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The challenges of offering post mortem: an exemplar

Abstract:

Six thirty am and the phone was ringing. I was happy. It would be the lady who was five days overdue; finally we would be underway. It was, however, not to be. The call was from a woman who was only 35 weeks pregnant and who had had a stillbirth less than a year ago. She was bleeding. I was on the road within minutes after having rung my colleague to attend first as she was only three minutes’ drive from their house. My fifteen-minute drive had me covering many things in my mind but not the one I was greeted with. No fetal heart. The bleed was minimal. I had seen much more than that during labours with other women. The loss of the baby was huge. We transferred in the ambulance to the base hospital one hour away. We hoped for the best while we travelled. On arrival an ultrasound was performed which confirmed that the baby had died. We shed tears and struggled to believe that it could happen again. The woman went on to birth beautifully a very normal looking daughter. However this story is not about the birth but about the decision to proceed with a postmortem and the challenges that this presented to me as a midwife.

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Maori protocol for burial of stillborn, postmortem, stillbirth