Amanda J Myers1, Patricia A Lohr2, Naomi Pfeffer3. 1. Director of Nursing and Operations, British Pregnancy Advisory Service, Stratford upon Avon, UK. 2. Medical Director, British Pregnancy Advisory Service, Stratford upon Avon, UK. 3. Professor, Department of Science and Technology Studies, University College London, London, UK.
Abstract
BACKGROUND AND METHODOLOGY: UK regulations on managing fetal tissue after pregnancy loss, including abortion, are underscored by the concept of 'sensitive disposal'. This involves offering women burial or cremation and, when disposal is by the health care provider, separating fetal tissue from other clinical waste before incineration. We interviewed 23 women who had undergone one or more abortions about their understanding, attitudes and experiences of fetal tissue disposal and 'sensitive disposal'. Transcripts were analysed for representative themes. RESULTS: Prior to the abortion, most participants did not give consideration to disposal methods because their focus was on ending the pregnancy. Appropriate disposal by health professionals was assumed but some women undergoing early medical abortion reported anxiety about how to manage disposal at home. The term 'sensitive disposal' was unfamiliar to most respondents. Participants generally favoured separation of fetal tissue from other clinical waste and approved of incineration as a means of destruction. Ceremonial disposal was approved of following the loss of a wanted pregnancy but not following elective abortion. Most wanted the opportunity to access information about disposal but did not favour being asked or required to make decisions about disposal. DISCUSSION AND CONCLUSIONS: Knowledge about the management of fetal tissue after abortion or the concept of 'sensitive disposal' was limited among the women we interviewed. Current guidelines appear discordant with the views of women terminating an unwanted pregnancy. Further research is needed to better inform policy on this issue. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND AND METHODOLOGY: UK regulations on managing fetal tissue after pregnancy loss, including abortion, are underscored by the concept of 'sensitive disposal'. This involves offering women burial or cremation and, when disposal is by the health care provider, separating fetal tissue from other clinical waste before incineration. We interviewed 23 women who had undergone one or more abortions about their understanding, attitudes and experiences of fetal tissue disposal and 'sensitive disposal'. Transcripts were analysed for representative themes. RESULTS: Prior to the abortion, most participants did not give consideration to disposal methods because their focus was on ending the pregnancy. Appropriate disposal by health professionals was assumed but some women undergoing early medical abortion reported anxiety about how to manage disposal at home. The term 'sensitive disposal' was unfamiliar to most respondents. Participants generally favoured separation of fetal tissue from other clinical waste and approved of incineration as a means of destruction. Ceremonial disposal was approved of following the loss of a wanted pregnancy but not following elective abortion. Most wanted the opportunity to access information about disposal but did not favour being asked or required to make decisions about disposal. DISCUSSION AND CONCLUSIONS: Knowledge about the management of fetal tissue after abortion or the concept of 'sensitive disposal' was limited among the women we interviewed. Current guidelines appear discordant with the views of women terminating an unwanted pregnancy. Further research is needed to better inform policy on this issue. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Natalie C Spach; Elana F Jaffe; Kristen A Sullivan; Ilona T Goldfarb; Jean R Anderson; Jenell Coleman; Sappho Z Gilbert; Marielle S Gross; Lisa Rahangdale; Ruth R Faden; Anne D Lyerly Journal: Obstet Gynecol Date: 2021-11-01 Impact factor: 7.661
Authors: Katherine E MacDuffie; Insoo Hyun; Michaela M Krogen; Jennifer C Dempsey; Charles E Murry; Andrew J Copp; Ian A Glass; Dan Doherty Journal: Stem Cell Reports Date: 2021-11-24 Impact factor: 7.765