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Improving perinatal autopsy rates: who is counseling bereaved parents for autopsy consent?
1Department of Histopathology, Women's and Children's Hospital, North Adelaide, Australia.
Background:
Concern has been expressed recently about perinatal autopsy rates, which are often below recommended levels. Since a possible reason for the decline in adult autopsy rates is the person seeking permission for autopsy, a study was undertaken to ascertain who were seeking consent and who offered counseling for perinatal postmortem examinations.
Methods:
A postal questionnaire survey of members of a support group, Stillbirths and Neonatal Death Society in South Australia, was conducted.
Results:
The idea for an autopsy was initiated by a physician in 20 of 46 cases and by junior medical doctors, midwives, nurses, or social workers in 22 of 46. Women had further counseling and discussion with physicians in 22 cases, junior medical staff in 10, midwives or nurses in 20, social worker in 9, and support group member in 1. Only 33 of the 46 women thought that they had been counseled about the advantages of the autopsy.
Conclusions:
It is important that all health workers involved in counseling the bereaved mother know of the benefits and the mechanics of an autopsy so that consent or refusal is based on informed counseling.