GUEST CORNER
Disposition of the Body After Stillbirth
Sue Lendborg, M.S.S.W.
Sue Lendborg, M.S.S.W., works with bereaved
parents in her position as a perinatal social worker at
Meriter-Park Hospital in Madison, Wisconsin. In this Guest
Corner she shares with us some of the
information she has learned to help parents make
decisions about the disposition of their baby’s
body.
As we all know, families experience a wide range of
emotions when they find out that their baby has died and
will be stillborn. During a very short period of time,
they are asked to make decisions about things that they
may never have thought about. Hopefully, staff at the
clinic and hospital can help guide them through this
tragic time.
All these families ultimately have to make decisions
about the disposition of the baby’s body. This is
one area where there is considerable confusion. Although
well intentioned, staff and family members often give
misinformation to parents. It is important to explore
options with families while at the same time being
sensitive to their personal, ethnic, or cultural beliefs
and traditions.
There are three options that families have regarding
the disposition of the baby’s body. The first is
burial. Parents can work with a funeral home to make
these arrangements, or they can contact the cemetery
sexton directly. It is also possible for families to do
the burial themselves. Occasionally families have wanted
to bury their baby on their own land. There are no state
laws in Wisconsin that require families to work with a
funeral home, nor are there laws that restrict burial to
a cemetery. However, there may be local (i.e. county or
city) ordinances that restrict burial to a cemetery or to
other specific areas. Families should first check with
their local government to determine any regulations.
Although it is not necessary to work with a funeral home,
it can be advantageous. Staff has knowledge of or access
to information about burial laws. Families may not have
the time, energy, or resources to research all of this
during such an emotional time. The funeral home staff can
also provide further support and grief counseling to
family members.
Second, some families prefer cremation over burial.
Not all funeral homes have a crematory but they can all
make the necessary arrangements. If a family decides on
cremation, they need to decide whether they want the
cremains or whether they want the crematory to dispose of
them. Most families choose to take the cremains. Some
families decide to scatter the cremains somewhere
special. Some keep the cremains and others choose to bury
them. Ashes can generally be placed anywhere, but again
local laws should be checked for possible restrictions.
Finally, the family may authorize the hospital to
"dispose" of the baby. I do not encourage
families to choose this option. We know from experience
that families do better if they have created some type of
personal good-bye. Again, we need to respect the
family’s decision and keep in mind their personal
beliefs. It is possible for families to have the hospital
cremate the body and still create other personal ways of
saying good-bye.
In addition to disposition to the body, there are many
options parents have when planning a memorial service.
For some this is a complete funeral service at their
place of worship or at a funeral home. Others choose to
have a small private graveside service or a gathering at
another site that has special meaning to them. A formal
service is not necessary when having a burial or
cremation. It is important that families are assisted
with exploring the options and making a decision that is
best for them.
Many families have initially rejected the idea of
burial or cremation because they fear the cost. Keep in
mind, however, that families have made arrangements for
as little as $25.00. I have found funeral directors to be
very understanding and supportive of families when
finances are a problem. Encourage parents to talk with
the funeral director if finances may prevent planning a
special good-bye. The funeral home staff can help explore
other resources that may help financially. Resources to
consider are life insurance through an employer,
Veteran’s benefit for burial, and the Public
Assistance Program in the family’s county if they
are already receiving benefits. Some families have chosen
to make their own casket and to bury their baby on their
own property (local ordinance may prevent this). Some of
these options not only save money but can also add a very
personal touch to a burial.
Many people are under the opinion that it is illegal
to transport a body. Wisconsin law does permit a family
to transport the body of the deceased but there are some
restrictions. The family must perform all the legal
functions and they cannot embalm. The family may not
transport if they are going to hire a funeral director to
conduct duties involved with the disposal of the body. If
transport is out of state, the laws of the other state
must be followed also.
Legal functions for a stillbirth are much different
than for other deaths. If the baby was 20 weeks gestation
or greater, or if the baby was 350 grams or larger, then
a Fetal Death Report must be completed and filed with the
state registrar. This form usually is completed by the
hospital or physician. No other forms are required, but
generally the hospital requests that a "notice of
removal" be completed by the person removing the
body. This is for their records only. There is also a
form called "report for final disposition"
which can be obtained from the local registrar of deeds
or from a funeral director. This should accompany a body
if there is transport to another state. When a baby is
stillborn this form is not legally filed. This document
is used as proof of circumstances regarding the birth and
death should anyone require this. Cremation permits are
not required for stillbirths, but the crematory may
require proof that the baby was not live born. The family
could use the "report for final disposition" or
could have a statement from their physician to present to
the crematory or the cemetery sexton as proof that the
baby was not live born.
Generally families and staff discuss burial and
cremation options when there is a vaginal or C-section
delivery. Many families have expressed concerns about
disposition of a fetus following a D&E (Dilation and
Evacuation). It is possible to have cremation performed
following a D&E in the second trimester of pregnancy.
Burial is also an option. The physician, hospital, or
clinic staff and funeral director should be informed in
advance so that necessary arrangements can be made.
Again, families that have chosen one of these options
have expressed great relief that something personal was
done for their baby.
Each family is different and will choose options that
are best for them at that particular period of time.
Staff can guide and educate but must remain sensitive to
their individual needs. Do not hesitate to contact the
following organizations regarding laws or procedure that
pertain to burial and cremation:
- Vital Statistics Department, State of Wisconsin;
Peggy Peterson, Field Representative, (608)
267-78112
- Coroner or Medical Examiner — County Office
- Registrar of Deeds — County Office
- Local Funeral Home Director
Editor’s Note: We have available several
resources that may be informative to those who help
parents with decisions about disposition. These include
copies of the Wisconsin State Statute, and a book, Caring
for Your Own Dead, by Lisa Carlson, Upper Access
Publishers, Hinesburg, VT. The latter includes
compilation of regulations and laws governing disposition
on a state by state basis. R.M.P.
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