There Are Unused Ways to Get Answers After Stillbirths

Each year, some 20,000 pregnancies in the US end in stillbirth. In a lengthy piece for ProPublica, Duaa Eldeib explains that we have tools that can offer grieving would-be parents answers in many of those cases—but those tools are underutilized. Eldeib cites stats that show placental exams can help determine a cause of death or rule out a suspected one in about two-thirds of stillbirths; autopsies can do the same in 40% of cases. And yet placental exams aren't automatically performed. CDC figures from 2020 show the "placenta was thrown out without ever being tested" in about a third of stillbirths. Autopsies occurred that year in just one out of five stillbirths. Eldeib catalogs some reasons why the number of autopsies is so low. Cost is one (Medicaid doesn't cover them, for instance).

Communication and timing are another. The autopsy decision needs to be made fairly quickly, and "many families can’t process the loss, let alone imagine their baby's body being cut open," writes Eldeib. But some doctors don't fully understand the benefits, so they aren't able to communicate to their patients that it could be a way for them to understand what happened and potentially prevent a similar outcome in the future. Preventative knowledge is what Dr. Karen Gibbins gained after her son was stillborn in 2018. Genetic testing and the placental exam returned no answers. But the maternal-fetal medicine specialist knew to ask for an autopsy, and it showed her antibodies had been attacking his liver cells. When she became pregnant again, her doctor had her receive antibody infusions weekly, and she gave birth to a son. (Read the full story for much more.)