Leaflet Details
| Title | Consent for Laboratory Examination and Cremation or Sensitive Disposal of Early Pregnancy Loss up to 11+6 Weeks |
| Department | Early Pregnancy Unit / Obstetrics and Gynaecology |
| Author(s) | Zara Chamberlin, Sandra Simpson, Dr Louise Sanderson, Miss Ngozi Izuwah-Njoku |
| Review Date | October 2025 |
| Next Review | October 2028 |
| Download | A5 Booklet PDF |
| Accessibility Options | Click on the Recite Me button to show our accessibility resources |
Patient Information
Introduction
We are sorry that your pregnancy is no longer progressing following confirmation of a miscarriage or an ectopic pregnancy. We understand this is a difficult time for you and we will do our best to support you and your partner as you process and come to terms with your loss. Your decisions are important to us. This information is provided to assist you in choosing whether your pregnancy tissue is examined and deciding how the pregnancy loss will be disposed.
We are mindful that some of the language used in this leaflet may be difficult, but we are obliged to make clear your options using this terminology.
If you are unsure or need further information at any time, please speak to your doctor, midwife or nurse.
The law requires your permission to undertake examination and disposal of pregnancy tissue. The hospital has procedures in place which are governed by the Human Tissue Authority (2015).
What examination will be made of the pregnancy loss?
Information can be obtained from looking at tissue samples visually, however, sometimes the only way to get further information is to look at the tissue under a microscope also known as a histopathological examination.
Why do we examine pregnancy tissue / remains?
This is done to confirm that the tissue / pregnancy remains is that of a normal pregnancy, and to ensure there is no evidence of a molar pregnancy.
A molar pregnancy is a rare condition where the baby (fetus) and/or placenta doesn’t develop normally. A molar pregnancy unfortunately will not develop into a healthy pregnancy. It affects approximately 1 in 600 pregnancies and needs follow-up or treatment to ensure it resolves and does not develop into a more serious condition.
How will this examination help me?
Although this examination often provides no specific explanation for what happened to you on this occasion, it may provide information which could affect your future treatment e.g., if a molar pregnancy is identified, you will be referred to Charing Cross Hospital for follow up.
If you have suffered 3 or more miscarriages, in addition to histopathological examination, we will offer to send your pregnancy tissue / remains for a specialist test that can rule out chromosomal (chromosomes are the genes we inherit from our parents) causes that may have contributed to your recurrent pregnancy loss. We will offer a referral to our recurrent pregnancy loss clinic, or your GP could also refer you to this clinic.
Does the tissue have to be examined?
No. It is your decision whether to allow this examination. Your doctor, nurse or midwife will be able to advise you how important this examination is in your case.
How is this examination performed?
To look at the tissue under the microscope small pieces of pregnancy tissue / remains are placed into small plastic blocks. These blocks are normally about 20mm (less than one inch) square and about 5mm thick. This is approximately the size of a fifty pence piece. This is then cut into thin slices with a sharp knife. The slices are very thin - ten times thinner than a hair. These sections are placed on a glass slide and stained with special dyes to enable the cells to be looked at under a microscope by a special doctor (a pathologist) who provides the result in a written report.
What happens to the slides and blocks after they have been examined?
Slides and blocks make up a part of your medical records for 30 years.
Why would blocks and slides be kept?
Blocks and slides make up a part of your medical record which may be reviewed in the future if necessary. Blocks and slides can be used anonymously to improve understanding of the disease process (research) or monitor the examination process itself (audit).
What are my options for disposal of the pregnancy tissue?
There is no legal requirement to have a burial or cremation if your pregnancy ends before 24 weeks.
We offer you the following choices:
- The hospital has an agreement with the local crematorium who will cremate pregnancy losses. The pregnancy loss is sensitively handled by all staff throughout the process, and each loss is kept separately. They are taken together for cremation, and this is done anonymously with up to twenty pregnancy losses / remains at a time. No service takes place at the crematorium. The ashes are scattered collectively in the Lewis Carroll Garden at Woking Crematorium.
- You can make your own arrangements for burial or cremation. If you choose to have the pregnancy tissue examined under the microscope, the tissue can still be returned to you for burial or cremation. The Early Pregnancy unit (EPU) will contact you when you can collect your pregnancy tissue/remains after examination.
- Pregnancy loss / remains can be incinerated in the same way that the hospital disposes of clinical waste.
You may wish to consider taking your pregnancy remains home to bury yourself. Current national guidelines state that legally you can take the pregnancy remains home with you for burial outside of a cemetery, providing certain requirements are met including:
- 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 fetal tissue must be buried at a depth of at least 18 inches(45cm)
- Permission must be obtained from the landowner if the parents do not own the land
Please contact your local environmental health department to confirm requirements.
What if I can’t decide what to do with my pregnancy tissue / remains?
You can take additional time to decide on what you would like to do with your pregnancy remains / tissue. Please contact EPU once you have decided.
Please be aware that National guideline is that pregnancy tissue should be disposed of after 12 weeks if you are undecided on how to manage the pregnancy remains. After this time, the pregnancy remains will be sensitively disposed of using approved hospital incineration. Please contact our unit should you wish to discuss this further.
What if I don’t want to be involved in discussion on how to manage the pregnancy remains?
We will respect your decision not to be involved in discussions around the management of the pregnancy remains / loss. We will sensitively dispose of the pregnancy remains after 12 weeks by incineration and disposal as clinical waste.
Making Memories
You may want to make some memories following your pregnancy loss. Some people may prefer not to make any memories. This is highly dependent on the individual/s and there is no right or wrong way to mourn for the loss of your pregnancy. Some people may want to plant a flower or tree in the garden, make a special jewellery, visit a memorial garden or make you own special arrangement. Whatever you decide is okay.
In our Unit, we have memory boxes we can offer for early pregnancy loss. Please let us know if you are interested in this.
Baby Loss Awareness Week
We hold an annual memory day service each year in October during Baby Loss Awareness Week. This is led by our Chaplain and supported by senior bereavement midwives. Please let us know if you would like us to sign post you to our bereavement midwifery counsellors who can give you further information.
A certificate for your baby?
There is no requirement for registration of a pregnancy loss before 24 weeks in UK. People in England and Scottland may receive a certificate of loss. In England you can get further information on how to request a baby loss certificate on the government website https://www.gov.uk/request-baby-loss-certificate. You can also request a pregnancy loss certificate through the miscarriage association.
Who can I contact if I have any other questions or concerns?
The Early Pregnancy Unit (EPU): 01932 722662
Please note that the EPU is open Monday to Friday 09.00 to 17.00 excluding bank holidays.
Further Support
The Miscarriage Association: 01924 200799
Pregnancy Loss Information & Support
https://www.miscarriageassociation.org.uk/
The Association of Early Pregnancy Units
https://aepu.org.uk/
AtaLoss: Helping bereaved people find support and wellbeing:
https://www.ataloss.org/
References
Human Tissue Authority Code of Practice 5. The removal, storage and disposal of human organs and tissue. 2015
Royal College of Nursing. Sensitive disposal of foetal remains, Guidance for nurses and midwives. December 2024.
Institute of Cemetery and Cremation Management. Policy document for the disposal of foetal remains. January 2004 revised 2015.
SANDS. Pregnancy Loss and the death of a baby: Guidelines for Professionals 4th ed. 2016
