Anything but dignified: The problem with forced fetal remains arrangements

Ohio is attempting to introduce legislation that would require abortion clinics to incinerate or bury products of conception from abortion. This legislation is already in place in Arkansas and Indiana. These laws are supposed to afford human tissue a “respectful and proper” end as lawmakers were apparently horrified that products of conception were disposed of as medical waste.

Medical waste is not an offensive term. When we call an amputated leg medical waste we don’t mean that that leg was somehow unimportant to the person or that it was disrespected by the surgeon or pathologist, it is  simply a descriptor that a biohazard threat exists, and appropriate safe disposal is required. Different tissue and body fluids pose different biohazard risks and hospitals, and clinics have to make sure that risk is dealt with appropriately.

As investigation after investigation into Planned Parenthood has turned up nothing illegal, some lawmakers needing to deliver something punitive regarding abortion and making sure the term “body parts” was included have decided to focus on the “dignity” of tissue and that “dignity” can only be preserved with burial or cremation.

Let me tell you about my experience with the “dignity” of forced fetal remains arrangements.

In 2003, I was pregnant with triplets, ruptured my membranes at 22 1/2 weeks, and 36 hours later my first son Aidan was born and died minutes later.

A day or two after delivery, while I still felt like I was on Mars courtesy of an intravenous medication called magnesium sulfate to try and stop my contractions, a woman came to visit asking what I wanted to do with Aidan’s body?

Right. His body. I had a son. He died.

I couldn’t focus on anything because of medication side effects and my emotional state, but apparently I had to focus on this. Now. Rules and paperwork and such. Who knew the practicalities of death had a timeline?

“Could I just keep him in the morgue … until I know what will happen to his brothers?” I asked. The only thing I knew what that I had to to keep the boys as together as possible until they all delivered.

What do you say when you have to barter to keep your one pound dead child’s body in the hospital? Thanks ever so much?

How people absolutely devoid of empathy and sympathy and kindness get the jobs that most require them is unknown to me, but if ever there was an example this was it.

About a week later at 24 weeks and still in a precarious situation medically and sleep deprived from medication given every four hours to stop my increasing contractions Dead Body Lady called me up. I had to decide what to do with Aidan’s body. Today. If I didn’t, he would be shipped off to some county grave that sounded right out of Tess of the d’Urbervilles.

Apparently Dead Body Lady had paperwork that needed to be finished in so many days by law, so my son needed to be cleared out. In my own hospital, I could not even be afforded the kindness to keep a one pound body in the morgue’s freezer for what would be (if I were lucky) a few more weeks.

I sobbed as if the earth had opened up and swallowed everything good. Then I started contracting. I could barely get the story out to my secretary between heaves of my chest. She fixed everything, and I am sure Dead Body Lady got in a lot of trouble, but likely she had seniority so nothing really happened and I am sure she is still treating devastated women who are haunted forever by the pain she inflicts and the click of her cloven hooves on the tiled floor.

I delivered at 26 weeks due to an infection. Four days later while I was very ill with sepsis (an infection in my blood stream) some other administrator with an equal amount of empathy dropped off a packet with the names of funeral homes with convenient stars beside the ones that offered free cremation for stillborns and newborn deaths. So alone in my hospital room between drenching sweats and Richter scale shaking chills I did research on funeral homes and the merits and pricing of burial versus cremation.

I was asked if I had a plot, as if choosing a graveyard and picking the right spot for burial go hand in hand with painting the nursery and assembling the crib.

“Oh honey, do you like the arctic white or the lily white for the nursery walls? And the backup headstone, should that be white marble to stick with the theme? And should we get a plot or just hope for the best and use grandma’s in a pinch?”

What circle of hell was this?

Cremation seemed like the safest bet. Yes, I cremated my son because I had a short externally imposed timeline and it seemed like the most cost conscious option that provided the greatest flexibility lest I have one or two more dead babies in the next couple of weeks. Not quite my definition of dignity.

The funeral home called me about two weeks later to let me know it was done. I got the call on my cell in the intensive care nursery standing next to Oliver and Victor, who were doing very poorly. I’d been discharged from the hospital three days earlier.

My then-husband drove the two of us to the funeral home. It was decorated in early Addams family. That actually made me laugh, which helped a lot considering what came next. We sat in a waiting room resplendent in dark velvet waiting for what seemed like a long time. I cracked a joke about them losing his body. It was then that I noticed the open book on the table with all the “options” for his ashes. Mostly fancy (and expensive) urns (engraving extra, of course) and lockets to keep a bit of him with me always. You could choose several in case you wanted to divide the ashes up among loved ones. What a nice bait and switch to call your cremation free then hit grieving parents up when they are at their most vulnerable.

“No thanks, we’ll take the cheapest urn you have. If you don’t have a cheap or free one, I’ll take a box.” I said barely containing my anger.

Maybe some hospitals do it better, and maybe some funeral homes really do offer free cremation to grieving mothers, but I doubt my experience is unique and just imagine what it will be like when there are thousands of miscarriages to process in addition to previable deliveries and stillbirths. Abortion clinics will pass on the cost to their patients (clearly the intent), but what about hospitals? Now women recovering from a miscarriage or previable delivery will have some administrative lackey hunt them down to sign a form for the remains, and they will be on a timeline. Hospital paper pushers with an administrative deadline don’t always care about your grief or how sick you are.

Some women may have already elected to have a burial or cremation, but others don’t want to do that. Many will be stunned, as I was, and not able to process it all. Might some hospitals pressure women to make their own arrangements to avoid a hospital cremation fee? After all cremation is more expensive than processing medical waste. Some women who don’t feel an emotional connection may feel guilted into doing something. Some may make decisions they later regret because they were too sick to think straight or felt pressured.

I have no memory of Aidan alive all I have is the absolute horror show of dealing with his remains, which plays over and over again in my head at inconvenient times. I do not wish that on anyone. If I could do it all again, I would have nothing to do with the disposal of his body and let the hospital decide and tell me nothing about it, that’s how bad it was.

If your pregnancy was wanted then you should get to deal with the physical remains of your tragedy in your own way, but requiring cremation or burial, paperwork, and a timeline under the guise of “dignity” is a joke.

My son’s ashes are sitting in an urn that looks like it was from the scratch and dent bin at Bed, Bath & Beyond and it’s tucked in the back of my closet. I simply don’t have it in me to do anything else. I’d like the people who passed these laws and those considering them to explain to me exactly how the administrative process that got me to this point displayed “dignity” for human remains and how a discount urn on a shelf is a more “respectful and proper” resting place than any other.

Jennifer Gunter is an obstetrician-gynecologist and author of the Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.

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