an autopsy. A post-mortem may be able to identify why your baby died and may also help your doctor to care for you in a future pregnancy.
A partial post-mortem will involve a detailed external examination of your baby and perhaps x-rays or scans, but can also include taking small samples of blood or of skin.
A full post-mortem will include an internal examination of your baby, their organs and tissue. Any tissue removed at the post-mortem will be examined in a laboratory. This can take some time and it may be several weeks before you can be given results.
In all cases the post-mortem examination will be carried out very gently and respectfully.
If your baby has to be transferred to another hospital for the examination, this too will be done with care and respect. It may be up to eight weeks before they are returned. You may be able to see your baby again afterwards. You can talk this through with the pathologist or other staff.
If you decide not to have a full post-mortem, you can still ask for the placenta to be examined and for an external examination of your baby.
After the post-mortem examination, you would normally be invited for a follow-up consultation with your consultant to discuss the results. This would usually be your named consultant obstetrician but depending on local services, it may be the pathologist or your GP who explains the results.
For some parents, understanding why the baby died can help with the grieving process. However, a post-mortem does not always provide a reason. For some parents this is sad and frustrating. Others are comforted by the thought that there was nothing obviously wrong that might affect a future pregnancy.
How can I decide?
Deciding whether or not to have a post-mortem for your baby can be very difficult.
When you are in such a cloud of deep grief you simply cannot retain information, think clearly or make decisions. Grief and the shock of it all massively affected me and made it hard to make decisions. It was helpful to have 24hrs between the loss and the start of the physical process to also think about all these decisions as a couple.
To help you decide, you should have the chance to talk about it with someone who understands the process, either in the hospital or perhaps your GP.
You don’t have to feel rushed into making a decision. You may need time as well as clear information to help you decide, and a few days’ delay won’t make a difference to the findings.
We finally agreed on an external examination and a look at the chromosomes. The results were normal, which we found reassuring even though we still had no explanation as to why we lost our baby.
Follow-up
You should be offered a follow-up appointment with your hospital consultant or a member of their team a few weeks after your loss.
This is the opportunity to get the results of any investigations, to ask any questions you have and to find out about any treatment that might help now or in another pregnancy.
You may not get answers to all your questions – and that might be because there sadly isn’t an answer. But it could be that the appointment felt rushed or the doctor did not seem well prepared, and you are worried that you haven’t received enough information.
It may help to talk to your GP, who might be able to find out more for you. GPs aren’t always sent this information from the hospital, so allow time for them to chase it up if necessary.
Whoever you see, it can be useful to take a written list of questions with you, as it’s easy to forget once you are there.
You might want to make notes of the information you are given, as there may be too much to take in and remember at the time.
On the next page, we talk about what happens to your baby after your loss, and about making memories and marking your loss.