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Respectful Disposition in Early Pregnancy Loss

Limbo, Rana PhD, RN, PMHCNS-BC; Kobler, Kathie MS, APN, PCNS-BC; Levang, Elizabeth PhD

MCN, The American Journal of Maternal/Child Nursing: September-October 2010 - Volume 35 - Issue 5 - p 271–277
doi: 10.1097/NMC.0b013e3181e6f084

This article discusses an issue rarely seen in the professional literature: the tangible ways nurses can respect a woman's needs following miscarriage by ensuring the safe handling and disposition of fetal tissue or remains. Concepts of personhood, place, and protection are important for nurses to understand within the context of a woman's response to miscarriage. Hospitals or clinics that foster a culture of respectful fetal disposition should have a system in place to bury tissue or fetal remains in a designated area; in fact, several states have enacted laws that regulate what hospitals and clinics must do, or what women must be offered, after a miscarriage or ectopic pregnancy. Barriers may exist to creating a culture of respectful disposition, including staff attitudes, perceived time and financial constraints, lack of knowledge, and inefficient communication between departments. Nurses can begin implementing change in this regard through conducting a needs assessment using guiding questions contained in this article. In addition, through communication, education, and implementation of respectful disposition, nurses can promote safe processes that will honor women's preferences and wishes for care following a miscarriage.

Dr. Limbo has taken on a subject that is rarely discussed in the nursing literature: how to help families deal with disposition of the products of conception early in pregnancy. Her wise and learned approach will teach you much.

Rana Limbo, PhD, RN, PMHCNS-BC, is the Director of Bereavement and Advance Care Planning Services, Gundersen Lutheran Medical Foundation, Inc., La Crosse, WI. The author can be reached via e-mail at

Kathie Kobler, MS, APN, PCNS-BC, is an APN, Pediatric Palliative Care, Advocate Lutheran General Hospital, Park Ridge, IL.

Elizabeth Levang, PhD, is a Psychotherapist, WomenCare, Wayzata, MN.

The authors have disclosed that there are no financial relationships related to this article.

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